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Publication
Cardiomiopatia hipertrófica felina
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Abstract(s)
A Cardiomiopatia Hipertrófica (CMH) é uma doença é a doença cardíaca primária mais comum em gatos causada por uma mutação genética autossómica de dominância incompleta com apresentações clínicas variadas que apresenta uma grande dispersão mundial e racial.
O carácter hereditário desta doença cardíaca resulta de uma mutação genética autossómica dominante com penetração incompleta, sendo mais exuberante em situações de homozigotia. A mutação mais comum ocorre em genes que codificam para a Proteína C3 de Ligação à Miosina, com alterações estruturais do mesmo e consequente hipertrofia concêntrica parcial ou total do ventrículo esquerdo. Com o aumento do septo interventricular, dos músculos papilares e/ou da parede do ventrículo esquerdo, ocorre comprometimento tanto do enchimento ventricular como do seu relaxamento, o que por sua vez contribui para a progressão da hipertrofia. A diminuição da câmara cardíaca, a diminuição do débito cardíaco, o aumento compensatório do ritmo, o aumento da pressão de enchimento diastólico e o aumento do átrio esquerdo predispõem para uma insuficiência cardíaca congestiva, formação trombos e até morte súbita.
A avaliação clínica de um gato com suspeita de Cardiomiopatia Hipertrófica deve ser exaustiva, mesmo que o diagnóstico definitivo apenas possa ser confirmado através de ecocardiografia e de métodos de biologia molecular no sentido de identificar a mutação genética. A ecocardiografia pode ainda ser útil para direcionar a terapêutica em função do grau de hipertrofia estabelecer prognóstico. Atualmente, em medicina humana, existem outras formas de terapêutica, como o novo MYK 461, que se revelam bastante promissores.
The Hypertrophic Cardiomyopathy is the heart disease more common in cats caused by a genetic autossomic mutation with imcomplete penetrance, having several clinic findings worldwide and inbreed. This disease assumes an hereditary character associated with a genetic mutation autossomic dominant with incomplete penetrance, being more exuberant in homozigotic. It’s a common mutation in genes that codify for the Myosin Binding Protein C (MYBPC3), with structural alteration of itself and leading to the partial or total concentric hypertrophy os left ventricule. With the increase of the interventricular septum and/or papillary muscles and/or left ventricle hall there is a compromise of the ventricular filling and it’s relaxation, which in other hand contributes to the progression of the hypertrophy. The decrease of the cardiac chamber, the decrease of cardiac output, the compensatory increase of rhythm, the increase of pressure in diastolic filling and the increase of the left atrium predispose to congestive heart failure and even sudden death. Cats clinical evaluation under the suspect of Hypertrophic Cardiomyopathy should be exhaustive, even if the definite diagnostic can only be confirmed throght Ultrasound and bio molecular methods looking for identification of genetic mutations. Ultrasound can also be useful to direct the therapeutics accordingly to the level of Hypertrophy, and better prognostics. Nowadays, there are other new therapeutic drugs, like MYK 461, that are showing promissing results.
The Hypertrophic Cardiomyopathy is the heart disease more common in cats caused by a genetic autossomic mutation with imcomplete penetrance, having several clinic findings worldwide and inbreed. This disease assumes an hereditary character associated with a genetic mutation autossomic dominant with incomplete penetrance, being more exuberant in homozigotic. It’s a common mutation in genes that codify for the Myosin Binding Protein C (MYBPC3), with structural alteration of itself and leading to the partial or total concentric hypertrophy os left ventricule. With the increase of the interventricular septum and/or papillary muscles and/or left ventricle hall there is a compromise of the ventricular filling and it’s relaxation, which in other hand contributes to the progression of the hypertrophy. The decrease of the cardiac chamber, the decrease of cardiac output, the compensatory increase of rhythm, the increase of pressure in diastolic filling and the increase of the left atrium predispose to congestive heart failure and even sudden death. Cats clinical evaluation under the suspect of Hypertrophic Cardiomyopathy should be exhaustive, even if the definite diagnostic can only be confirmed throght Ultrasound and bio molecular methods looking for identification of genetic mutations. Ultrasound can also be useful to direct the therapeutics accordingly to the level of Hypertrophy, and better prognostics. Nowadays, there are other new therapeutic drugs, like MYK 461, that are showing promissing results.
Description
Keywords
Cardiomiopatia hipertrófica felina Insuficiência cardíaca congestiva Hipertrofia ventricular esquerda MYK 461 R820W A31P Maincoon Ragdoll Feline hypertrophic cardiomyopathy Congestive heart failure Left ventricular hypertrophy