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Evaluation of Plasma D-Dimer Concentration in Dogs with Chronic Mitral Valve Insufficiency

만성 이첨판 폐쇄부전증에 걸린 개에서 혈장 D-dimer 농도 측정 연구

  • Park, Joungsoon (Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University) ;
  • Suh, Sang-Il (Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University) ;
  • Oh, Yeonsu (Department of Veterinary Pathology, College of Veterinary Medicine, Kangwon National University) ;
  • Hyun, Changbaig (Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University)
  • 박정순 (강원대학교 수의과대학 소동물 내과교실) ;
  • 서상일 (강원대학교 수의과대학 소동물 내과교실) ;
  • 오연수 (강원대학교 수의학과 병리학교실) ;
  • 현창백 (강원대학교 수의과대학 소동물 내과교실)
  • Accepted : 2015.01.30
  • Published : 2015.02.28

Abstract

D-dimer is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. D-dimer concentration is widely used for determining thrombosis and thromboembolism. Because one major cause of thromboembolism is congestive heart failure in human, we investigated the degree and risk of thromboembolism in dogs with different stage of congestive heart failure caused by chronic mitral valvular insufficiency (CMVI). The plasma level of d-dimer was evaluated in 20 healthy dogs and 30 dogs with different stage of congestive heart failure caused by CMVI. The d-dimer concentrations were measured by a commercialized assay kit. The plasma levels of d-dimer were not significantly different between healthy and CMVI dogs. Furthermore, there was no association of d-dimer concentrations to left atrium to aorta (LA/Ao) ratio, left ventricular dimension at diastole to aorta (LVIDd/Ao) ratio and severity of heart failure in our study population. Our study results implied that the degree of thromboembolism in canine heart failure might be minimal or the plasma d-dimer test might not be reliable for detecting thromboembolism in dogs.

D-dimer란 섬유소분해산물로 응고혈액이 섬유소용해 후에 혈액 내에 보이는 작은 단백질 파편이다. D-dimer의 농도는 혈전증과 혈전색전증을 결정하기 위해서 널리 사용되고 있다. 인의에서 혈전색전증의 주요 원인 중 하나는 울혈성 심부전이기 때문에, 금번 연구에서 만성 이첨판 폐쇄부전증에 의한 울혈성 심부전의 다양한 심각도를 가진 개들에서 혈전색전증의 정도와 위험성을 조사하였다. 혈장 d-dimer의 농도는 건강한 개 20마리와 만성 이첨판 폐쇄부전증에 의해 울혈성 심부전에 이환된 다양한 중등도의 30마리 개에서 평가되었다. D-dimer의 농도는 상품화 된 키트로 측정하였다. 혈장 D-dimer의 농도는 건강한 개체 집단과 만성 이첨판 폐쇄부전증에 이환된 집단 사이에 유의적인 차이는 존재하지 않았다. 게다가, d-dimer의 농도는 심초음파 인덱스 중 대동맥대 좌심방비, 대동맥대 좌심실 이완말기 직경비와 연관성이 보이지 않았고, 이번 연구 집단의 심부전의 심각도와도 연관성이 존재하지 않았다. 따라서 금번 연구는 심부전을 가진 개에서 혈전색전증의 정도가 심하지 않거나 혈장 d-dimer의 농도 검사 자체가 개의 혈전색전증을 발견하는데 신뢰하지 못하다는 점을 암시하고 있다.

Keywords

References

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