1
|
Partington C, Hodgkiss-Geere H, Woods GRT, Dukes-McEwan J, Flanagan J, Biourge V, German AJ. The effect of obesity and subsequent weight reduction on cardiac morphology and function in cats. BMC Vet Res 2024; 20:154. [PMID: 38658930 PMCID: PMC11040875 DOI: 10.1186/s12917-024-04011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND In people, obesity is a risk factor for cardiovascular disease, associated with systemic hypertension, cardiac remodelling and systolic and diastolic dysfunction. Weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. In cats, far less is known regarding the effects of obesity and subsequent weight reduction on cardiovascular morphology and function. This prospective study aimed to assess cardiac morphology and function, heart rate variability, cardiac biomarkers and body composition before and after controlled weight reduction in cats with obesity. Body composition analysis (by dual energy x-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, systemic arterial systolic blood pressure, electrocardiography, plasma cardiac biomarkers) were performed prior to weight management in twenty cats with obesity. These investigations were repeated in eleven cats that reached target weight. RESULTS At baseline, systemic hypertension was not documented, but the majority of cats with obesity (15 out of 19) showed echocardiographic evidence of diastolic dysfunction. Eleven of 20 cats had increased maximal end-diastolic septal or left ventricular free wall thickness (≥ 6.0 mm) at baseline. Median (interquartile range) percentage of weight lost in the cats reaching target weight was 26% (17-29%), with a median reduction in body fat mass of 45% (26-64%). Both the end-diastolic left ventricular free wall (median magnitude of change -0.85 mm, IQR -0.05 mm to -1.55 mm, P = 0.019; median percentage reduction 14.0%) and end-diastolic interventricular septum (median magnitude of change -0.5 mm, IQR -0.2 mm to -1.225 mm, P = 0.047; median percentage reduction 7.9%) thickness decreased after weight reduction. Following weight reduction, pulsed wave tissue Doppler imaging of the left ventricular free wall was consistent with improved diastolic function in 4 out of 8 cats, however there was no significant difference in overall diastolic function class. Further, there was no change in heart rate variability or cardiac biomarkers with weight reduction. CONCLUSION An increase in left ventricular wall thickness and diastolic dysfunction were common echocardiographic features in cats with obesity within our study and may be reversible with successful weight and fat mass loss. Further studies are required to clarify the clinical consequences of these findings.
Collapse
Affiliation(s)
- Catheryn Partington
- Institute of Infection, Veterinary, Ecological and Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK.
- Present address: Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK.
| | - Hannah Hodgkiss-Geere
- Institute of Infection, Veterinary, Ecological and Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| | - Georgia R T Woods
- Institute of Life Course and Medical Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| | - Joanna Dukes-McEwan
- Institute of Infection, Veterinary, Ecological and Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| | | | | | - Alexander J German
- Institute of Life Course and Medical Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| |
Collapse
|
2
|
Reynolds BS, Chetboul V, Elliott J, Laxalde J, Nguyen P, Testault I, Dorso L, Abadie J, Lefebvre HP, Biourge V. Long-term safety of dietary salt: A 5-year ProspEctive rAndomized bliNded and controlled stUdy in healThy aged cats (PEANUT study). J Vet Intern Med 2024; 38:285-299. [PMID: 38084870 PMCID: PMC10800216 DOI: 10.1111/jvim.16952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND High-salt diets promote urine dilution and decrease urolithiasis risk. OBJECTIVE Prospectively evaluate the safety of chronic high dietary salt intake (randomized controlled trial). ANIMALS Twenty research colony neutered, healthy aged cats (11.5 years [10.0-11.6], median [interquartile range]). METHODS Healthy cats were randomized to control or high-salt dry diets (sodium: 1.02 ± 0.16 [mean, SD] and 3.26 ± 0.30 g/Mcal metabolizable energy [ME], respectively; chloride: 2.26 ± 0.33 and 5.71 ± 0.28 g/Mcal ME, respectively), fed for up to 60 months. Assessments included CBC, plasma biochemistry, urinalysis, glomerular filtration rate (GFR), blood pressure, renal and cardiac (conventional Doppler and 2-dimensional color tissue Doppler) imaging, annually. Cats that died or were euthanized underwent necropsy. Diet effects over time were evaluated with linear mixed models. RESULTS Follow-up duration (median [Interquartile range]) was similar between the control (38.7 months [28.6-48.2]) and high-salt group (51.4 months [45.7-59.0]). Diet had no significant effect on changes in GFR, blood pressure, plasma creatinine concentration, end-diastolic left ventricular (LV) wall thicknesses, LV internal diameters, LV systolic function, left atrial size, or systolic and diastolic Doppler variables. One control cat developed hypertension. One high-salt group cat developed persistent azotemia. Serial plasma biochemistry and urine specific gravity suggested early chronic kidney disease in 4 nonazotemic cats (2 per group), consistent with necropsy findings. CONCLUSIONS AND CLINICAL IMPORTANCE In healthy aged cats, a commercial veterinary diet containing 3.26 ± 0.30 g/Mcal ME sodium was safe with regard to renal and cardiac function for up to 5 years.
Collapse
Affiliation(s)
| | - Valerie Chetboul
- Unité de cardiologie d'Alfort (UCA), CHUVAEcole Nationale Vétérinare d'AlfortMaisons‐AlfortFrance
- Université Paris‐Est Créteil, INSERM, IMRBCréteilFrance
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary CollegeUniversity of LondonLondonUK
| | | | - Patrick Nguyen
- Nutrition and Endocrinology Unit, LUNAM UniversitéOnirisNantesFrance
| | | | - Laëticia Dorso
- Centre hospitalier Univesitaire VétérinaireOnirisNantesFrance
| | | | | | | |
Collapse
|
3
|
Tosuwan J, Surachetpong SD, Hunprasit V. Assessment of left atrial myocardial deformation using two-dimensional speckle-tracking echocardiography in cats with cardiogenic and non-cardiogenic arterial thromboembolism. Int J Vet Sci Med 2023; 11:11-22. [PMID: 37025927 PMCID: PMC10071954 DOI: 10.1080/23144599.2023.2196853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Arterial thromboembolism (ATE) in cats usually relates to cardiogenic causes that can be diagnosed by conventional echocardiography. Two-dimensional speckle-tracking echocardiography (2D-STE) is a new ultrasound modality with higher sensitivity. Our objective was to investigate left atrial myocardial deformation in cats with both cardiogenic and non-cardiogenic ATE and normal cats using 2D-STE. Twenty-three normal cats and 21 cats with ATE cats were recruited and performed conventional echocardiography and 2D-STE. From the results, left atrial (LA) strain and strain rate from 2D-STE were significantly decreased in cats with cardiogenic ATE (P < 0.001), but there was no significant difference in non-cardiogenic ATE compared with normal cats. From the correlation test, the use of left atrial strain during the reservoir phase (LASr) could represent the overall LA deformation. The intra- and inter-observer coefficient of variation of LASr was less than 15%. The logistic regression revealed that the LASr value of less than 11% was a significant factor for the occurrence of ATE (odd ratio = 189.0, P < 0.001). In conclusion, LASr derived by 2D-STE is a repeatable and non-invasive technique to assess LA myocardial deformation in cats with ATE. By 2D-STE, impaired LA function was detected in cats with cardiogenic ATE. LASr < 11% may use as a predictor of the risk of ATE occurrence in cats.
Collapse
|
4
|
Brložnik M, Lunka E, Avbelj V, Nemec Svete A, Domanjko Petrič A. Cardiac Electromechanical Activity in Healthy Cats and Cats with Cardiomyopathies. SENSORS (BASEL, SWITZERLAND) 2023; 23:8336. [PMID: 37837166 PMCID: PMC10574989 DOI: 10.3390/s23198336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Optimal heart function depends on perfect synchronization between electrical and mechanical activity. In this pilot study, we aimed to investigate the electromechanical activity of the heart in healthy cats and cats with cardiomyopathy with phonocardiography (PCG) synchronized to an electrocardiography (ECG) pilot device. We included 29 cats (12 healthy cats and 17 cats diagnosed with cardiomyopathy) and performed a clinical examination, PCG synchronized with ECG and echocardiography. We measured the following durations with the pilot PCG device synchronized with ECG: QRS (ventricular depolarization), QT interval (electrical systole), QS1 interval (electromechanical activation time (EMAT)), S1S2 (mechanical systole), QS2 interval (electrical and mechanical systole) and electromechanical window (end of T wave to the beginning of S2). The measured parameters did not differ between healthy cats and cats with cardiomyopathy; however, in cats with cardiomyopathy, EMAT/RR, QS2/RR and S1S2/RR were significantly longer than in healthy cats. This suggests that the hypertrophied myocardium takes longer to generate sufficient pressure to close the mitral valve and that electrical systole, i.e., depolarization and repolarization, and mechanical systoles are longer in cats with cardiomyopathy. The PCG synchronized with the ECG pilot device proved to be a valuable tool for evaluating the electromechanical activity of the feline heart.
Collapse
Affiliation(s)
- Maja Brložnik
- Faculty of Health Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.L.); (A.N.S.)
| | - Ema Lunka
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.L.); (A.N.S.)
| | - Viktor Avbelj
- Department of Communication Systems, Jožef Stefan Institute, 1000 Ljubljana, Slovenia;
| | - Alenka Nemec Svete
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.L.); (A.N.S.)
| | - Aleksandra Domanjko Petrič
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (E.L.); (A.N.S.)
| |
Collapse
|
5
|
Diggelmann ALR, Baron Toaldo M, Bektas RN, Furthner E, Reichler IM, Kutter APN. Atipamezole Reverses Cardiovascular Changes Induced by High-Dose Medetomidine in Cats Undergoing Sedation for Semen Collection. Animals (Basel) 2023; 13:1909. [PMID: 37370419 DOI: 10.3390/ani13121909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed at describing the change in echocardiographic variables after high-dose medetomidine and the reversal with atipamezole in six cats undergoing sedation for semen collection. Further cardiac Troponin I (cTnI) concentration and the effect of repeated sedation were assessed. Echocardiography was performed before and 20 min after sedation with 0.1 mg/kg medetomidine intramuscularly (IM) for urethral catheterisation. Prior to epididymectomy, S-ketamine was administered intravenously. Twenty minutes after reversal with 0.5 mg/kg atipamezole IM, the third echocardiography was performed. Sedation with medetomidine and reversal with atipamezole was repeated on day 7, 14, 21 and 28. Heart rate (HR) and rhythm were monitored throughout all sedations. On day 0 and 28 cTnI concentrations were measured before and after the procedure. After normality testing, the values were compared over time. The administration of medetomidine led to a marked reduction in HR, cardiac output and ventricular systolic function and a significant increase in left ventricular dimensions. Rhythm abnormalities, such as ventricular premature complexes and idioventricular rhythm, could be observed. The administration of atipamezole completely reversed sedation and the changes in haemodynamic variables. No significant increase in cTnI concentrations could be detected, although two out of six cats showed values above the reference range.
Collapse
Affiliation(s)
- Anna-Lea R Diggelmann
- Section of Anaesthesiology, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Marco Baron Toaldo
- Clinic for Small Animal Internal Medicine, Division of Cardiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Rima N Bektas
- Section of Anaesthesiology, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Etienne Furthner
- Clinic of Reproductive Medicine, Department for Farm Animals, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Iris M Reichler
- Clinic of Reproductive Medicine, Department for Farm Animals, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Annette P N Kutter
- Section of Anaesthesiology, Department for Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| |
Collapse
|
6
|
Effects of Aficamten on cardiac contractility in a feline translational model of hypertrophic cardiomyopathy. Sci Rep 2023; 13:32. [PMID: 36593243 PMCID: PMC9807554 DOI: 10.1038/s41598-022-26630-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/16/2022] [Indexed: 01/03/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiac disease in humans and cats and lacks efficacious pharmacologic interventions in the preclinical phase of disease. LV outflow tract obstruction (LVOTO) is commonly observed in HCM-affected patients and is a primary driver of heart failure symptoms and reduced quality of life. Novel small-molecule cardiac myosin inhibitors target actin-myosin interactions to alleviate overactive protein interactions. A prospective, randomized, controlled cross-over study was performed to evaluate pharmacodynamic effects of two doses (0.3 and 1 mg/kg) of a next-in-class cardiac myosin inhibitor, aficamten (CK-3773274, CK-274), on cardiac function in cats with the A31P MYBPC3 mutation and oHCM. Dose-dependent reductions in LV systolic function, LVOT pressure gradient, and isovolumetric relaxation times compared to baseline were observed. Promising beneficial effects of reduced systolic function warrant further studies of this next-in-class therapeutic to evaluate the benefit of long-term administration in this patient population.
Collapse
|
7
|
Sharpe AN, Oldach MS, Kaplan JL, Rivas V, Kovacs SL, Hwee DT, Morgan BP, Malik FI, Harris SP, Stern JA. Pharmacokinetics of a single dose of Aficamten (CK-274) on cardiac contractility in a A31P MYBPC3 hypertrophic cardiomyopathy cat model. J Vet Pharmacol Ther 2023; 46:52-61. [PMID: 36382714 PMCID: PMC10099566 DOI: 10.1111/jvp.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) is the most prevalent cardiac disease in cats and lacks efficacious preclinical pharmacologic intervention, prompting investigation of novel therapies. Genetic mutations encoding sarcomeric proteins are implicated in the development of HCM and small molecule myosin inhibitors are an emerging class of therapeutics designed to target the interaction of actin and myosin to alleviate the detrimental effects of inappropriate contractile protein interactions. The purpose of this study was to characterize the pharmacodynamic effects of a single oral dose of the novel cardiac myosin inhibitor aficamten (CK-274) on cardiac function in purpose bred cats with naturally occurring A31P MYBPC3 mutation and a clinical diagnosis of HCM with left ventricular outflow tract obstruction (LVOTO). Five purpose bred cats were treated with aficamten (2 mg/kg) or vehicle and echocardiographic evaluations were performed at 0, 6, 24, and 48 h post-dosing. High dose aficamten (2 mg/kg) reduced left ventricular fractional shortening (LVFS%) by increasing the LV systolic internal dimension (LVIDs) and reduced isovolumic relaxation time (IVRT) compared with baseline without significant adverse effects. The marked reduction in systolic function and reduced IVRT coupled with an increased heart rate in treated cats, suggest a lower dose may be optimal. Further studies to determine optimal dosing of aficamten are indicated.
Collapse
Affiliation(s)
- Ashley N Sharpe
- Department of Medicine and Epidemiology, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Maureen S Oldach
- Department of Medicine and Epidemiology, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Joanna L Kaplan
- Department of Medicine and Epidemiology, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Victor Rivas
- Department of Medicine and Epidemiology, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Samantha L Kovacs
- Department of Medicine and Epidemiology, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Darren T Hwee
- Research and Non-clinical Development, Cytokinetics, Inc, South San Francisco, California, USA
| | - Bradley P Morgan
- Research and Non-clinical Development, Cytokinetics, Inc, South San Francisco, California, USA
| | - Fady I Malik
- Research and Non-clinical Development, Cytokinetics, Inc, South San Francisco, California, USA
| | - Samantha P Harris
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, Arizona, USA
| | - Joshua A Stern
- Department of Medicine and Epidemiology, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| |
Collapse
|
8
|
Veronezi TM, Lopes DJ, Zardo IL, Ferronatto JVB, Trojan MM, Franck KR, de Azevedo AF, Spiering AG, Nunes LN, Fadel L, da Costa FVA. Evaluation of the effects of gabapentin on the physiologic and echocardiographic variables of healthy cats: a prospective, randomized and blinded study. J Feline Med Surg 2022; 24:e498-e504. [PMID: 36383193 PMCID: PMC10812358 DOI: 10.1177/1098612x221131270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate, using echocardiography, the effects of oral administration of a single dose of gabapentin on the physiologic variables (heart rate [HR], respiratory rate [RR] and systolic blood pressure [SBP]) and systolic and diastolic cardiac function of healthy cats. METHODS This was a prospective, randomized and blinded study with 40 healthy cats aged between 6 months and 2 years. The cats' health status was assessed on the first appointment (T1) when they underwent a physical examination, complete blood count, biochemical profile, assessment of physiologic variables and echocardiogram. The echocardiogram was used to measure the left ventricle's (LV) internal diameter during systole and diastole, isovolumic relaxation time, transmitral flow, E-wave deceleration time and HR. The cats were randomly divided into two groups: (1) a treatment group with 20 cats that received a single oral dose of gabapentin (100 mg/cat); and (2) a control group with 20 cats that received a single oral dose of placebo. All variables of the physiologic and echocardiographic variables were re-evaluated 1-3 weeks after T1 (T2), 90 mins after medication or placebo administration. RESULTS There was no difference in the physiologic variables evaluated in both groups. The proportion of cats in the treatment group that had their ventricular filling waves fused on T1 but did not have them fused on T2 was significantly higher (45%) compared with cats in the control group (15%; P = 0.0384). CONCLUSIONS AND RELEVANCE There was no difference between the groups in regard to SBP, HR, RR and echocardiographic variables. Gabapentin improved evaluation of diastolic function on echocardiogram because it reduced the fusion of ventricular filling waves during the evaluation of the diastolic function of the LV. Gabapentin did not cause adverse effects on the cardiovascular hemodynamics of young healthy cats.
Collapse
Affiliation(s)
- Tayná M Veronezi
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Daniela J Lopes
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Izadora L Zardo
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - João VB Ferronatto
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo M Trojan
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Kirian R Franck
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André F de Azevedo
- Post Graduation Program in Veterinary Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Adriana G Spiering
- Graduation Program in Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana N Nunes
- Department of Statistics, Institute of Mathematics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Leandro Fadel
- Veterinary Teaching Hospital, School of Veterinary Medicine, Lutheran University of Brazil, Porto Alegre, Brazil
| | - Fernanda VA da Costa
- Department of Animal Medicine, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
9
|
Tuleski GLR, Pscheidt MJGR, dos Santos JP, Sousa MG. Timolol 0.5% ophthalmic solution influences cardiac function in healthy cats. J Feline Med Surg 2022; 24:e57-e69. [PMID: 35470745 PMCID: PMC11104227 DOI: 10.1177/1098612x221083372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to ascertain the effect of a drop of timolol 0.5% ophthalmic solution on the systolic function of the left ventricle (LV) and left atrium (LA), and to confirm if timolol helped appraisal of diastolic function by reducing heart rate (HR) and separating the transmitral outflow waves from tissue Doppler imaging (TDI). METHODS A total of 41 client-owned healthy cats underwent two echocardiograms 20 mins apart. The timolol group (33 cats) received a drop of timolol solution after the first examination. Standard and speckle-tracking echocardiography evaluated the LV and LA function of both groups at the two time points evaluated. RESULTS Timolol reduced HR (19%), and fractional shortening from LV (20.3%) and LA (16.6%). Septal S' decreased by 51% (from 7.7 to 5.2 cm/s) and lateral S' dropped by 43.1% (7.3 to 5.1 cm/s). Most longitudinal techniques did not change after timolol, including the mitral annular plane systolic excursion from the interventricular annulus, tricuspid annular plane systolic excursion, LV longitudinal strain and LV tissue motion annular displacement. The isovolumic relaxation time increased by 15.2% (from 54 to 64.6 ms), with most cats presenting this variable above the reference (>60 ms). Timolol did not support diastolic assessment, enabling evaluation in only 2/11 cats when using lateral TDI and 1/9 cats using septal TDI. Regarding side effects, miosis occurred in 18 cats (54.5%). CONCLUSIONS AND RELEVANCE Timolol reduced systolic function, decreasing standard echocardiographic variables. Regarding diastolic evaluation, although timolol decreased HR, it did not separate the mitral diastolic waves, as expected.
Collapse
Affiliation(s)
- Giovana LR Tuleski
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | | | - Júlio Pereira dos Santos
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Marlos Gonçalves Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| |
Collapse
|
10
|
Matsuura K, Bach MB, Takahashi K, Willesen JL, Koch J, Tanaka R. Non-invasive assessment of left ventricular relaxation property using color M-mode-derived intraventricular pressure gradients in cats. J Vet Cardiol 2022; 41:236-248. [DOI: 10.1016/j.jvc.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/26/2022]
|
11
|
Feline Hypertrophic Cardiomyopathy (FHCM). FOLIA VETERINARIA 2022. [DOI: 10.2478/fv-2022-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The feline hypertrophic cardiomyopathy (HCM) is one of many cardiac diseases known in domestic animals, and it is especially frequent in cats of all ages. HCM is the most common heart disease in cats, affecting almost 15 % of the feline population. The Maine Coon and the Ragdoll breeds of domestic cats are shown to have a special gene that is responsible for the appearance of HCM in these breeds. Hypertrophic cardiomyopathy can be detected by: echocardiography, electrocardiography (ECG), radiography, genetic testing, and a test including N- terminal prohormone of brain natriuretic peptide (NT-proBNP). The most frequently used method used for clinical purposes is echocardiography. Patients with HCM will most of the time not have any clinical signs of the disease, which makes it difficult for the owner to detect that there is something wrong with their cat. Some cats, on the other hand, will get heart arrhythmias which can cause sudden death. There are several prognosis-worsening findings that may occur due to the hypertrophy of the ventricles. These include: Feline Arterial Thromboembolism (FATE), Congestive Heart Failure (CHF), and the Dynamic Obstruction of the Left Ventricular Outflow Tract (DOLVOT). The prognosis for HCM depends on the stage of the disease. In some cats, they are well-tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death.
Collapse
|
12
|
Tissue motion annular displacement to assess the left ventricular systolic function in healthy cats. Vet Res Commun 2022; 46:823-836. [PMID: 35258757 DOI: 10.1007/s11259-022-09907-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/16/2022] [Indexed: 10/18/2022]
Abstract
The tissue motion annular displacement (TMAD) measures the longitudinal displacement of the mitral annulus during systole, using speckle-tracking echocardiography (STE). The main objective was to determine the TMAD means in healthy cats, exploring the correlations with systolic surrogates. The influence of age, body surface area (BSA), heart rate, and systemic blood pressure on the indices was also analyzed. One hundred ninety-three healthy, client-owned cats participated in this prospective, cross-sectional observational study undergoing conventional and STE. Apical four-chamber (AP4) and two-chamber (AP2) images were recorded for offline calculations. Mean TMAD values were similar to mitral annulus plane systolic excursion (MAPSE), varying between 4 to 4.8 mm depending on the annulus and image used. No significant differences between age and BSA categories were detected, except for AP4 MP%, reduced in the heavier group. TMAD variables showed moderate correlation with longitudinal strain (LSt) and MAPSE, but not with fraction shortening (FS) and ejection fraction (EF). The median time required for the offline calculation was 12.2 s for AP4 and 11.8 s for AP2. The technique showed moderate inter and intraobserver variation, proving a reliable tool for assessing left ventricular longitudinal systolic function in cats.
Collapse
|
13
|
Chetboul V, Foulex P, Kartout K, Klein AM, Sailleau C, Dumarest M, Delaplace M, Gouilh MA, Mortier J, Le Poder S. Myocarditis and Subclinical-Like Infection Associated With SARS-CoV-2 in Two Cats Living in the Same Household in France: A Case Report With Literature Review. Front Vet Sci 2021; 8:748869. [PMID: 34746286 PMCID: PMC8566889 DOI: 10.3389/fvets.2021.748869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/13/2021] [Indexed: 12/15/2022] Open
Abstract
This report provides the first clinical, radiographic, echocardiographic, and biological description of SARS-CoV-2-associated myocarditis with a 6-month follow-up in a 5-year-old obese male domestic shorthair cat (Cat-1) presented for refractory congestive heart failure, with high cardiac troponin-I level (5.24 ng/ml), and a large lingual ulcer. The animal was SARS-CoV-2 positive on serology. The other cat living in the same household (Cat-2) never showed any clinical sign but was also confirmed SARS-CoV-2 positive on serology. Both cats were SARS-CoV-2 PCR negative. Cat-1 had closer contact than Cat-2 with their owner, who had been in close contact with a coworker tested PCR positive for COVID-19 (Alpha (B.1.1.7) variant) 4 weeks before Cat-1's first episode of congestive heart failure. A focused point-of-care echocardiography at presentation revealed for Cat-1 numerous B-lines, pleural effusion, severe left atrial dilation and dysfunction, and hypertrophic cardiomyopathy phenotype associated with focal pulmonary consolidations. Both myocarditis and pneumonia were suspected, leading to the prescription of cardiac medications and antibiotics. One month later, Cat-1 recovered, with normalization of left atrial size and function, and radiographic and echocardiography disappearance of heart failure signs and pulmonary lesions. An extensive literature review of SARS-CoV-2-related cardiac injury in pets in comparison with human pathology is discussed.
Collapse
Affiliation(s)
- Valérie Chetboul
- École Nationale Vétérinaire d'Alfort, CHUVA, Unité de Cardiologie d'Alfort (UCA), Maisons-Alfort, France.,Université Paris Est Créteil, INSERM, IMRB, Créteil, France
| | - Pierre Foulex
- École Nationale Vétérinaire d'Alfort, CHUVA, Unité de Cardiologie d'Alfort (UCA), Maisons-Alfort, France
| | - Kahina Kartout
- École Nationale Vétérinaire d'Alfort, CHUVA, Unité de Cardiologie d'Alfort (UCA), Maisons-Alfort, France
| | | | - Corinne Sailleau
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| | - Marine Dumarest
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| | - Manon Delaplace
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| | - Meriadeg Ar Gouilh
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Université, UNICAEN, 13 UNIROUEN, Caen, France
| | - Jeremy Mortier
- École Nationale Vétérinaire d'Alfort, CHUVA, Service d'Imagerie Médicale, Maisons-Alfort, France
| | - Sophie Le Poder
- École Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, INRAE, ANSES, Laboratoire de santé animale, Université Paris-Est, Maisons-Alfort, France
| |
Collapse
|
14
|
Kittleson MD, Côté E. The Feline Cardiomyopathies: 3. Cardiomyopathies other than HCM. J Feline Med Surg 2021; 23:1053-1067. [PMID: 34693805 PMCID: PMC8723175 DOI: 10.1177/1098612x211030218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Practical relevance: Although feline hypertrophic cardiomyopathy (HCM) occurs more commonly,
dilated cardiomyopathy (DCM), restrictive cardiomyopathy (RCM),
arrhythmogenic right ventricular cardiomyopathy (ARVC), left ventricular
noncompaction (LVNC) and cardiomyopathy – nonspecific phenotype (NCM;
formerly unclassified cardiomyopathy) are all recognized in domestic
cats. Patient group: Any adult domestic cat, of either sex and of any breed, can be affected. Diagnostics: The non-HCM cardiomyopathies are rarely suspected in subclinically affected
cats, so most are first identified when a cat presents with signs of heart
failure or systemic thromboembolic disease. The definitive clinical
confirmatory test for these other feline cardiomyopathies is
echocardiography. Key findings: ‘Cardiomyopathy – nonspecific phenotype’ is a catch-all term that groups
hearts with myocardial changes that either do not meet the criteria for any
one type of cardiomyopathy (HCM, RCM, DCM, ARVC, LVNC) or meet the
echocardiography criteria for more than one type. RCM is characterized by
diastolic dysfunction due to fibrosis that results in a restrictive
transmitral flow pattern on Doppler echocardiography and usually marked left
or biatrial enlargement. DCM is characterized by decreased myocardial
contractility and is rare in cats. When it occurs, it is seldom due to
taurine deficiency. However, since taurine-deficient DCM is usually
reversible, a diet history should be obtained, whole blood and plasma
taurine levels should be measured and taurine should be supplemented in the
diet if the diet is not commercially manufactured. ARVC should be suspected
in adult cats with severe right heart enlargement and right heart failure
(ascites and/or pleural effusion), especially if arrhythmia is present.
Feline LVNC is rare; its significance continues to be explored. Treatment of
the consequences of these cardiomyopathies (management of heart failure,
thromboprophylaxis, treatment of systemic arterial thromboembolism) is the
same as for HCM. Conclusions: While these other cardiomyopathies are less prevalent than HCM in cats, their
clinical and radiographic presentation is often indistinguishable from HCM.
Echocardiography is usually the only ante-mortem method to determine which
type of cardiomyopathy is present. However, since treatment and prognosis
are often similar for the feline cardiomyopathies, distinguishing among the
cardiomyopathies is often not essential for determining appropriate
therapy. Areas of uncertainty: The feline cardiomyopathies do not always fit into one distinct category.
Interrelationships among cardiomyopathies in cats may exist and
understanding these relationships in the future might provide critical
insights regarding treatment and prognosis.
Collapse
Affiliation(s)
| | - Etienne Côté
- Department of Companion Animals, Atlantic
Veterinary College, University of Prince Edward Island, Charlottetown,
Prince Edward Island, Canada
| |
Collapse
|
15
|
Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
Collapse
Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| |
Collapse
|
16
|
Teixeira-Neto FJ, Valverde A. Clinical Application of the Fluid Challenge Approach in Goal-Directed Fluid Therapy: What Can We Learn From Human Studies? Front Vet Sci 2021; 8:701377. [PMID: 34414228 PMCID: PMC8368984 DOI: 10.3389/fvets.2021.701377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
Resuscitative fluid therapy aims to increase stroke volume (SV) and cardiac output (CO) and restore/improve tissue oxygen delivery in patients with circulatory failure. In individualized goal-directed fluid therapy (GDFT), fluids are titrated based on the assessment of responsiveness status (i.e., the ability of an individual to increase SV and CO in response to volume expansion). Fluid administration may increase venous return, SV and CO, but these effects may not be predictable in the clinical setting. The fluid challenge (FC) approach, which consists on the intravenous administration of small aliquots of fluids, over a relatively short period of time, to test if a patient has a preload reserve (i.e., the relative position on the Frank-Starling curve), has been used to guide fluid administration in critically ill humans. In responders to volume expansion (defined as individuals where SV or CO increases ≥10–15% from pre FC values), FC administration is repeated until the individual no longer presents a preload reserve (i.e., until increases in SV or CO are <10–15% from values preceding each FC) or until other signs of shock are resolved (e.g., hypotension). Even with the most recent technological developments, reliable and practical measurement of the response variable (SV or CO changes induced by a FC) has posed a challenge in GDFT. Among the methods used to evaluate fluid responsiveness in the human medical field, measurement of aortic flow velocity time integral by point-of-care echocardiography has been implemented as a surrogate of SV changes induced by a FC and seems a promising non-invasive tool to guide FC administration in animals with signs of circulatory failure. This narrative review discusses the development of GDFT based on the FC approach and the response variables used to assess fluid responsiveness status in humans and animals, aiming to open new perspectives on the application of this concept to the veterinary field.
Collapse
Affiliation(s)
- Francisco José Teixeira-Neto
- Departmento de Cirurgia Veterinária e Reprodução Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista, Botucatu, Brazil
| | - Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| |
Collapse
|
17
|
Saito T, Suzuki R, Yuchi Y, Teshima T, Matsumoto H, Koyama H. Early detection of myocardial dysfunction in a cat that gradually progressed to endomyocardial form of restrictive cardiomyopathy. BMC Vet Res 2021; 17:274. [PMID: 34391430 PMCID: PMC8364115 DOI: 10.1186/s12917-021-02987-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Background Restrictive cardiomyopathy (RCM) is a common myocardial disease in cats, characterized by diastolic dysfunction and atrial enlargement without myocardial hypertrophy. Especially, endomyocardial form of RCM, one of the subtypes in RCM, is characterized by endocardial fibrosis, endocardial scar bridging the interventricular septum and left ventricular (LV) free wall, and deformation and distortion of the LV. However, it is unclear how the myocardial dysfunction and the endocardial scar contribute to the pathophysiology of RCM disease progression. Case presentation A 3 years and 2 months old, intact male, Domestic shorthaired cat was presented for consultation of cardiac murmur. At the first visit (day 0), the notable abnormal finding was echocardiography-derived chordae tendineae-like structure bridging the interventricular septum and the LV free wall, resulting high-speed blood flow in the left ventricle. Electrocardiography, thoracic radiography and noninvasive blood pressure measurements were normal. No left atrial enlargement was observed, and LV inflow velocity showed an abnormal relaxation pattern. Although there was no abnormality in tissue Doppler imaging-derived myocardial velocity, two-dimensional speckle tracking echocardiography (2D-STE) revealed a decrease in the LV longitudinal strain and an increase in endocardial to epicardial ratio of the LV circumferential strain on day 0. On day 468, obvious left atrium enlargement and smoke like echo in the left atrium were observed. The LV inflow velocity was fused, and the tissue Doppler imaging-derived early-diastolic myocardial velocity of the septal mitral annulus decreased. Regarding 2D-STE, LV circumferential strain was further decreased, and right ventricular strain was additionally decreased. Although the general condition was good, we made a clinical diagnosis of endomyocardial RCM based on the above findings. On day 503, the cat showed the radiographic evidence of pulmonary edema and congestive heart failure signs. Conclusions Cats with abnormal LV structure and associated myocardial dysfunction like this case needs careful observation. Additionally, 2D-STE indices may be useful for early detection of myocardial dysfunction in feline RCM.
Collapse
Affiliation(s)
- Takahiro Saito
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, 180-8602, Musashino-shi, Tokyo, Japan.,Sagamihara Animal Medical Center, 10-17-2 Kobuchi, Minami-ku, 252-0344, Sagamihara-shi, Kanagawa, Japan
| | - Ryohei Suzuki
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, 180-8602, Musashino-shi, Tokyo, Japan.
| | - Yunosuke Yuchi
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, 180-8602, Musashino-shi, Tokyo, Japan
| | - Takahiro Teshima
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, 180-8602, Musashino-shi, Tokyo, Japan
| | - Hirotaka Matsumoto
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, 180-8602, Musashino-shi, Tokyo, Japan
| | - Hidekazu Koyama
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, 180-8602, Musashino-shi, Tokyo, Japan
| |
Collapse
|
18
|
Spalla I, Smith GW, Chang YM, Luis Fuentes V, Connolly DJ. Paroxysmal high-grade second-degree and persistent third-degree atrioventricular block in cats. J Vet Cardiol 2021; 36:20-31. [PMID: 34051641 DOI: 10.1016/j.jvc.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/01/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Both paroxysmal high-grade second-degree and persistent third-degree atrioventricular block (AVB) are recognised in cats. Our aim was to document the presentation, echocardiographic data, comorbidities and outcome in affected cats from a single referral hospital, including those that underwent epicardial pacemaker implantation (EPI). ANIMALS, MATERIALS AND METHODS This retrospective study included 64 cats diagnosed with persistent third-degree or paroxysmal high-grade AVB, for which detailed patient history was available. Non-parametric testing, Kaplan-Meier curves and Cox proportional hazard testing were performed. RESULTS Atrioventricular block was persistent in 43 cats (67%) and paroxysmal in 21 (33%). Forty-seven cats (74%) were referred for cardiac complaints (e.g. collapse, arrhythmia, tachypnea), 6 (9%) had non-specific complaints and AVB was an incidental finding in 11 cats (17%). Median duration of clinical signs prior to presentation was 21 days (1-1138 days). Thirty-nine (63%) cats had echocardiographic abnormalities; 13 (20%) presented with congestive heart failure. Forty-five (70%) cats had one or more comorbidities. Fifteen cats underwent EPI with immediate resolution of signs in 12 cats. Following EPI, two and four cats experienced major and minor complications, respectively. Forty-seven cats died; median survival time was 799 days (all-cause mortality). Cardiac-related death occurred in 17 cats (36%); median survival in these cats was 132 days. Heart failure on presentation was the only independent risk factor for cardiac death (p=0.002). CONCLUSIONS Outcome in cats with AVB was variable, although most had good medium- to long-term survival. Cardiac death occurred in a minority of cats. Pacemaker implantation was effective in relieving clinical signs.
Collapse
Affiliation(s)
- I Spalla
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom; Ospedale Veterinario San Francesco, via Isaac Newton 2, 20148 Milano, Italy.
| | - G W Smith
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - Y-M Chang
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - V Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - D J Connolly
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| |
Collapse
|
19
|
Myocardial transcription of inflammatory and remodeling markers in cats with hypertrophic cardiomyopathy and systemic diseases associated with an inflammatory phenotype. Res Vet Sci 2021; 136:484-494. [PMID: 33848803 DOI: 10.1016/j.rvsc.2021.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 12/17/2022]
Abstract
Feline hypertrophic cardiomyopathy (HCM) is characterized by macrophage-driven myocardial remodeling processes in a pro-inflammatory environment. To further investigate the mechanisms behind these processes, the myocardial transcription of cytokines and remodeling enzymes was comparatively assessed in cats with HCM and cats without cardiac diseases. Sixty-seven cats were included, 17 cats with HCM (including 5 with atrial thrombus; AT), and 50 cats without cardiac diseases. The latter comprised 10 control cats (no cardiac or relevant systemic disease), 34 cats with diseases suspected to be associated with a systemic inflammatory state of which 18 suffered from feline infectious peritonitis (FIP), and 6 cats with multicentric lymphoma. Samples from atria, ventricular free walls and interventricular septum were examined using quantitative reverse transcriptase PCR. The overall highest myocardial marker transcriptions were observed in cats with multicentric lymphoma, FIP and HCM, followed by diseases likely associated with a systemic inflammatory state, and control cats. Inflammatory marker transcription predominated in the myocardium of cats with systemic inflammatory diseases, whereas in HCM the transcription of remodeling enzymes prevailed. Sex significantly influenced the myocardial transcription of several remodeling enzymes. These results suggest a versatile myocardial response depending on the disease and illustrates the relevance of sex for the cardiac response to cardiac and systemic disease in cats. A systemic inflammatory state appears to elicit an inflammatory phenotype in the myocardium, whereas in HCM, the myocardium mediates its own remodeling. In HCM, the identified markers might be involved in the ongoing remodeling processes causing structural and functional changes.
Collapse
|
20
|
Eosinophilic pericardial effusion in a cat with complex systemic disease and associated peripheral eosinophilia. J Vet Cardiol 2021; 35:55-62. [PMID: 33823336 DOI: 10.1016/j.jvc.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 02/20/2021] [Accepted: 03/01/2021] [Indexed: 11/22/2022]
Abstract
An 11-year-old domestic shorthair cat was referred for investigation of dry cough of 1-week duration and cardiomegaly. Echocardiography revealed pericardial effusion, and eosinophils were identified as the predominant cell type in fluid collected by pericardiocentesis. Thoracic computed tomography imaging and bronchoscopy were supportive of mild lower airway disease, while bronchoalveolar lavage confirmed eosinophilic inflammation and concurrent Mycoplasma felis infection. A few months after the initial presentation, there was clinical deterioration, and further investigation suggested intestinal lymphoma. It was hypothesized that pericardial effusion and lower airway inflammation were an early manifestation of hypereosinophilic syndrome, possibly as a paraneoplastic consequence of lymphoma.
Collapse
|
21
|
Steele MM, Borgeat K, Payne JR, Coss P, Navarro-Cubas X, Church DB, Niessen SJ, Connolly DJ. Increased insulin-like growth factor 1 concentrations in a retrospective population of non-diabetic cats diagnosed with hypertrophic cardiomyopathy. J Feline Med Surg 2021; 23:952-958. [PMID: 33541239 DOI: 10.1177/1098612x20987995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of the study was to document whether a proportion of non-diabetic cats with left ventricular hypertrophy (LVH) previously diagnosed with hypertrophic cardiomyopathy (HCM) have elevated circulating insulin-like growth factor 1 (IGF-1) concentrations. METHODS A retrospective analysis of residual blood samples obtained at the time of echocardiographic diagnosis of HCM from a population of 60 non-diabetic cats were analysed for circulating IGF-1 concentrations using a validated radioimmunoassay and compared with a control group of 16 apparently healthy cats without LVH. Clinical and echocardiographic data for cats with an IGF-1 level >1000 ng/ml were compared with those with an IGF-1 level <800 ng/ml. RESULTS In total, 6.7% (95% confidence interval 1.8-16.2%) of cats with HCM had an IGF-1 level >1000 ng/ml. The prevalence of an IGF-1 level >1000 ng/ml in the control group was zero. CONCLUSIONS AND RELEVANCE A small proportion of non-diabetic cats previously diagnosed with HCM had an IGF-1 concentration at a level that has been associated with feline hypersomatotropism (fHS) in the diabetic cat population. Further prospective research is required to confirm or refute the presence of fHS in non-diabetic cats with LVH and increased IGF-1.
Collapse
Affiliation(s)
- Matthew Me Steele
- Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | | | | | - Peter Coss
- Langford Vets, University of Bristol, Bristol, UK
| | | | - David B Church
- Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | | | - David J Connolly
- Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| |
Collapse
|
22
|
Schober KE, Rush JE, Luis Fuentes V, Glaus T, Summerfield NJ, Wright K, Lehmkuhl L, Wess G, Sayer MP, Loureiro J, MacGregor J, Mohren N. Effects of pimobendan in cats with hypertrophic cardiomyopathy and recent congestive heart failure: Results of a prospective, double-blind, randomized, nonpivotal, exploratory field study. J Vet Intern Med 2021; 35:789-800. [PMID: 33543810 PMCID: PMC7995419 DOI: 10.1111/jvim.16054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/11/2022] Open
Abstract
Background The benefits of pimobendan in the treatment of congestive heart failure (CHF) in cats with hypertrophic cardiomyopathy (HCM) have not been evaluated prospectively. Hypothesis/Objectives To investigate the effects of pimobendan in cats with HCM and recent CHF and to identify possible endpoints for a pivotal study. We hypothesized that pimobendan would be well‐tolerated and associated with improved outcome. Animals Eighty‐three cats with HCM and recently controlled CHF: 30 with and 53 without left ventricular outflow tract obstruction. Methods Prospective randomized placebo‐controlled double‐blind multicenter nonpivotal field study. Cats received either pimobendan (0.30 mg/kg q12h, n = 43), placebo (n = 39), or no medication (n = 1) together with furosemide (<10 mg/kg/d) with or without clopidogrel. The primary endpoint was a successful outcome (ie, completing the 180‐day study period without a dose escalation of furosemide). Results The proportion of cats in the full analysis set population with a successful outcome was not different between treatment groups (P = .75). For nonobstructive cats, the success rate was 32% in pimobendan‐treated cats versus 18.2% in the placebo group (odds ratio [OR], 2.12; 95% confidence interval [CI], 0.54‐8.34). For obstructive cats, the success rate was 28.6% and 60% in the pimobendan and placebo groups, respectively (OR, 0.27; 95% CI, 0.06‐1.26). No difference was found between treatments for the secondary endpoints of time to furosemide dose escalation or death (P = .89). Results were similar in the per‐protocol sets. Adverse events in both treatment groups were similar. Conclusions and Clinical Importance In this study of cats with HCM and recent CHF, no benefit of pimobendan on 180‐day outcome was identified.
Collapse
Affiliation(s)
- Karsten E Schober
- The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, Ohio, USA
| | - John E Rush
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | | | - Tony Glaus
- University of Zürich, Clinic for Small Animal Internal Medicine, Zürich, Switzerland
| | | | | | | | - Gerhard Wess
- University of Munich, Clinic of Small Animal Medicine, Munich, Germany
| | - Margaret P Sayer
- Charlotte Animal Referral & Emergency, Charlotte, North Carolina, USA
| | | | - John MacGregor
- New England Veterinary Cardiology, Durham, North Carolina, USA
| | - Nicole Mohren
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim, Germany
| |
Collapse
|
23
|
Kochie SL, Schober KE, Rhinehart J, Winter RL, Bonagura JD, Showers A, Yildez V. Effects of pimobendan on left atrial transport function in cats. J Vet Intern Med 2020; 35:10-21. [PMID: 33241877 PMCID: PMC7848333 DOI: 10.1111/jvim.15976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Arterial thromboembolism is a sequela of hypertrophic cardiomyopathy (HCM) in cats related to left atrial (LA) enlargement and dysfunction. HYPOTHESIS Pimobendan improves LA transport function in cats. ANIMALS Twenty-two client-owned cats with HCM and 11 healthy cats. METHODS Prospective, double-blind, randomized, placebo-controlled clinical cohort study. Cats were randomized to receive either pimobendan (0.25 mg/kg PO q12h) or placebo for 4 to 7 days. Nineteen echocardiographic variables of LA size and function were evaluated. Statistical comparisons included t tests, analysis of variance, and multivariable analyses. RESULTS Peak velocity of left auricular appendage flow (LAapp peak; mean ± SD, 0.85 ± 0.20 vs 0.71 ± 0.22 m/s; P = .01), maximum LA volume (P = .03), LA total emptying volume (P = .03), peak velocity of late diastolic transmitral flow (A peak velocity; 0.77 ± 0.12 vs 0.62 ± 0.17 m/s; P = .05), and A velocity time integral (A VTI; 3.05 ± 0.69 vs 3.37 ± 0.49; P = .05) were increased after pimobendan. Mean change after pimobendan was larger in cats with HCM compared to healthy cats for LA fractional shortening (2.1% vs -2.1%; P = .05), A VTI (0.58 vs 0.01 cm; P = .01), LAapp peak (0.20 vs 0.02 m/s; P = .02), LA kinetic energy (3.51 vs -0.10 kdynes-cm; P = .05), and LA ejection force (1.93 vs -0.07 kdynes; P = .01) in the multivariable model. The stronger effect of pimobendan in cats with HCM was independent of LA size. CONCLUSIONS AND CLINICAL IMPORTANCE We identified positive, albeit minor, effects of pimobendan on LA function in cats with HCM. Whether or not treatment with pimobendan decreases the risk of cardiogenic embolism deserves further study.
Collapse
Affiliation(s)
- Samantha L Kochie
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Karsten E Schober
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jaylyn Rhinehart
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Randolph L Winter
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - John D Bonagura
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Annie Showers
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Vedat Yildez
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
24
|
van Hoek I, Hodgkiss-Geere H, Bode EF, Hamilton-Elliott J, Mõtsküla P, Palermo V, Pereira YM, Culshaw GJ, Laxalde J, Dukes-McEwan J. Association of diet with left ventricular wall thickness, troponin I and IGF-1 in cats with subclinical hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:2197-2210. [PMID: 33118674 PMCID: PMC7694815 DOI: 10.1111/jvim.15925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cats with subclinical hypertrophic cardiomyopathy (sHCM) have elevated serum insulin and serum amyloid A concentrations correlating with the degree of cardiac hypertrophy. Diet might affect these and other cardiac variables. OBJECTIVE Evaluate the effect of a complete, balanced diet with restricted starch and supplemented with eicosapentaenoic acid + docosahexaenoic acid (EPA + DHA) on echocardiographic variables and cardiac biomarkers in cats with sHCM. ANIMALS Forty-four client-owned cats with sHCM. METHODS A prospective, randomized, double-blind, multicenter study enrolled cats with end-diastole interventricular septum thickness (IVSd) or left ventricular wall thickness (LVWd) ≥6 mm, or both. Nonsedated, fasted cats were examined at baseline and after 6 and 12 months of Test (restricted starch and EPA + DHA supplements) (n = 23) or Control (unrestricted starch without EPA + DHA supplementation) (n = 21) diet. Assessments included auscultation, body weight, body condition score, echocardiography and blood analysis. Linear and generalized mixed models analyzed diet, time and diet * time interactions (5% significance level). RESULTS No differences between diet groups were significant for any variable at any timepoint. There were significant decreases in the Test but not Control group in maximum IVSd (P = .03), maximum LVWd (P = .02) and insulin-like growth factor-1 levels (P = .04) after 12 months, and in ultrasensitive cardiac troponin I (cTnI) (P = .001) after 6 months; effect sizes (95% confidence interval) were 0.53 (0.09; 0.99), 0.63 (0.18; 1.09), 0.61 (0.16; 1.07), and 0.37 (-0.06; 0.8), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Cats with sHCM fed Test diet had significant decreases in echocardiographic variables of sHCM and in cTnI and IGF-1.
Collapse
Affiliation(s)
| | - Hannah Hodgkiss-Geere
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| | - Elizabeth F Bode
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| | - Julie Hamilton-Elliott
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| | - Paul Mõtsküla
- Estonian University of Life Sciences, Tartu, Estonia
| | | | | | | | | | - Joanna Dukes-McEwan
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| |
Collapse
|
25
|
Winter RL, Jennings RN, Cronin JP, Rhinehart JD, Schober KE. Acquired left-to-right shunting through a valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy and congestive heart failure. JFMS Open Rep 2020; 6:2055116920959607. [PMID: 33062291 PMCID: PMC7536497 DOI: 10.1177/2055116920959607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Case summary An 8-year-old spayed female domestic shorthair cat was presented for a recheck
evaluation of hypertrophic cardiomyopathy and chronic kidney disease. Three years prior
to presentation, the patient was diagnosed with obstructive hypertrophic cardiomyopathy
and started on atenolol. The left ventricular outflow tract obstruction subsequently
resolved. Biochemical analysis a week prior to presentation demonstrated severe
azotemia. Transthoracic echocardiograph revealed pericardial effusion, pleural effusion,
severe left ventricular concentric hypertrophy, severe left atrial enlargement and
continuous left-to-right flow through the interatrial septum near the fossa ovalis. The
patient was euthanized owing to poor prognosis, and gross examination at necropsy
revealed a valve-incompetent patent foramen ovale secondary to severe left atrial
dilation. Relevance and novel information To our knowledge, this is the first report of an acquired left-to-right shunt through a
valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy. Severe left
atrial dilation was suspected to cause interatrial shunting through the
valve-incompetent foramen ovale, and this finding may be relevant to echocardiographic
evaluations in other cats.
Collapse
Affiliation(s)
- Randolph L Winter
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Ryan N Jennings
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - James P Cronin
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Jaylyn D Rhinehart
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Karsten E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
26
|
Khor KH, Chin MX. Occurrences of heart disease in apparently healthy cats in Klang Valley, Malaysia. J Adv Vet Anim Res 2020; 7:501-508. [PMID: 33005676 PMCID: PMC7521808 DOI: 10.5455/javar.2020.g446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 11/03/2022] Open
Abstract
Objective Annual health screening inclusive of heart workup is recommended for the detection of heart diseases, especially in asymptomatic patients (no clinical signs). This study determined the occurrences of the common heart disease and the risk factors in apparently healthy cats. Materials and methods This prospective study that screened 59 healthy cats and the status of the heart were evaluated based on a combination of findings from physical examination, electrocardiography, blood pressure measurement, routine blood test, urinalysis, and total thyroid level. Results Approximately 40.7% (n = 24/59) of the apparently healthy cats were diagnosed with heart disease hypertrophic cardiomyopathy (62.5%) remains to be the most commonly diagnosed. The mean age was 4.9-year old (age range, 7-month-old to 19-year-old). The prevalence was higher in males (45.0%; n = 17/38) cats, especially the domestic shorthairs (46.0%; n = 11/24). Among the healthy cats with vertebral heart scale (VHS) > 8.0, only 52% (n = 12/23) of them were diagnosed with cardiomyopathy. However, 33% (n = 12/36) of the cats with normal VHS ≤ 7.9 were diagnosed with heart disease. Consistently, all healthy cats with abnormal heart sounds were diagnosed with heart disease. About 31.4% (n = 16/51) of these cats with typical heart sound had cardiomyopathy too. Conclusion The occurrence of cardiomyopathy in apparently healthy cats has no association with the patient's age, sex, and VHS, except for the heart sound. Echocardiography remains the best diagnostic tool, as normal heart size and normal heart sound do not exclude cardiomyopathy in this group of apparently healthy cats.
Collapse
Affiliation(s)
- Kuan Hua Khor
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mei Xin Chin
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| |
Collapse
|
27
|
Rohrbaugh MN, Schober KE, Rhinehart JD, Bonagura JD, Habing A, Yildiz V. Detection of congestive heart failure by Doppler echocardiography in cats with hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:1091-1101. [PMID: 32364632 PMCID: PMC7255654 DOI: 10.1111/jvim.15777] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/23/2020] [Indexed: 12/21/2022] Open
Abstract
Background Left‐sided congestive heart failure (CHF) is characterized by increased filling pressures and related Doppler echocardiographic (DE) filling patterns. Hypothesis Doppler echocardiographic variables of left ventricular filling derived from transmitral flow, pulmonary vein flow, and tissue Doppler can be used to detect CHF in cats with hypertrophic cardiomyopathy (HCM). Animals Forty‐seven client‐owned cats. Methods Prospective clinical cohort study. Cats underwent physical examination, thoracic radiography, analysis of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), and transthoracic echocardiography and were divided into 3 age‐matched groups: Group 1 (apparently healthy control), Group 2 (preclinical HCM), and Group 3 (HCM and CHF). Measured and calculated variables included respiratory rate, DE estimates, serum NT‐proBNP concentration, and radiographic CHF score. Groups were compared using ANOVA, and receiver operating characteristic (ROC) curve and multivariate analyses were used to identify diagnostic cutoffs for the detection of CHF. Results Fifteen cats were in Group 1, 17 in Group 2, and 15 in Group 3. The ROC analysis indicated that the ratio of peak velocity of early diastolic transmitral flow to peak velocity of late diastolic transmitral flow (area under the curve [AUC], 1.0; diagnostic cutoff, 1.77; P = .001), ratio of left atrial size to aortic annular dimension (AUC, 0.91; diagnostic cutoff, 1.96; P = .003), left atrial diameter (AUC, 0.89; cutoff, 18.5 mm; P = .004), diastolic functional class (AUC, 0.89; cutoff, class 2; P = .005), respiratory (AUC, 0.79; cutoff, 36 breaths per minute [brpm]; P = .02), and the ratio of the peak velocity of fused early and late transmitral flow velocities to the peak velocity of the fused early and late diastolic tissue Doppler waveforms (AUC, 0.74; cutoff, 15.1; P = .05) performed best for detecting CHF. Conclusions and Clinical Importance Various DE variables can be used to detect CHF in cats with HCM. Determination of the clinical benefit of such variables in initiating treatments and assessing treatment success needs further study.
Collapse
Affiliation(s)
- Michelle N Rohrbaugh
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Karsten E Schober
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jaylyn D Rhinehart
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - John D Bonagura
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Amy Habing
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Vedat Yildiz
- Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
28
|
Accessory left ventricular chamber in a cat: multimodality imaging description by cardiac magnetic resonance imaging and echocardiography. J Vet Cardiol 2020; 28:55-61. [PMID: 32339994 DOI: 10.1016/j.jvc.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 11/21/2022]
Abstract
A left ventricular accessory chamber is a complex and uncommon phenotype consisting in a subdivision of the left ventricle by a thick-walled muscle bundle or septum into two cavities. Multiple aetiologies such as congenital double-chambered left ventricle and acquired endomyocardial form of restrictive cardiomyopathy have been reported. The endomyocardial form of restrictive cardiomyopathy, owing to its structural heterogeneity, can present a similar phenotype to the congenital abnormality with intraventricular lesions bridging the ventricular septum and left ventricular free wall. Conventional echocardiography is the first-line, accepted, non-invasive imaging modality to investigate underlying cardiac disease but presents limitations for the overall assessment of myocardial tissue. This report describes the use of cardiac magnetic resonance imaging as an additional imaging modality to provide multiplanar morphological, structural, and functional information of the myocardium. In the presented images, hyperintensities on cardiac magnetic resonance imaging within the myocardium along with hyperechoic and heterogeneous myocardial tissue on echocardiography and elevated troponin I were suggestive of a presumptive acquired pathological process such as feline endomyocarditis-left ventricular endomyocardial fibrosis complex, rather than a sole congenital anomaly. Although the diagnosis was not confirmed, this case exemplifies the advantages of using complementary multimodality imaging in a cat presented with a left ventricular accessory chamber.
Collapse
|
29
|
Luis Fuentes V, Abbott J, Chetboul V, Côté E, Fox PR, Häggström J, Kittleson MD, Schober K, Stern JA. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med 2020; 34:1062-1077. [PMID: 32243654 PMCID: PMC7255676 DOI: 10.1111/jvim.15745] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022] Open
Abstract
Cardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are well‐tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death. Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk of life‐threatening complications and those at higher risk. Based on the available literature, we offer recommendations for the approach to diagnosis and staging of cardiomyopathies, as well as for management at each stage.
Collapse
Affiliation(s)
- Virginia Luis Fuentes
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Valérie Chetboul
- Alfort Cardiology Unit (UCA), Université Paris-Est, École Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Maisons-Alfort cedex, France
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Mark D Kittleson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Karsten Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| |
Collapse
|
30
|
Baron Toaldo M, Pollesel M, Diana A. Effect of pimobendan on left atrial function: an echocardiographic pilot study in 11 healthy cats. J Vet Cardiol 2020; 28:37-47. [PMID: 32244178 DOI: 10.1016/j.jvc.2020.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES - To evaluate the effect of a single dose of pimobendan on left atrial (LA) function in healthy cats. ANIMALS - Eleven client owned healthy cats. MATERIAL AND METHODS - Standardized and repeated echocardiographic examinations were performed on healthy and conscious cats before and after a single dose of orally administered pimobendan (1.25 mg/cat). Left atrial systolic functional parameters were assessed. RESULTS - Some of the tested parameters of LA function showed significant improvement after pimobendan administration, whereas no significant effect on left ventricular function was observed. In particular, LA minimal diameters obtained from M-mode images in short (p=0.018) and long (p=0.009) axis reduced after pimobendan administration, whereas LA fractional shortening from short (p=0.027) and long (p=0.042) axis and LA appendage emptying velocity (p<0.001) significantly increased. A mild increase in heart rate (p=0.001), and a transient increase on the peak systolic wave pulmonary vein velocity (p=0.008) were also recorded as a possible effect. CONCLUSIONS - A single dose of pimobendan appears to impact LA function in healthy cats. However, because of the small number of cats included, and the absence of a placebo group, these results cannot be definitively separated from the effect of time. Additional studies are needed to understand if similar effects are observed in cats with cardiomyopathy and LA dilatation.
Collapse
Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy.
| | - M Pollesel
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| |
Collapse
|
31
|
De Silva M, Mihailovic A, Baron Toaldo M. Two-dimensional, M-mode, and Doppler echocardiography in 22 conscious and apparently healthy pet guinea pigs. J Vet Cardiol 2020; 27:54-61. [PMID: 32070937 DOI: 10.1016/j.jvc.2020.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study was to report normal echocardiographic values in healthy guinea pigs. ANIMALS, MATERIALS, AND METHODS Twenty-two privately owned, apparently healthy, conscious guinea pigs underwent complete transthoracic echocardiography. Left ventricular (LV), right ventricular, left atrial, and aortic root dimensions were measured, as were forward flow velocities across the mitral, aortic, and pulmonic valves. The effects of age, body weight, sex, and heart rate on these variables were also investigated. RESULTS The median age (interquartile range) was 3.0 (1.8-4.0) years with a body weight of 902 (822-998) grams. Echocardiography was feasible in all conscious animals. Early and late diastolic transmitral flow waves were summated in 17 of 22 individuals. In the remaining five animals, the two waves were reversed (E wave-to-A wave velocity less than 1.0). A positive correlation was detected between body weight and LV internal diameter at end-diastole and end-systole and left atrial diameter (P < 0.05). Heart rate was negatively correlated with LV internal diameter at end-systole (r = -0.463, P = 0.035). Age was positively correlated with LV posterior wall thickness at end-diastole and aortic diameter (P < 0.05). LV internal diameter at end-systole was larger in males than in females (P = 0.012), while fractional shortening was lower (P = 0.008). CONCLUSIONS Descriptive echocardiography ranges in apparently healthy awake guinea pigs have been provided and can be used for cardiac assessment in these pet animals.
Collapse
Affiliation(s)
- M De Silva
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy.
| | | | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| |
Collapse
|
32
|
Duler L, Scollan KF, LeBlanc NL. Left atrial size and volume in cats with primary cardiomyopathy with and without congestive heart failure. J Vet Cardiol 2019; 24:36-47. [PMID: 31405553 DOI: 10.1016/j.jvc.2019.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION/OBJECTIVES Myocardial diseases are the most common acquired cardiac diseases in cats and may result in left atrial enlargement and congestive heart failure (CHF). Volume calculations have replaced linear measurements for chamber quantification in humans but are not commonly measured in cats. The aims of this retrospective study were to compare the left atrial (LA) size by two-dimensional linear measurements to two-dimensional LA volumes (LAV). ANIMALS One hundred sixty-two client-owned cats were included. MATERIALS AND METHODS Cats with complete echocardiographic examinations were included and categorized into one of the three groups: healthy, cardiomyopathy (CM), and CHF. Seven measurements of the LA size were performed including minimal and maximal LA-to-aortic ratio (LA:Ao) and LAV and also maximal left atrial diameter (LAD). RESULTS Cats were classified as healthy (n = 56), CM (n = 62), and CHF (n = 44). The minimal LA:Ao (LA:Aomin) and minimal LAV from the left apical view (LAVmin-LAP) best differentiated the CM and CHF groups. The LA:Aomin value with the optimal sensitivity and specificity to distinguish CM and CHF cats was 1.64 (sensitivity 84% and specificity 75%). CONCLUSIONS Left atrial volumes were not superior to linear measurements of LA size in distinguishing CM and CHF cats in this study. Minimal LA size and volumes resulted in a larger area under the curve than each corresponding maximal value. Minimum LA size may be a better prognostic factor of CHF in cats with CM.
Collapse
Affiliation(s)
- L Duler
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331, USA
| | - K F Scollan
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331, USA.
| | - N L LeBlanc
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97331, USA
| |
Collapse
|
33
|
Spalla I, Boswood A, Connolly DJ, Luis Fuentes V. Speckle tracking echocardiography in cats with preclinical hypertrophic cardiomyopathy. J Vet Intern Med 2019; 33:1232-1241. [PMID: 30993757 PMCID: PMC6524080 DOI: 10.1111/jvim.15495] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/27/2019] [Indexed: 12/20/2022] Open
Abstract
Background Cats with hypertrophic cardiomyopathy (HCM) have decreased left ventricular (LV) longitudinal deformation detected by mitral annular plane systolic excursion (MAPSE) and speckle tracking echocardiography. People with preclinical HCM have decreased systolic LV longitudinal and radial strain (S) and strain rate (SR), with preserved circumferential S and SR. Hypothesis/Objectives Cats with preclinical HCM have decreased systolic LV deformation compared to normal cats. Animals Seventy‐three client‐owned cats with (n = 37) and without (n = 36) preclinical HCM. Methods Retrospective echocardiographic study. Left and right ventricular longitudinal S and SR, LV radial and circumferential S and SR were calculated by STE. Left ventricular mass was also calculated. Correlation between STE variables and LV hypertrophy was determined and receiver‐operating characteristic (ROC) curves were plotted for prediction of HCM. Results Cats with HCM had smaller absolute longitudinal S (−14.8 ± 3.3% vs −19.7 ± 2.7%, P < .001), longitudinal SR (−2.36 ± 0.62 vs −2.95 ± 0.68 second−1, P < .001), radial S (46.2 ± 21.3% vs 66.7 ± 17.6%, P < .001), and radial SR (5.60 ± 2.08 vs 6.67 ± 1.8 second−1, P < .001) compared to healthy controls. No difference was observed for circumferential S and SR. Cats with HCM had greater LV mass (13.2 ± 3.7 g vs 8.6 ± 2.7 g, P < .001). The ROC with the greatest area under the curve (AUC) for the identification of HCM (0.974) was plotted from a logistic regression equation combining LV mass, MAPSE at the free wall, and LV internal diameter in diastole (LVIDd). Conclusions and clinical importance Cats with preclinical HCM have decreased long axis and radial deformation. Decreased longitudinal deformation and decreased LVIDd are factors that would support a diagnosis of HCM.
Collapse
Affiliation(s)
- Ilaria Spalla
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Adrian Boswood
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - David J Connolly
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Virginia Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| |
Collapse
|
34
|
Chetboul V, Passavin P, Trehiou-Sechi E, Gouni V, Poissonnier C, Pouchelon JL, Desquilbet L. Clinical, epidemiological and echocardiographic features and prognostic factors in cats with restrictive cardiomyopathy: A retrospective study of 92 cases (2001-2015). J Vet Intern Med 2019; 33:1222-1231. [PMID: 30924221 PMCID: PMC6524389 DOI: 10.1111/jvim.15464] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 02/14/2019] [Indexed: 12/15/2022] Open
Abstract
Background Restrictive cardiomyopathy (RCM) is a common primary cardiomyopathy of cats. However, little information is available regarding prognostic variables in large populations of cats with RCM. Objectives To characterize the epidemiological, clinical, and echocardiographic features of cats with RCM and to document their survival times and risk factors for cardiac death (CD). Animals Ninety‐two cats with RCM. Methods Retrospective study. Diagnosis of RCM was based on echocardiographic and Doppler criteria. Median survival time to CD and adjusted hazard ratios (HR) were estimated by the Kaplan‐Meier method and multivariate Cox models, respectively. Results The feline population (median age [interquartile range], 8.6 years [4.1‐12.4]; body weight, 4.0 kg [3.3‐4.7]) included 83 cats (90%) with the myocardial RCM form and 9 (10%) with the endomyocardial fibrosis RCM form. Most RCM cats (64/92, 70%) were symptomatic at the time of diagnosis, with dyspnea related to congestive heart failure in 57 of 64 cats (89%). The median survival time of the 69 cats with the myocardial RCM form and available follow‐up was 667 days (range, 2‐3710 days) considering CD. Independent of age, biatrial enlargement, and arrhythmias, increase of the left atrium (LA)‐to‐aorta (Ao) ratio (hazard ration [HR], 2.5 per 0.5‐unit increase; 95% confidence interval [CI], 1.5‐4.2; P < .001) and presence of severe LA enlargement (end‐diastolic LA : Ao ≥2; HR, 3.4; 95% CI, 1.3‐8.7; P = .01) were significantly associated with shorter time to CD. Conclusions and Clinical Importance Cardiac death is common in RCM cats, and LA enlargement seems independently associated with decreased survival time in these cats.
Collapse
Affiliation(s)
- Valérie Chetboul
- Alfort Cardiology Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France.,INSERM, Unité 955, Equipe 03, Université Paris-Est Créteil, Paris, France
| | - Peggy Passavin
- Alfort Cardiology Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Emilie Trehiou-Sechi
- Alfort Cardiology Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Vassiliki Gouni
- Alfort Cardiology Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France.,INSERM, Unité 955, Equipe 03, Université Paris-Est Créteil, Paris, France
| | - Camille Poissonnier
- Alfort Cardiology Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Jean-Louis Pouchelon
- Alfort Cardiology Unit, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Loic Desquilbet
- U955-IMRB, INSERM, École Nationale Vétérinaire d'Alfort, UPEC, Maisons-Alfort Cedex, France
| |
Collapse
|
35
|
Vezzosi T, Schober KE. Doppler-derived echocardiographic evidence of pulmonary hypertension in cats with left-sided congestive heart failure. J Vet Cardiol 2019; 23:58-68. [PMID: 31174730 DOI: 10.1016/j.jvc.2019.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 01/21/2019] [Accepted: 01/28/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Pulmonary hypertension (PH) caused by left-sided congestive heart failure (L-CHF) is common in dogs and contributes to clinical signs and outcome. The aim of this study was to evaluate the prevalence of Doppler echocardiography-derived PH in a population of cats with L-CHF. ANIMALS The study involved 131 cats with L-CHF and 56 control cats. METHODS The study design is retrospective, observational study. Tricuspid regurgitation velocity, right atrial dimension, right ventricular (RV) dimension and function, RV wall thickness, pulmonary artery (PA) dimension, Doppler-derived systolic time intervals of PA flow, and presence of septal flattening were evaluated. Pulmonary hypertension was considered if tricuspid regurgitation velocity was >2.7 m/s. RESULTS Tricuspid regurgitation was present in 57/131 (44%) of cats with L-CHF and 24/56 (43%) in control cats based on color flow Doppler. Doppler-derived of PH was identified in 22/131 cats with L-CHF (17%). In 15/22 cats, PH was associated with cardiomyopathy, in 5/22 cases with congenital heart disease, and in 2/22 cases with other causes. Cats with Doppler-derived PH more often had chronic L-CHF, as opposed to acute L-CHF (p<0.05). All cats with Doppler-derived PH had subjectively-assessed right-sided heart enlargement, with larger right atrial and RV diameters (p<0.001), increased RV wall thickness (p<0.05), and higher prevalence of septal flattening (<0.001) and PA enlargement (p<0.05). CONCLUSIONS Pulmonary hypertension identified by Doppler echocardiography is not a common finding in cats with L-CHF. Right-sided heart enlargement, more frequently observed, may raise the suspicion of PH in cats with L-CHF.
Collapse
Affiliation(s)
- T Vezzosi
- Department of Veterinary Sciences, University of Pisa, via Livornese, 56122, San Piero a Grado, Pisa, Italy.
| | - K E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, OH, 43210, USA
| |
Collapse
|
36
|
Spalla I, Payne JR, Borgeat K, Luis Fuentes V, Connolly DJ. Prognostic value of mitral annular systolic plane excursion and tricuspid annular plane systolic excursion in cats with hypertrophic cardiomyopathy. J Vet Cardiol 2018; 20:154-164. [DOI: 10.1016/j.jvc.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 12/31/2022]
|
37
|
James R, Guillot E, Garelli-Paar C, Huxley J, Grassi V, Cobb M. The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. J Vet Cardiol 2017; 20:1-12. [PMID: 29277469 DOI: 10.1016/j.jvc.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The pathophysiology of heart failure involves activation of several neurohormonal systems including the renin-angiotensin-aldosterone system. The mineralocorticoid receptor antagonist spironolactone has been shown to be beneficial in humans and dogs with heart failure. The objective of this pilot study was to investigate the efficacy and safety of spironolactone in cats with heart failure secondary to cardiomyopathy already treated with furosemide and an angiotensin-converting enzyme inhibitor. ANIMALS Twenty cats with heart failure due to cardiomyopathy. METHODS The study was a double-blind, randomised, placebo-controlled, multicentre clinical study assessing the effect of spironolactone on survival and clinical parameters in cats with heart failure due to cardiomyopathy. The primary end point was mortality, defined as death (spontaneous or by euthanasia) due to cardiac causes. RESULTS Twenty cats were enrolled: 9 in the spironolactone group and 11 in the placebo group of which 56% (5/9) and 0% (0/11) completed the 15-month period respectively. At inclusion, differences in systemic blood pressure, body condition score, electrocardiographic abnormalities and LA/Ao ratio suggested that disease may be less severe in the spironolactone group. Twenty-two percent (2/9) of cats in the spironolactone group and 82% (9/11) in the control group reached the primary end point (Fisher's exact test, p = 0.0216). No safety issues were identified in either group. CONCLUSIONS This study suggests that spironolactone is well tolerated, and preliminary results support further investigation to evaluate the efficacy of spironolactone in the treatment of cats with cardiac failure due to cardiomyopathy.
Collapse
Affiliation(s)
- Rachel James
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough, Leicestershire, LE12 5RD, United Kingdom
| | - Emilie Guillot
- Ceva Santé Animale, 10 av. de la Ballastière, 33500 Libourne, France
| | | | - Jacqueline Huxley
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough, Leicestershire, LE12 5RD, United Kingdom
| | - Vanessa Grassi
- Ceva Santé Animale, 10 av. de la Ballastière, 33500 Libourne, France
| | - Malcolm Cobb
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough, Leicestershire, LE12 5RD, United Kingdom.
| |
Collapse
|
38
|
Pereira N, Novo Matos J, Baron Toaldo M, Bartoszuk U, Summerfield N, Riederer A, Reusch C, Glaus T. Cats with diabetes mellitus have diastolic dysfunction in the absence of structural heart disease. Vet J 2017; 225:50-55. [DOI: 10.1016/j.tvjl.2017.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/15/2022]
|
39
|
Spalla I, Payne JR, Borgeat K, Pope A, Fuentes VL, Connolly DJ. Mitral Annular Plane Systolic Excursion and Tricuspid Annular Plane Systolic Excursion in Cats with Hypertrophic Cardiomyopathy. J Vet Intern Med 2017; 31:691-699. [PMID: 28370313 PMCID: PMC5435071 DOI: 10.1111/jvim.14697] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 01/03/2017] [Accepted: 02/23/2017] [Indexed: 11/29/2022] Open
Abstract
Background Left ventricular (LV) systolic dysfunction is associated with increased risk of death in cats with hypertrophic cardiomyopathy (HCM). Mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE, respectively) are measures of longitudinal systolic function and are reduced in human patients with HCM. Hypotheses Cats with HCM have lower MAPSE and TAPSE compared to control cats; lower MAPSE and TAPSE are associated with the presence of congestive heart failure (CHF) and reduced survival time. Animals 64 cats with HCM and 27 healthy cats. Forty‐five cats with HCM were not showing clinical signs, and 19 had CHF. Methods Retrospective study. Anatomic M‐mode from the left apical 4‐chamber view was used to record MAPSE from the free wall (MAPSE FW) and septum (MAPSE IVS) and TAPSE. Results Compared to controls, cats with HCM had lower MAPSE IVS (controls 5.2 [4.6–5.6] mm, asymptomatic HCM 4.7 [4.1–5.2] mm, HCM with CHF 2.6 [2.5–3.2] mm, P < .001), MAPSE FW (controls 5.9 [5.3–6.2] mm, asymptomatic HCM 4.7 [4.1–5.1] mm, HCM with CHF 2.8 [2.4–3.2] mm) and TAPSE (controls 8.6 [7.4–10.2] mm, asymptomatic HCM 7.2 [6.3–8.2] mm, HCM with CHF 4.6 [4.1–5.4] mm), with the lowest in the CHF group. Univariate survival analysis showed a shorter survival in cats displaying lower MAPSE IVS, MAPSE FW, and TAPSE. Conclusions and Clinical Importance MAPSE and TAPSE were lower in cats with HCM than in control cats and were lowest in CHF, suggesting that systolic longitudinal dysfunction is present in cats with HCM. MAPSE and TAPSE have potential prognostic significance.
Collapse
Affiliation(s)
- I Spalla
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| | - J R Payne
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK.,Highcroft Veterinary Referrals, Whitchurch, Bristol, UK
| | - K Borgeat
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK.,Highcroft Veterinary Referrals, Whitchurch, Bristol, UK
| | - A Pope
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| | - V Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| | - D J Connolly
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| |
Collapse
|