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Dell'Angela L, Nicolosi GL. Mitral valve three-dimensional anatomic assessment for predicting systolic anterior motion during dobutamine stress echocardiography: Where are we now? Echocardiography 2024; 41:e15903. [PMID: 39132827 DOI: 10.1111/echo.15903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Affiliation(s)
- Luca Dell'Angela
- Cardio-Thoracic and Vascular Department, Cardiology Division, Gorizia & Monfalcone Hospital, ASUGI, Gorizia, Italy
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Romito G, Palatini L, Sabetti MC, Cipone M. Myocardial injury in dogs: a retrospective analysis on etiological, echocardiographic, electrocardiographic, therapeutic, and outcome findings in 102 cases. J Vet Cardiol 2024; 53:36-51. [PMID: 38640640 DOI: 10.1016/j.jvc.2024.03.004] [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] [Received: 06/01/2023] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION In dogs, myocardial injury (MI) is a poorly characterized clinical entity; therefore, this study aimed to provide a detailed description of dogs affected by this condition. ANIMALS, MATERIALS, AND METHODS Dogs diagnosed with MI according to the concentration of cardiac troponin I (cTnI) were retrospectively searched. Signalment, diagnostic, therapeutic, and outcome data were retrieved. Dogs were divided into six echocardiographic (dilated cardiomyopathy phenotype; hypertrophic cardiomyopathy phenotype; hypertrophic cardiomyopathy phenotype with systolic dysfunction; abnormal echogenicity only; endocarditis; and no echocardiographic abnormalities suggestive of MI), four electrocardiographic (abnormalities of impulse formation; abnormalities of impulse conduction; abnormalities of ventricular repolarization; and no electrocardiographic abnormalities suggestive of MI), and nine etiological (infective; inflammatory; neoplastic; metabolic; toxic; nutritional; immune-mediated; traumatic/mechanical; and unknown) categories. Statistical analysis was performed to compare cTnI values among different categories and analyze survival. RESULTS One hundred two dogs were included. The median cTnI value was 3.71 ng/mL (0.2-180 ng/mL). Echocardiographic and electrocardiographic abnormalities were documented in 86 of 102 and 89 of 102 dogs, respectively. Among echocardiographic and electrocardiographic categories, the dilated cardiomyopathy phenotype (n = 52) and abnormalities of impulse formation (n = 67) were overrepresented, respectively. Among dogs in which a suspected etiological trigger was identified (68/102), the infective category was overrepresented (n = 20). Among dogs belonging to different echocardiographic, electrocardiographic, and etiological categories, cTnI did not differ significantly. The median survival time was 603 days; only eight of 102 dogs died due to MI. CONCLUSIONS Dogs with MI often have an identifiable suspected trigger, show various echocardiographic and electrocardiographic abnormalities, and frequently survive to MI-related complications.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy.
| | - L Palatini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - M C Sabetti
- Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, 43126, Parma, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
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Nebel Y, Williams K, Lyons LA, Reinero C, Ferriani R, Toschi Corneliani R, Spalla I. Developmental lung disease in a cat associated with high probability of severe pulmonary hypertension: natural history, histopathology and genetic analysis. JFMS Open Rep 2024; 10:20551169241249003. [PMID: 38827566 PMCID: PMC11141230 DOI: 10.1177/20551169241249003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024] Open
Abstract
Case summary This report describes the diagnostic findings, natural history and genetic analysis of the candidate gene Forkhead Box F1 (FOXF1) in a young cat with developmental lung disease and high probability of pulmonary hypertension. A 1-year-old male entire Chartreux cat was referred for cardiac murmur investigation and exercise intolerance. Echocardiography identified a high-velocity tricuspid regurgitant jet with right-sided cardiac changes, supporting a high probability of pulmonary hypertension. No congenital cardiac shunts or left-sided cardiac changes were found to support a primary cardiac cause of pulmonary hypertension. Extensive laboratory work, thoracic radiographs and CT were performed. Histopathological characterisation (lung biopsy and later post mortem) was necessary to reach the final diagnosis. Eight months after diagnosis, the cat developed right-sided congestive heart failure, eventually leading to euthanasia. Survival from diagnosis to death was 12 months. Relevance and novel information Developmental lung disease belongs to a group of diffuse lung diseases in humans associated with pulmonary hypertension. The veterinary literature describing lung growth disorders in cats is sparse, and the present report provides information on clinical presentation and progression alongside a thorough diagnostic workup, which may aid clinicians in identifying this condition. Lung biopsy was pivotal in reaching the final diagnosis. No causal variants in FOXF1 were identified.
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Affiliation(s)
- Yari Nebel
- Ospedale Veterinario San Francesco, Milan, Italy
| | - Kurt Williams
- Department of Biomedical Sciences and Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Leslie A Lyons
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Carol Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
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Novo Matos J, Silva J, Regada S, Rizzo S, Serena Beato M, Basso C. Hypertrophic cardiomyopathy in a dog: a systematic diagnostic approach. J Vet Cardiol 2023; 51:1-8. [PMID: 37967487 DOI: 10.1016/j.jvc.2023.10.002] [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: 05/02/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 11/17/2023]
Abstract
A seven-year-old female neutered Parson Russel Terrier was referred for syncopal episodes. An electrocardiogram revealed paroxysmal atrial flutter followed by periods of sinus arrest, suggesting sick sinus syndrome. Echocardiography showed severe biventricular wall thickening (hypertrophic cardiomyopathy (HCM) phenotype) with no signs of fixed or dynamic left ventricular outflow tract obstruction. Blood pressure, abdominal ultrasound, serum total thyroxin and thyroid-stimulating hormone, and insulin-like growth factor-1 were all within normal limits. Cardiac troponin I was elevated (1.7 ng/mL, ref<0.07). Serological tests for common infectious diseases were negative. A 24-h Holter confirmed that the syncopal episodes were associated with asystolic pauses (sinus arrest after runs of atrial flutter) ranging between 8.5 and 9.6 s. Right ventricular endomyocardial biopsies (EMB) were performed at the time of pacemaker implantation to assess for storage or infiltrative diseases that mimic HCM in people. Histological analysis of the EMB revealed plurifocal inflammatory infiltrates with macrophages and lymphocytes (CD3+ > 7/mm2) associated with myocyte necrosis, but no evidence of myocyte vacuolisation or infiltrative myocardial disorders. These findings were compatible with myocardial ischaemic injury or acute lymphocytic myocarditis. Molecular analysis of canine cardiotropic viruses were negative. The dog developed refractory congestive heart failure and was euthanised 16 months later. Cardiac post-mortem examination revealed cardiomyocyte hypertrophy and disarray with diffuse interstitial and patchy replacement fibrosis, and small vessel disease, confirming HCM. We described a systemic diagnostic approach to an HCM phenotype in a dog, where a diagnosis of HCM was reached by excluding HCM phenocopies.
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Affiliation(s)
- J Novo Matos
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK.
| | - J Silva
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - S Regada
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - S Rizzo
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Via A. Gabelli 61, 35121, Padua, Italy
| | - M Serena Beato
- Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Viale dell'università 10, 35020, Legnaro, Padua, Italy
| | - C Basso
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Via A. Gabelli 61, 35121, Padua, Italy
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Schober KE, Fox PR, Abbott J, Côté E, Luis‐Fuentes V, Matos JN, Stern JA, Visser L, Scollan KF, Chetboul V, Schrope D, Glaus T, Santilli R, Pariaut R, Stepien R, Arqued‐Soubeyran V, Toaldo MB, Estrada A, MacDonald K, Karlin ET, Rush J. Retrospective evaluation of hypertrophic cardiomyopathy in 68 dogs. J Vet Intern Med 2022; 36:865-876. [PMID: 35322461 PMCID: PMC9151492 DOI: 10.1111/jvim.16402] [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] [Received: 04/14/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is a lack of clinical data on hypertrophic cardiomyopathy (HCM) in dogs. HYPOTHESIS/OBJECTIVES To investigate signalment, clinical signs, diagnostic findings, and survival in dogs with HCM. ANIMALS Sixty-eight client-owned dogs. METHODS Retrospective multicenter study. Medical records were searched between 2003 and 2015. The diagnosis of left ventricular (LV) hypertrophy was made by echocardiographic examination. RESULTS Three hundred and forty-five dogs with LV hypertrophy were identified, of which 277 were excluded. The remaining 68 dogs were 0.3 to 14 years old and predominantly <10 kg (85%), and without a sex predilection. Twenty-four % were Shih Tzu and 24% terrier breeds. Most (80%) had a systolic heart murmur. Owner-determined exercise intolerance (37%) and syncope (18%) were most commonly reported signs. The majority (84%) of dogs had symmetrical LV hypertrophy, whereas asymmetrical septal and LV free wall hypertrophy was observed in 9% and 6% of dogs, respectively. Isolated basal interventricular septal hypertrophy was not observed. Commonly recorded were systolic anterior motion of the mitral valve (60%) and LV diastolic dysfunction (89% of dogs where diastolic function was evaluated). Six dogs died unexpectedly, and 3 developed congestive heart failure. Known survival times were between 1 day and 114 months after diagnosis. CONCLUSIONS AND CLINICAL IMPORTANCE Hypertrophic cardiomyopathy in dogs should be considered as a differential diagnosis if LV hypertrophy is identified. Small breed dogs are overrepresented, and it is uncommon for dogs with HCM to develop CHF although sudden death can occur.
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Affiliation(s)
- Karsten E. Schober
- Department of Veterinary Clinical SciencesThe Ohio State UniversityColumbusOhioUSA
| | - Phillip R. Fox
- Department of CardiologyThe Animal Medical CenterNew YorkNew YorkUSA
| | - Jonathan Abbott
- Department of Small Animal Clinical SciencesUniversity of TennesseeKnoxvilleTennesseeUSA
| | - Etienne Côté
- Ecole Nationale Vétérinaire d'Alfort, Unite de Cardiologie d'Alfort (UCA)Université Paris‐EstMaisons‐AlfortFrance
| | | | - Jose Novo Matos
- Clinical Sciences and ServicesRoyal Veterinary CollegeLondonUK
- Clinic for Small Animal Internal MedicineUniversity of ZürichZürichSwitzerland
| | - Joshua A. Stern
- Department of Medicine and EpidemiologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Lance Visser
- Department of Medicine and EpidemiologyUniversity of CaliforniaDavisCaliforniaUSA
| | | | - Valerie Chetboul
- Atlantic Veterinary CollegeUniversity of Prince Edward IslandPrince Edward IslandCanada
| | - Donald Schrope
- Department of CardiologyOradell Animal HospitalParamusNew JerseyUSA
| | - Tony Glaus
- Clinic for Small Animal Internal MedicineUniversity of ZürichZürichSwitzerland
| | | | - Romain Pariaut
- Department of Clinical SciencesCornell College of Veterinary MedicineIthacaNew YorkUSA
| | - Rebecca Stepien
- Department of Medical SciencesUniversity of Wisconsin School of Veterinary MedicineMadisonWisconsinUSA
| | - Vanessa Arqued‐Soubeyran
- Ecole Nationale Vétérinaire d'Alfort, Unite de Cardiologie d'Alfort (UCA)Université Paris‐EstMaisons‐AlfortFrance
| | - Marco Baron Toaldo
- Clinic for Small Animal Internal MedicineUniversity of ZürichZürichSwitzerland
| | - Amara Estrada
- Department of Small Animal Clinical SciencesUniversity of FloridaGainesvilleFloridaUSA
| | | | - Emily T. Karlin
- Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - John Rush
- Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
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Boysen SR, Gommeren K. Assessment of Volume Status and Fluid Responsiveness in Small Animals. Front Vet Sci 2021; 8:630643. [PMID: 34124213 PMCID: PMC8193042 DOI: 10.3389/fvets.2021.630643] [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: 11/18/2020] [Accepted: 04/29/2021] [Indexed: 12/30/2022] Open
Abstract
Intravenous fluids are an essential component of shock management in human and veterinary emergency and critical care to increase cardiac output and improve tissue perfusion. Unfortunately, there are very few evidence-based guidelines to help direct fluid therapy in the clinical setting. Giving insufficient fluids and/or administering fluids too slowly to hypotensive patients with hypovolemia can contribute to continued hypoperfusion and increased morbidity and mortality. Similarly, giving excessive fluids to a volume unresponsive patient can contribute to volume overload and can equally increase morbidity and mortality. Therefore, assessing a patient's volume status and fluid responsiveness, and monitoring patient's response to fluid administration is critical in maintaining the balance between meeting a patient's fluid needs vs. contributing to complications of volume overload. This article will focus on the physiology behind fluid responsiveness and the methodologies used to estimate volume status and fluid responsiveness in the clinical setting.
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Affiliation(s)
- Søren R. Boysen
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Kris Gommeren
- Department of Companion Animals, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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Ferasin L, Kilkenny E, Ferasin H. Evaluation of N-terminal prohormone of brain natriuretic peptide and cardiac troponin-I levels in cats with systolic anterior motion of the mitral valve in the absence of left ventricular hypertrophy. J Vet Cardiol 2020; 30:23-31. [PMID: 32645686 DOI: 10.1016/j.jvc.2020.05.001] [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: 11/30/2019] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To identify the prevalence of systolic anterior motion of the mitral valve (SAM) in apparently healthy cats in the absence of left ventricular hypertrophy (LVH) and examine the relationship between specific cardiac biomarker concentrations and echocardiographic parameters in these individuals. ANIMALS eighty client-owned cats. MATERIALS AND METHODS retrospective study; inclusion criteria were the presence of SAM on conscious echocardiography and concurrent measurement of plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and serum cardiac troponin-I (cTnI). Cats were excluded if they had LVH, left atrial enlargement or systemic disease. The percentages of cats with NT-proBNP and cTnI concentrations above the normal reference range were calculated. The correlation between each biomarker concentration and left ventricular myocardial wall thickness, left atrial size and maximum left ventricular outflow tract velocity was evaluated. RESULTS Thirty-four of 80 patients with SAM showed no evidence of cardiac remodelling (LVH or left atrial enlargement). Of these patients, 30 of 34 had elevated NT-proBNP, and cTnI was elevated in 13 of 27 (48.1%) cats where this biomarker was measured in association with the NT-proBNP assay. A positive correlation was observed between concentration of plasma NT-proBNP and maximum left ventricular outflow tract velocity (rs = 0.67, p<0.0001). No significant correlations were found between the concentration of biomarkers and the remaining echocardiographic parameters. CONCLUSIONS SAM is frequently observed in cats even in the absence of cardiac remodelling, and these individuals often demonstrate elevated plasma NT-proBNP and serum cTnI concentrations. Plasma NT-proBNP elevation is correlated with the severity of the left ventricular outflow obstruction caused by SAM.
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Affiliation(s)
- L Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd., Alton, Hampshire, United Kingdom.
| | - E Kilkenny
- Lumbry Park Veterinary Specialists, Alton, Hampshire, United Kingdom
| | - H Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd., Alton, Hampshire, United Kingdom
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