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Woo IS, Kim JH. Predictive value of left atrial volumes assessed using real-time three-dimensional echocardiography for pulmonary hypertension in dogs with myxomatous mitral valve disease. Front Vet Sci 2024; 11:1441839. [PMID: 39220767 PMCID: PMC11362095 DOI: 10.3389/fvets.2024.1441839] [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: 05/31/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Left atrial volume (LAV) obtained using real-time three-dimensional echocardiography (RT3DE) is an independent predictor of post-capillary pulmonary hypertension (PH) in humans; however, no studies have investigated LAV obtained using RT3DE as a predictor of post-capillary PH in dogs with myxomatous mitral valve disease (MMVD). Therefore, we aimed to evaluate the clinical applicability of LAV obtained using RT3DE compared to that obtained using two-dimensional echocardiography (2DE) in dogs with MMVD, with or without PH. Methods Medical records and echocardiographic images of 237 privately owned dogs with naturally occurring MMVD with or without PH were retrospectively reviewed. A total of 49 privately owned dogs with naturally occurring MMVD, with or without PH, were finally included (35 MMVD without PH, 14 MMVD with PH). The LAV and left ventricular volumes were obtained using 2DE and RT3DE. Echocardiographic parameters were analyzed to identify independent predictors of post-capillary PH. Results We found that the left atrial and left ventricular volumes obtained using 2DE and RT3DE indexed to body weight and several 2DE-derived variables were univariately associated with post-capillary PH. Furthermore, multivariable logistic regression analysis revealed that the RT3DE minimum LAV indexed to body weight (LAVi min) was the only significant independent predictor of post-capillary PH (odds ratio, 12.86; 95% confidence interval [CI], 2.40-68.99; p = 0.003), with the highest area under the curve value of 0.86 (95% CI, 0.75-0.96; p < 0.001). Discussion In conclusion, LAV indexed to body weight obtained using 2DE and RT3DE, can be a useful predictor of post-capillary PH in dogs with MMVD. In particular, the RT3DE LAVi min was observed to be the strongest predictor of post-capillary PH.
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Affiliation(s)
| | - Jung-Hyun Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
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Crosara S, Fidanzio F, Oricco S, Dondi F, Mazzoldi C, Monari E, Romito G, Sabetti MC, Troìa R, Quintavalla C. Association between echocardiographic indexes and urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) in dogs with myxomatous mitral valve disease. Res Vet Sci 2024; 171:105211. [PMID: 38458044 DOI: 10.1016/j.rvsc.2024.105211] [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: 11/03/2023] [Revised: 02/24/2024] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of tubular damage, and its elevation has been described in human and canine cardiorenal syndrome. The aim was to evaluate the association between echocardiographic indexes and urine NGAL (uNGAL) and uNGAL normalized to urine creatinine (uNGALC) in dogs with MMVD. This is a multicentric prospective cross-sectional study. A total of 77 dogs with MMVD at different ACVIM stages were included. All dogs underwent echocardiography, serum chemistry, and urinalysis. Echocardiographic data analyzed were shortening fraction (SF), left ventricular diastolic (LVIDDn) and systolic (LVIDSn) diameters normalized for body weight, left atrium to aortic root ratio (LA/Ao), maximal (LAVMax) and minimal (LAVMin) left atrial volumes, LA stroke volume (LASV), early diastolic mitral peak velocity (EVmax), EVmax to tissue Doppler E' wave (E/E'), aortic (VTIAo) and mitralic (VTIMit) velocity time integrals and their ratio (VTIMit/VTIAo), and tricuspid regurgitation velocity (TRVmax). In the univariate analysis LASV, TRVmax, LAVMax, LVIDDn, and VTIMit/VTIAo were independent predictors of increased uNGAL and uNGALC; however, only LASV [(OR: 1.96, 95% CI: 1.16 to 3.31) P = 0.01 for NGAL, and (OR: 2.79, 95% CI: 1.50 to 5.17) P < 0.001 for NGALC] and TRVmax [(OR: 1.73, 95% CI: 1.20-2.51) P = 0.002 for NGAL, and (OR: 1.50, 95% CI: 10.07-2.10) P = 0.015 for NGALC] remained statistically significant in the multivariable analysis. Based on our results, LASV and TRVmax are associated with increased uNGAL and uNGALC. These parameters might detect dogs with MMVD at higher risk of developing kidney damage.
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Affiliation(s)
- Serena Crosara
- Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, Parma, Italy
| | - Francesca Fidanzio
- Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, Parma, Italy
| | - Stefano Oricco
- Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, Parma, Italy; Centro Veterinario Imperiese, Via Armelio 10, Imperia, Italy.
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Chiara Mazzoldi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Erika Monari
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Giovanni Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Maria Chiara Sabetti
- Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, Parma, Italy
| | - Roberta Troìa
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia, Bologna, Italy
| | - Cecilia Quintavalla
- Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, Parma, Italy
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Chetboul V, Poissonnier C, Foulex P, Alvarado MP, Trehiou-Sechi É, Saponaro V, Passavin P, Desquilbet L. Volumetric quantification identifies some left atrial dilations undetected by left atrium:aorta ratio measurements: A prospective echocardiographic study in 155 Cavalier King Charles Spaniels with and without degenerative mitral valve disease. PLoS One 2024; 19:e0300827. [PMID: 38547236 PMCID: PMC10977888 DOI: 10.1371/journal.pone.0300827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/05/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION Degenerative mitral valve disease (DMVD) is the most common canine heart disease with a high predisposition in Cavalier King Charles Spaniels (CKCSs). Mitral regurgitation related to DMVD can lead to left atrial (LA) dilation, which is associated with survival time. Left-atrial-to-aortic (LA:Ao) ratio assessed by two-dimensional echocardiography is commonly used to evaluate LA size. The objectives of this prospective observational study were therefore 1) to compare different echocardiographic methods (i.e., monoplane and biplane Simpson's methods of discs (SMOD) and area-length methods (ALM)) in evaluating LA volume (LAvol) in CKCSs, 2) to assess LA volumes according to DMVD severity and, 3) compare the ability of LAvol and LA:Ao ratio to identify LA enlargement in CKCSs with subclinical DMVD (i.e., American College of Veterinary Internal Medicine (ACVIM) stage B). MATERIALS AND METHODS 155 CKCSs, either healthy or affected by DMVD, were recruited. Variability and concordance between volumetric methods were evaluated. Values were analyzed according to 2019 ACVIM stages. RESULTS All Lin's concordance correlation coefficients regarding intra- and inter-observer variability were considered as very good to excellent. Monoplane methods and ALM produced higher values of LAvol than biplane methods and SMOD, respectively. The upper limit of normal end-systolic LAvol/body weight (LASvol/BW) was defined as 0.90 mL/kg. Left atrial volumes significantly increased with ACVIM stages. Additionally, 37% of stage B1 CKCSs demonstrated LA enlargement using LASvol/BW assessment, with significantly lower LASvol/BW values in dogs with regurgitation fraction ≤30% than in others (p<0.01). CONCLUSION In CKCSs, LAvol methods are not interchangeable. In ACVIM stage B CKCSs, LAvol quantification is more effective to detect LA enlargement than LA linear measurements.
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Affiliation(s)
- Valérie Chetboul
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
- INSERM, IMRB, Univ Paris Est Créteil, Créteil, France
| | - Camille Poissonnier
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
| | - Pierre Foulex
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
| | - Maria Paz Alvarado
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
| | - Émilie Trehiou-Sechi
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
| | - Vittorio Saponaro
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
| | - Peggy Passavin
- École Nationale Vétérinaire d’Alfort, CHUVA, Unité de Cardiologie d’Alfort (UCA), Maisons-Alfort, France
| | - Loïc Desquilbet
- INSERM, IMRB, Univ Paris Est Créteil, Créteil, France
- Department of Biostatistics and Clinical Epidemiology, École Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
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Treibert J, Friederich J, Fischer S, Küchenhoff H, Wess G. Reference intervals for various measurements of canine left atrial size and function obtained using two-dimensional and three-dimensional echocardiography. J Vet Cardiol 2024; 52:43-60. [PMID: 38428366 DOI: 10.1016/j.jvc.2024.02.005] [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: 12/07/2022] [Revised: 01/18/2024] [Accepted: 02/04/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Many canine cardiac diseases are associated with left atrial (LA) remodeling and decreased function. For accurate assessment of LA indices, large-scale and prospectively determined reference intervals are necessary. OBJECTIVES To generate reference intervals of LA size and function using two-dimensional and three-dimensional echocardiography. ANIMALS Two hundred and one healthy adult dogs. METHODS Left atrial volume was assessed in right parasternal long-axis, left apical 4-chamber and 2-chamber views using monoplane Simpson's method, two-dimensional and three-dimensional speckle tracking. Additionally, LA diameter was measured in right parasternal short-axis and long-axis views. Furthermore, LA function was determined by measuring strain and calculating LA fractional shortening and ejection fraction. All variables were tested for correlation to heart rate, age, and body weight. For LA diameter and volume, scaling exponents and prediction intervals were generated using allometric scaling. Reference intervals for LA function parameters were calculated using nonparametric methods. RESULTS Left atrial diameter and volume showed a strong correlation with body weight. The scaling exponent for LA diameter was approximately 1/3 (0.34-0.40) and approximately 1 for volume measurements (0.97-1.26). Parameters of LA function showed no clinically relevant correlation with body weight, except for two variables, which showed a mild negative correlation. No clinically relevant correlations with age or heart rate were found. CONCLUSIONS Reference intervals for linear, two-dimensional and three-dimensional measurements of LA size and function were established. The wide range of measurement methods offers the opportunity to select the appropriate reference values for LA evaluation depending on the available technical possibilities.
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Affiliation(s)
- J Treibert
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
| | - J Friederich
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
| | - S Fischer
- Statistical Consulting Unit StaBLab, LMU University, Munich, Germany
| | - H Küchenhoff
- Statistical Consulting Unit StaBLab, LMU University, Munich, Germany
| | - G Wess
- Clinic of Small Animal Medicine, LMU University, Munich, Germany.
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Tidholm A, Menciotti G, Borgarelli M. Current use of real-time three-dimensional transthoracic echocardiography in animals. J Vet Cardiol 2023; 51:97-104. [PMID: 38118235 DOI: 10.1016/j.jvc.2023.11.009] [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: 11/10/2022] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/22/2023]
Abstract
This review includes 36 studies of transthoracic real-time three-dimensional echocardiography (RT3DE) in animals. Most of these studies concern cardiac chamber quantification of the left atrium and left ventricle, in dogs. Comparisons of RT3DE and different two-dimensional echocardiographic (2DE) methods have been reported in dogs with myxomatous mitral valve disease (MMVD), dilated cardiomyopathy, and in healthy control dogs. Comparisons of RT3DE and standard reference methods have been reported in healthy control dogs. In dogs with MMVD, volumetric RT3DE measurements of left atrium do not appear to provide superior prognostic value compared with 2DE methods using Simpson's method of discs in dogs with MMVD. The major advantages of RT3DE compared to 2DE include improvements in visualization of the complex morphology of the mitral valve, the estimation of mitral valve regurgitation, and improved visualization of complex congenital cardiac abnormalities.
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Affiliation(s)
- A Tidholm
- Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden; Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
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Kim HJ, Kim J, Kim S, Kim HJ. Can cartilage intermediate layer protein 1 (CILP1) use as a novel biomarker for canine myxomatous mitral valve degeneration levels or not? BMC Vet Res 2023; 19:59. [PMID: 36882760 PMCID: PMC9990206 DOI: 10.1186/s12917-023-03583-7] [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: 09/06/2022] [Accepted: 01/20/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Myxomatous mitral valve degeneration (MMVD) is the most common degenerative heart disease in dogs and is associated with irreversible changes in the valve tissue. Although traditional cardiac biomarkers are efficient for diagnosing MMVD, there are limitations, therefore, it is important to find novel biomarkers. Cartilage intermediate layer protein 1 (CILP1), an extracellular matrix-derived protein, acts as a transforming growth factor-β antagonist and is involved in myocardial fibrosis. This study aimed to evaluate serum CILP1 levels in canines with MMVD. Dogs with MMVD were staged according to the American College of Veterinary Internal Medicine consensus guidelines. Data analysis was performed using the Mann-Whitney U test, Spearman's correlation, and receiver operating characteristic (ROC) curves. RESULTS CILP1 levels were elevated in dogs with MMVD (n = 27) compared to healthy controls (n = 8). Furthermore, results showed that CILP1 levels were significantly higher in stage C group dogs compared to healthy controls. The ROC curve of CILP1 and NT-proBNP were good predictors of MMVD, although no similarity was observed between the two. Left ventricular end-diastolic diameter normalized to the body weight (LVIDdn) and left atrial to aorta dimension (LA/Ao) showed a strong association with CILP1 levels; however, no correlation was observed between CILP1 levels and vertebral heart size (VHS) and vertebral left atrial score (VLAS). The optimal cut-off value was selected from the ROC curve and dogs were classified according to the cut-off value (1.068 ng/mL, sensitivity 51.9%, specificity 100%). Results showed a significant association of CILP1 with cardiac remodeling indicators, such as VHS, VLAS, LA/Ao, and LVIDdn. CONCLUSIONS CILP1 can be an indicator of cardiac remodeling in canines with MMVD and therefore, can be used as an MMVD biomarker.
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Affiliation(s)
- Hyeon-Jin Kim
- Department of Internal Medicine, College of Veterinary Medicine, Chonnam National University, 77 Yongbong-Ro, Buk-Gu, Gwangju, 61186, South Korea.,BK 21 Project Team, College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, South Korea
| | - Jihyun Kim
- Department of Internal Medicine, College of Veterinary Medicine, Chonnam National University, 77 Yongbong-Ro, Buk-Gu, Gwangju, 61186, South Korea.,BK 21 Project Team, College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, South Korea
| | - Soomin Kim
- Department of Internal Medicine, College of Veterinary Medicine, Chonnam National University, 77 Yongbong-Ro, Buk-Gu, Gwangju, 61186, South Korea.,BK 21 Project Team, College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, South Korea
| | - Ha-Jung Kim
- Department of Internal Medicine, College of Veterinary Medicine, Chonnam National University, 77 Yongbong-Ro, Buk-Gu, Gwangju, 61186, South Korea. .,BK 21 Project Team, College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, South Korea.
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Caivano D, Rishniw M, Colangeli G, Birettoni F, Nisini N, Porciello F. Two-dimensional echocardiographic estimates of left atrial volumes obtained from two different views in dogs are similar but not interchangeable. Vet J 2023; 293:105966. [PMID: 36801487 DOI: 10.1016/j.tvjl.2023.105966] [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: 09/09/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/21/2023]
Abstract
Left atrial (LA) volumes using a monoplane Simpson's Method of Discs (SMOD) can be obtained from the right parasternal long axis four-chamber (RPLA) or from the left apical four-chamber (LA4C) views in dogs; however, little information exists regarding the agreement of LA volume estimates using a SMOD on images obtained from LA4C and RPLA views. Therefore, we sought to examine the agreement between the two methods of obtaining LA volumes in a heterogenous population of healthy and diseased dogs. Additionally, we compared the LA volumes obtained by SMOD with estimates obtained from simple cube or sphere volume formulae. Archived echocardiographic examinations were retrieved and, where both RPLA and LA4C views were adequately recorded, included in the study. We obtained measurements from 194 dogs that were either apparently healthy (n = 80) or had various cardiac diseases (n = 114). The LA volumes of each dog was measured using a SMOD, from both views, in systole and diastole. Estimates of LA volumes obtained from simple cube or sphere volume formulae from RPLA-derived LA diameters were also calculated. We then used Limits of Agreement analysis to determine agreement between the estimates obtained with each view, and those calculated from linear dimensions. The two methods obtained by SMOD provided similar estimates for both systolic and diastolic volumes but did not agree sufficiently to be interchangeable. The LA4C view often slightly underestimated the LA volumes at small LA sizes and overestimated the LA volumes at large LA sizes compared to RPLA method, with increasing disagreement as the LA size increased. Estimates based on cube method overestimated volumes compared to both SMOD methods, whereas those based on sphere method performed reasonably. Our study suggests that monoplane volume estimates from the RPLA and LA4C views are similar but not interchangeable. Clinicians can also perform a rough estimate of LA volumes using RPLA-derived LA diameters to calculate the sphere volume.
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Affiliation(s)
- D Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia 06126, Italy.
| | - M Rishniw
- Veterinary Information Network, Davis, CA 95616, USA; Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - G Colangeli
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia 06126, Italy
| | - F Birettoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia 06126, Italy
| | - N Nisini
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia 06126, Italy
| | - F Porciello
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia 06126, Italy
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Mostafa MR, Magdi M, Al-Abdouh A, Abusnina W, Elbanna M, Abdelazeem B, Renjithal SLM, Mamas MA, Shah J. A systematic review and meta-analysis of the impact of the left atrial appendage closure on left atrial function. Clin Cardiol 2022; 45:614-621. [PMID: 35366380 PMCID: PMC9175246 DOI: 10.1002/clc.23824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/20/2022] [Indexed: 11/28/2022] Open
Abstract
Background Left atrial (LA) appendage closure (LAAC) is effective in patients with atrial fibrillation who are not candidates for long‐term anticoagulation. However, the impact of LAAC on LA function is unknown. The aim of this study is to evaluate the impact of LAAC on atrial function. Methods This meta‐analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. A search strategy was designed to utilize PubMed/Medline, EMBASE, and Google scholar for studies showing the effect of LAAC on the LA function from inception to November 20, 2021. The standardized mean difference (SMD) was calculated from the means and standard deviations. Results Of 247 studies initially identified, 8 studies comprising 260 patients were included in the final analysis. There was a significant increase in LA emptying fraction following LAAC compared with preoperative function (SMD: 0.53; 95% confidence interval [CI]: 0.04–1.01; p = .03; I2 = 75%). In contrast, there were no significant differences in LA volume (SMD: −0.07; 95% CI: −0.82–0.69; p = .86; I2 = 92%) peak atrial longitudinal strain (SMD: 0.50; 95% CI: −0.08–1.08; p = .09; I2 = 89%), peak atrial contraction strain (SMD: 0.38; 95% CI: −0.22–0.99; p = .21; I2 = 81%), strain during atrial contraction (SMD: −0.24; 95% CI: −0.61–0.13; p = .20; I2 = 0%), strain during ventricular systole (SMD: 0.47; 95% CI: −0.32–1.27; p = .24; I2 = 89%), strain during ventricular diastole (SMD: 0.09; 95% CI: −0.32–0.51; p = .66; I2 = 65%). Conclusion LAAC is associated with improvement in the left atrial emptying fraction, but did not significantly influence other parameters.
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Affiliation(s)
- Mostafa Reda Mostafa
- Department of Internal Medicine, Rochester Regional Health, Unity Hospital, Greece, New York, USA
| | - Mohamed Magdi
- Department of Internal Medicine, Rochester Regional Health, Unity Hospital, Greece, New York, USA
| | - Ahmad Al-Abdouh
- Department of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Waiel Abusnina
- Department of Cardiology, Creighton University School of Medicine, Omaha, Nebraska, USA
| | | | - Basel Abdelazeem
- Department of Medicine, McLaren Health System, Flint, Michigan, USA
| | | | - Mamas A Mamas
- Department of Cardiology, University of Manchester, Manchester, UK
| | - Jaffer Shah
- New York State Department of Health, New York, USA
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Tidholm A, Häggström J. Prognostic value of selected one-, two- and three-dimensional and Doppler echocardiographic methods to assess severity in dogs with myxomatous mitral valve disease. J Vet Cardiol 2021; 39:89-101. [PMID: 35008002 DOI: 10.1016/j.jvc.2021.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 11/18/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although challenging, predicting outcomes in dogs with myxomatous mitral valve disease (MMVD) is of importance to owners and veterinarians. Our aim was to compare the prognostic value of selected one-, two-, and three-dimensional and Doppler echocardiographic methods to predict cardiac-related and all-cause mortality in MMVD dogs. We hypothesize that three-dimensional methods would better predict prognosis than one- and two-dimensional methods. ANIMALS One-hundred thirty-eight privately-owned dogs with MMVD. MATERIALS AND METHODS Cox proportional Hazard analyses and Kaplan-Meier curves were used to investigate the predictive value of 14 variables; left atrial (LA) volume indexed to body weight (BW) measured by real-time three-dimensional echocardiography (RT3DE) and calculated using Simpson's modified method of discs (SMOD) and the area-length method; LA diameter in short-axis and long-axis to aortic in short-axis ratio, effective regurgitant orifice area indexed to body surface area measured in RT3DE en face view and calculated using four-chamber (4Ch) and two-chamber views alone or in combination; percentage increase in left ventricular end-diastolic and systolic internal diameters; fractional shortening; E wave velocity; regurgitant jet area/LA area. RESULTS All 14 variables were significantly predictive of cardiac-related mortality, and 11 were predictive of all-cause mortality. The prognosis was best predicted by LA volume/BW estimated by SMOD or RT3DE, consistently showing the highest predictive value in all analyses. CONCLUSIONS Left atrial volume calculated by SMOD showed a similar predictive value compared to RT3DE. Performing SMOD from apical 4Ch images should be considered an alternative to RT3DE for echocardiographic examinations where prognostication of disease outcome is sought.
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Affiliation(s)
- A Tidholm
- Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden; Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - J Häggström
- Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
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10
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Miki S, Nakamura K, Morita T, Osuga T, Kawamoto S, Sasaki N, Takiguchi M. Effects of intravenous administration of pimobendan on hemodynamic indices and indices of left atrial longitudinal strain derived from speckle-tracking echocardiography in healthy dogs. Am J Vet Res 2021; 82:795-801. [PMID: 34554874 DOI: 10.2460/ajvr.82.10.795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of IV administration of pimobendan on hemodynamic indices and indices of left atrial (LA) longitudinal strain by speckle-tracking echocardiography in healthy dogs. ANIMALS 6 healthy Beagles. PROCEDURES After the dogs were anesthetized, the right heart was catheterized and 2-D conventional and speckle-tracking echocardiography were performed before and after IV administration of 0.15 mg of pimobendan/kg. Speckle-tracking echocardiography was performed to assess the 3 LA phasic functions through LA deformation (longitudinal strain and strain rate) and volumetric analyses. RESULTS Pimobendan significantly increased stroke volume and cardiac output and decreased systemic vascular resistance. Pimobendan significantly improved left ventricular function assessed by the Tei index and LA booster pump function assessed by LA longitudinal strain and change in fractional volume during atrial systole. Indices of LA reservoir and conduit function were unchanged. CONCLUSIONS AND CLINICAL RELEVANCE In healthy dogs, IV administration of pimobendan improved the indices of LA booster pump function but had no effect on the indices of LA reservoir and conduit functions. Further studies are needed to validate whether these results can be extrapolated to dogs with myxomatous mitral valve disease.
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Lam C, Gavaghan BJ, Meyers FE. Radiographic quantification of left atrial size in dogs with myxomatous mitral valve disease. J Vet Intern Med 2021; 35:747-754. [PMID: 33634912 PMCID: PMC7995357 DOI: 10.1111/jvim.16073] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 11/28/2022] Open
Abstract
Background In the absence of echocardiography, identification of cardiomegaly via thoracic radiography is a necessary criterion for classification of disease severity in dogs with myxomatous mitral valve disease (MMVD). Objective Modified‐vertebral left atrial size (M‐VLAS) facilitates objective radiographic assessment of the left atrium (LA) in 2 dimensions and identifies LA enlargement more accurately than existing methods. Animals Sixty‐four dogs with various stages of MMVD and 6 control healthy dogs. Methods Retrospective case–control study. Medical records were searched for dogs with varying severity of MMVD. Modified‐vertebral left atrial size, vertebral left atrial size (VLAS), vertebral heart size (VHS), and radiographic left atrial dimension (RLAD) were measured from thoracic radiographs and compared with echocardiographically derived measurements. Results Positive correlation to LA/Ao was identified for M‐VLAS (r = 0.77, P < .001), VLAS (r = 0.76, P < .001), RLAD (r = 0.75, P < .001), and VHS (r = 0.67, P < .001). Receiver operating characteristic analyzes provided an area under the curve of 0.97 (95% CI, 0.94‐1.00) for M‐VLAS, which was superior to VHS (0.90, 95% CI, 0.94‐1.00, P = .03) in identifying dogs with LA/Ao ≥1.6. A cut‐off value of ≥3.4 vertebrae using M‐VLAS provided 92.7% sensitivity and 93.1% specificity in predicting LA enlargement. Conclusions and clinical importance M‐VLAS, which is superior to VHS, offers an accurate and repeatable way to radiographically identify LA enlargement in dogs with MMVD.
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Affiliation(s)
- Christopher Lam
- Cardiology Service, Veterinary Specialist Services, Brisbane, Queensland, Australia
| | - Brad J Gavaghan
- Cardiology Service, Veterinary Specialist Services, Brisbane, Queensland, Australia
| | - Fiona E Meyers
- Cardiology Service, Veterinary Specialist Services, Brisbane, Queensland, Australia
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12
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Levent P, Kocaturk M, Akgun E, Saril A, Cevik O, Baykal AT, Tanaka R, Ceron JJ, Yilmaz Z. Platelet proteome changes in dogs with congestive heart failure. BMC Vet Res 2020; 16:466. [PMID: 33256720 PMCID: PMC7708215 DOI: 10.1186/s12917-020-02692-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Platelets play a central role in the development of cardiovascular diseases and changes in their proteins are involved in the pathophysiology of heart diseases in humans. There is lack of knowledge about the possible role of platelets in congestive heart failure (CHF) in dogs. Thus, this study aimed to investigate the changes in global platelet proteomes in dogs with CHF, to clarify the possible role of platelets in the physiopathology of this disease. Healthy-dogs (n = 10) and dogs with acute CHF due to myxomatous mitral valve disease (MMVD, n = 10) were used. Acute CHF was defined based on the clinical (increased respiratory rate or difficulty breathing) and radiographic findings of pulmonary edema. Dogs Blood samples were collected into tubes with acid-citrate-dextrose, and platelet-pellets were obtained by centrifuge and washing steps. Platelet-proteomes were identified using LC-MS based label-free differential proteome expression analysis method and matched according to protein database for Canis lupus familiaris. RESULTS Totally 104 different proteins were identified in the platelets of the dogs being 4 out of them were significantly up-regulated and 6 down-regulated in acute CHF dogs. Guanine-nucleotide-binding protein, apolipoproteins (A-II and C-III) and clusterin levels increased, but CXC-motif-chemokine-10, cytochrome-C-oxidase-subunit-2, cathepsin-D, serine/threonine-protein-phosphatase-PP1-gamma-catalytic-subunit, creatine-kinase-B-type and myotrophin levels decreased in acute CHF dogs. These proteins are associated with several molecular functions, biological processes, signaling systems and immune-inflammatory responses. CONCLUSION This study describes by first time the changes in the protein composition in platelets of dogs with acute CHF due to MMVD. Our findings provide a resource for increase the knowledge about the proteome of canine platelets and their roles in CHF caused by MMVD and could be a tool for further investigations about the prevention and treatment of this disease.
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Affiliation(s)
- Pinar Levent
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey
| | - Meriç Kocaturk
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey
| | - Emel Akgun
- Department of Medical Biochemistry, Acibadem University School of Medicine, Istanbul, Turkey
| | - Ahmet Saril
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey
| | - Ozge Cevik
- Department of Basic Science, Medical Biochemistry, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Ahmet Tarik Baykal
- Department of Medical Biochemistry, Acibadem University School of Medicine, Istanbul, Turkey
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, 183-8509, Japan
| | - Jose Joaquin Ceron
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, University of Murcia, 30100, Murcia, Spain
| | - Zeki Yilmaz
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey.
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13
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Rubio CP, Saril A, Kocaturk M, Tanaka R, Koch J, Ceron JJ, Yilmaz Z. Changes of inflammatory and oxidative stress biomarkers in dogs with different stages of heart failure. BMC Vet Res 2020; 16:433. [PMID: 33167963 PMCID: PMC7654180 DOI: 10.1186/s12917-020-02650-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/28/2020] [Indexed: 12/22/2022] Open
Abstract
Background Heart failure (HF) is associated with changes in inflammatory and oxidative stress biomarkers. This study aimed to evaluate the changes of a panel of inflammatory and oxidative stress biomarkers in dogs with different stages of HF and its relation with the severity of the disease and echocardiographic changes. A total of 29 dogs with HF as a result of myxomatous mitral valve degeneration or dilated cardiomyopathy were included and classified as stage-A (healthy), B (asymptomatic dogs), C (symptomatic dogs) and D (dogs with end-stage HF) according to the ACVIM staging system. In these dogs an ecnhocardiographic examination was performed and cytokines, and inflammatory and oxidative stress markers were evaluated in serum. Results KC-like was significantly increased in dogs of stage-C (P < 0.01) and -D (P < 0.05) compared with stage-A and -B. Stage-D dogs showed significantly higher serum CRP and Hp (P < 0.05) but lower serum antioxidant capacity (PON1, TEAC, CUPRAC, and thiol) compared to stage-A and -B (P < 0.05). After the treatment, serum levels of CRP, Hp and KC-like decreased and serum antioxidant levels increased compared to their pre-treatment values. Left ventricular dimension and LA/Ao ratio correlated positively with CRP, MCP-1, and KC-like but negatively with PON1, GM-CSF, IL-7 and antioxidant biomarkers (P < 0.01). Conclusion Our results showed that dogs with advanced HF show increases in positive acute-phase proteins and selected inflammatory cytokines such as KC-like, and decreases in antioxidant biomarkers, indicating that inflammation and oxidative stress act as collaborative partners in the pathogenesis of HF. Some of these biomarkers of inflammation and oxidative stress could have the potential to be biomarkers to monitor the severity of the disease and the effect of treatment.
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Affiliation(s)
- Camila Peres Rubio
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, University of Murcia, 30100, Murcia, Spain
| | - Ahmet Saril
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey
| | - Meriç Kocaturk
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, 183-8509, Japan
| | - Jorgen Koch
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg - Copenhagen, Denmark
| | - Jose Joaquin Ceron
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, University of Murcia, 30100, Murcia, Spain
| | - Zeki Yilmaz
- Department of Internal Medicine, Faculty of Veterinary Medicine, Bursa Uludag University, 16059, Bursa, Turkey.
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14
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Ijuin S, Hamadanchi A, Haertel F, Baez L, Schulze PC, Franz M, Moebius-Winkler S. Improvement in Left Atrial Strain among Patients Undergoing Percutaneous Left Atrial Appendage Closure. J Cardiovasc Echogr 2020; 30:15-21. [PMID: 32766101 PMCID: PMC7307626 DOI: 10.4103/jcecho.jcecho_42_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/15/2020] [Accepted: 02/25/2020] [Indexed: 11/04/2022] Open
Abstract
Background Various clinical trials provide evidence about the safety, effectiveness, and therapeutic success of percutaneous left atrial appendage closure (LAAC) using various occlusion devices. These devices are foreign materials implanted into the left atrium and may deteriorate left atrial (LA) function. The aim of this study was to evaluate the change in transesophageal echocardiography (TEE)-derived LA strain after LAAC. Methods and Results The study included 95 patients (age: 75 ± 6.7 years, 67% male) who underwent percutaneous LAAC. LA strain was evaluated at three different time intervals by TEE (baseline, 45 days, and 180 days after the procedure). All data were analyzed using the software Image-Arena (TomTec®). Seventy patients had atrial fibrillation, whereas 25 were in sinus rhythm at baseline and during follow-up. Analysis was performed for peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS) from segments of the lateral wall in mid-esophageal four-chamber view. PACS was obtained in patients with sinus rhythm during examinations. Compared to baseline, PALS increased at 45 days after the procedure (12.4% ± 8.4% at baseline vs. 16.0% ± 10.6% after 45 days, P = 0.001) and remained stable from 45 days to 180 days after procedure (13.8% ± 9.1% after 45 days vs. 17.2% ± 12.6% after 180 days, P = 0.092). Similarly, PACS increased at 45 days after the procedure (5.8% ± 3.9% at baseline vs. 10.6% ± 7.6% after 45 days, P = 0.001) and remained stable from 45 days to 180 days after the procedure (7.6% ± 4.5% after 45 days vs. 7.9% ± 3.1% after 180 days, P = 0.876). Conclusions Our study demonstrated for the first time the improvement in TEE-derived LA strain following LAAC within 45 days of implantation. The findings suggest improved LA function following LAAC.
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Affiliation(s)
- Shun Ijuin
- Department of Internal Medicine I, Jena University Hospital, Jena, Germany.,Department of Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ali Hamadanchi
- Department of Internal Medicine I, Jena University Hospital, Jena, Germany
| | - Franz Haertel
- Department of Internal Medicine I, Jena University Hospital, Jena, Germany
| | - Laura Baez
- Department of Internal Medicine I, Jena University Hospital, Jena, Germany
| | | | - Marcus Franz
- Department of Internal Medicine I, Jena University Hospital, Jena, Germany
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15
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Morgan KRS, Monteith G, Raheb S, Colpitts M, Fonfara S. Echocardiographic parameters for the assessment of congestive heart failure in dogs with myxomatous mitral valve disease and moderate to severe mitral regurgitation. Vet J 2020; 263:105518. [PMID: 32928487 DOI: 10.1016/j.tvjl.2020.105518] [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: 12/24/2019] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
The objective of this study was to evaluate the influence of congestive heart failure (CHF) on echocardiographic variables in dogs with moderate or severe mitral valve regurgitation (MR) secondary to myxomatous mitral valve disease (MMVD). The secondary objective was to investigate the preliminary use of left ventricular early inflow-outflow index (LVEIO) and L-waves as indicators of CHF. Forty-five dogs with moderate or severe MR without (n = 23) or with (n = 22) CHF were retrospectively included. Echocardiographic variables of elevated left ventricular (LV) filling pressures and cardiac function, LVEIO and the presence of L-waves were obtained and statistically compared between the two groups. On general linear model analysis, mitral inflow peak E-wave velocity, E:A ratio, ratio of E to isovolumic relaxation time (IVRT) and LVEIO were increased, while left atrium (LA) fractional shortening was reduced, in dogs with CHF. Peak E-wave velocity, peak A-wave velocity, E:A ratio, LA minimum diameter, LA diameter before the P-wave, LA fractional shortening and LVEIO were found to be predictive of CHF. The absence of L-waves indicated a reduced risk of CHF. Several echocardiographic variables may be useful in identifying elevated LV filling pressures, consistent with CHF, in dogs with moderate and severe MR. Left ventricular early inflow-outflow index and L-waves might be of interest as clinical and prognostic markers in dogs with MMVD and require further investigation.
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Affiliation(s)
- K R S Morgan
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, ON N1G 2W1 Canada
| | - G Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, ON N1G 2W1 Canada
| | - S Raheb
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, ON N1G 2W1 Canada
| | - M Colpitts
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, ON N1G 2W1 Canada
| | - S Fonfara
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, ON N1G 2W1 Canada.
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16
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Hsue W, Visser LC. Reproducibility of echocardiographic indices of left atrial size in dogs with subclinical myxomatous mitral valve disease. J Vet Intern Med 2020; 34:1779-1786. [PMID: 32644291 PMCID: PMC7517857 DOI: 10.1111/jvim.15850] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 11/27/2022] Open
Abstract
Background Reliability of echocardiographic measurements of left atrial (LA) size, an important marker of disease severity, has not been reported in dogs with myxomatous mitral valve disease (MMVD). Objectives To define and compare reliability of left atrial dimension/diameter (LAD), LAD indexed to aortic valve diameter (LAD/AoD), left atrium‐to‐aortic root ratio (LA/Ao), left atrial volume acquired from a right parasternal long‐axis (LAVRPLx), and left apical view (LAVLAP) in dogs with subclinical MMVD. Animals Nine dogs with subclinical MMVD. Methods Prospective reproducibility study. Dogs underwent 12 echocardiographic examinations by 2 operators on the mornings and afternoons of 3 nonconsecutive days within 1 week. Reliability (measurement variability) was quantified using coefficients of variation (CV) and 95% repeatability/reproducibility coefficients (95% RC). A mixed‐model analysis of variance (ANOVA) was used to determine if time of day, day, and operator were significant sources of variability for each index. Results Linear measurements (LAD, LAD/AoD, and LA/Ao) exhibited less within‐day, between‐day, and interoperator variability (CVs, 3.9%‐12.5%) than did volume estimate measurements (LAVRPLx and LAVLAP; CVs, 11.8%‐17.9%). Of the linear measurements, LA/Ao exhibited greater variability (CVs, 9.9%‐12.5%) compared to LAD and LAD/AoD (CVs, 3.9%‐4.9%). Operator was a significant (P = .005) source of variability for LA/Ao. Conclusions and Clinical Importance Compared to other linear measurements, LA/Ao was the least reproducible and most dependent on operator. The 95% RC for each LA size index are provided to help identify clinically relevant changes (beyond intraoperator or interoperator variability) during serial echocardiographic examinations of dogs with subclinical MMVD.
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Affiliation(s)
- Weihow Hsue
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Lance C Visser
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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17
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Tidholm A, Bodegård-Westling A, Höglund K, Häggström J, Ljungvall I. Comparison between real-time 3-dimensional and 2-dimensional biplane echocardiographic assessment of left atrial volumes in dogs with myxomatous mitral valve disease. J Vet Intern Med 2019; 33:455-461. [PMID: 30628129 PMCID: PMC6430916 DOI: 10.1111/jvim.15408] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 12/05/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Assessment of left atrial (LA) size is important in medical decision making and prognostication in dogs with myxomatous mitral valve disease (MMVD). Real-time 3-dimensional (RT3DE) and 2-dimensional echocardiographic (2DE) methods may be used to assess LA size. OBJECTIVES To compare measured LA volumes obtained by RT3DE with those calculated by biplane Simpson's modified method of discs (SMOD) and the area-length method (ALM) using the same RT3DE acquisition with the same timing. ANIMALS One hundred twenty-one privately owned dogs with naturally occurring MMVD. METHODS Prospective observational study comparing LA volumes indexed to body weight using RT3DE and 2DE-based biplane SMOD and ALM. Agreement between methods was evaluated using Bland-Altman plots and linear regression analyses. RESULTS Estimations of LA volume using SMOD or ALM did not show good agreement with RT3DE-derived measurements. Absolute differences between methods increased with increasing LA volume, but SMOD underestimated whereas ALM overestimated calculated volumes compared to RT3DE-derived measurements. The difference in LA volume between RT3DE and the biplane methods showed a systematic underestimation of 7% for SMOD and a systematic overestimation of 24% for ALM. Comparison of LA volumes obtained by SMOD and ALM did not show good agreement. The ALM yielded 30% larger LA volumes compared to SMOD. CONCLUSION AND CLINICAL IMPORTANCE In comparison with RT3DE, SMOD systematically underestimated whereas ALM systematically overestimated LA volumes in dogs with MMVD. Because the systematic difference between RT3DE and SMOD was only 7%, SMOD might be considered the method of choice.
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Affiliation(s)
- Anna Tidholm
- Anicura Albano Animal Hospital, Danderyd, Sweden.,Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - Katja Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
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18
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Caivano D, Rishniw M, Birettoni F, Patata V, Giorgi M, Porciello F. Left atrial deformation and phasic function determined by two-dimensional speckle-tracking echocardiography in dogs with myxomatous mitral valve disease. J Vet Cardiol 2018; 20:102-114. [DOI: 10.1016/j.jvc.2018.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 11/14/2017] [Accepted: 01/16/2018] [Indexed: 01/23/2023]
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19
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Dickson D, Caivano D, Matos JN, Summerfield N, Rishniw M. Two-dimensional echocardiographic estimates of left atrial function in healthy dogs and dogs with myxomatous mitral valve disease. J Vet Cardiol 2017; 19:469-479. [PMID: 29111284 DOI: 10.1016/j.jvc.2017.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 08/28/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To provide reference intervals for 2-dimensional linear and area-based estimates of left atrial (LA) function in healthy dogs and to evaluate the ability of estimates of LA function to differentiate dogs with subclinical myxomatous mitral valve disease (MMVD) and similarly affected dogs with congestive heart failure (CHF). ANIMALS Fifty-two healthy adult dogs, 88 dogs with MMVD of varying severity. METHODS Linear and area measurements from 2-dimensional echocardiographs in both right parasternal long and short axis views optimized for the left atrium were used to derive estimates of LA active emptying fraction, passive emptying fraction, expansion index, and total fractional emptying. Differences for each estimate were compared between healthy and MMVD dogs (based on ACVIM classification), and between MMVD dogs with subclinical disease and CHF that had similar LA dimensions. Diagnostic utility at identifying CHF was examined for dogs with subclinical MMVD and CHF. Relationships with bodyweight were assessed. RESULTS All estimates of LA function decreased with increasing ACVIM stage of mitral valve disease (p<0.05) and showed negative relationships with increasing LA size (all r2 values < 0.2), except for LA passive emptying fraction, which did not differ or correlate with LA size (p=0.4). However, no index of LA function identified CHF better than measurements of LA size. Total LA fractional emptying and expansion index showed modest negative correlations with bodyweight. CONCLUSIONS Estimates of LA function worsen with worsening MMVD but fail to discriminate dogs with CHF from those with subclinical MMVD any better than simple estimates of LA size.
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Affiliation(s)
| | - Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy.
| | - Jose Novo Matos
- Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
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20
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Menciotti G, Borgarelli M. Review of Diagnostic and Therapeutic Approach to Canine Myxomatous Mitral Valve Disease. Vet Sci 2017; 4:vetsci4040047. [PMID: 29056705 PMCID: PMC5753627 DOI: 10.3390/vetsci4040047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/09/2017] [Accepted: 09/20/2017] [Indexed: 01/11/2023] Open
Abstract
The most common heart disease that affects dogs is myxomatous mitral valve disease. In this article, we review the current diagnostic and therapeutic approaches to this disease, and we also present some of the latest technological advancements in this field.
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Affiliation(s)
- Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
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