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Maffei A, Pariaut R, Perego M, Santilli RA. Use of combined cutting balloon and high-pressure balloon technique for the treatment of double-chambered right ventricle or primary infundibular stenosis: a case series. J Vet Cardiol 2024; 53:6-12. [PMID: 38555707 DOI: 10.1016/j.jvc.2024.01.003] [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: 09/20/2023] [Revised: 12/18/2023] [Accepted: 01/05/2024] [Indexed: 04/02/2024]
Abstract
Five dogs and two cats with a diagnosis of double-chambered right ventricle or primary infundibular stenosis were referred to undergo a combined cutting balloon and high-pressure balloon technique. At admission five cases were asymptomatic, one had a history of syncope and one had signs of right-sided congestive heart failure. Each patient underwent a complete transthoracic echocardiogram, thoracic radiographs, an angiogram and the combined interventional procedure. Median diameter of the right mid-ventricular stenosis was 4 mm (range 2-8.7 mm) in dogs, and it measured 1.9 and 2 mm in cats. Under general anesthesia initial dilation with an 8-mm × 2-cm cutting balloon was performed from a left external jugular vein approach followed by dilation with a high-pressure balloon (1.5:1 balloon diameter-right outflow tract diameter ratio). In one dog and the two cats the procedure was not completed due to technical issues. In the other four dogs the median intracavitary proximal chamber pressure decreased from 100 mmHg (range 70-150 mmHg) before the procedure to 57 mmHg (range 45-70 mmHg) post-dilation. Long-term follow-up (from six months to two years) showed complete or partial reverse remodeling of the proximal chamber with a median residual pressure gradient below 80 mmHg (range 46-75 mmHg) for all four dogs. This case series shows that this procedure should be considered in dogs with right ventricular outflow tract obstruction. In cats, the procedure might be feasible, if additional guidewire inventory were available.
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Affiliation(s)
- A Maffei
- Clinica Veterinaria Malpensa, AniCura, Viale Marconi 27, 21017 Samarate, Varese, Italy
| | - R Pariaut
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, 14853, Ithaca, NY, USA
| | - M Perego
- Clinica Veterinaria Malpensa, AniCura, Viale Marconi 27, 21017 Samarate, Varese, Italy
| | - R A Santilli
- Clinica Veterinaria Malpensa, AniCura, Viale Marconi 27, 21017 Samarate, Varese, Italy; Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, 14853, Ithaca, NY, USA.
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Bagardi M, Ghilardi S, Minozzi G, Fusi E, Locatelli C, Ferrari PL, Drago G, Polli M, Lorenzi E, Zanchi F, Brambilla PG. Study of correlations between serum taurine, thyroid hormones and echocardiographic parameters of systolic function in clinically healthy Golden retrievers fed with commercial diet. PLoS One 2024; 19:e0297811. [PMID: 38753635 PMCID: PMC11098416 DOI: 10.1371/journal.pone.0297811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
Taurine deficiency predisposes to the development of nutritional dilated cardiomyopathy and is widespread in dogs fed with non-traditional diets. However, Golden retrievers show lower plasma taurine concentration and an impaired systolic function compared to breeds of the same size and morphotype. For these reasons, it can be difficult to classify a subject from a cardiological point of view, with the risk of considering as pathological characteristics that can be completely normal in this breed. This is a cross-sectional multicenter study. The aims were 1) to identify breed-specific range of serum taurine concentration, 2) to describe a correlation between serum taurine concentration and echocardiographic parameters of systolic function in clinically healthy Golden retrievers fed with traditional diet, 3) to identify a correlation between thyroid hormones, serum taurine concentration and echocardiographic indices. Sixty clinically healthy Golden retrievers (33% males, 67% females) were included. Fifty-three dogs were fed with traditional diets and their range of serum taurine concentration was 398.2 (31.8-430) nmol/ml. Serum taurine concentration was found to be negatively correlated to systolic internal diameter of the left ventricle and systolic and diastolic left ventricular indices and volumes obtained with different methods, whereas was positively correlated to the left ventricle ejection and shortening fractions but difference was not statistically significative. A weak but significant correlation between serum taurine and T4 was demonstrated. Serum taurine median values in dogs with normal systolic function were higher than in dogs with impaired systolic function. A cut-off of serum taurine concentration of 140.6 nmol/ml had a moderate sensitivity and specificity in the identification of an impaired left ventricular systolic function (AUC 0.6, Se 78%, Sp 44%). This study showed that the median serum taurine concentration was significantly lower in dogs with impaired systolic function. Therefore, echocardiographic monitoring is recommended in all dogs with serum taurine concentration lower than 140.6 nmol/ml.
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Affiliation(s)
- Mara Bagardi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
- Cardiology Unit, Anicura Clinica Veterinaria Malpensa, Samarate, VA, Italy
| | - Sara Ghilardi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Giulietta Minozzi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Eleonora Fusi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Chiara Locatelli
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | | | - Giulia Drago
- Cardiology Unit, Anicura Clinica Veterinaria Orobica, Bergamo, Italy
| | - Michele Polli
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Elisa Lorenzi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Francesca Zanchi
- Department of veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
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Lekane M, Burnotte P, Gommeren K, Mc Entee K, Merveille AC. Left ventricular eccentricity index to assess precapillary pulmonary hypertension in dogs. J Vet Cardiol 2023; 51:220-231. [PMID: 38246109 DOI: 10.1016/j.jvc.2023.12.003] [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: 04/02/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Interventricular septal flattening, frequently present in pulmonary hypertension (PH) can be quantified by the left ventricular eccentricity index (EI) measured at end-diastole (EId), end-systole (EIs) and at maximal septal flattening (EIm). In humans, EI correlates with invasive pulmonary arterial pressure. The aim of this study was to evaluate if EI correlates with parameters of right heart remodeling (RHR) and if EI is a quantitative marker of PH in dogs. MATERIALS AND METHODS Left ventricular eccentricity indices were retrospectively measured in four groups (no, mild, moderate and severe PH) with interpretable tricuspid and/or pulmonary regurgitation. RESULTS Ninety-seven dogs were included, with no (n = 29), mild (n = 13), moderate (n = 25) and severe (n = 30) PH. The intra- and inter-observer variability for EI measurements ranged from 2 % to 11 %. All EI were significantly elevated in severe compared to no, mild and moderate PH (P < 0.0005). In the moderate group, EIs and EIm were higher compared to the no PH group (P < 0.01). Tricuspid and pulmonary regurgitation pressure gradients and RHR parameters correlated with EId, EIs and EIm in all groups. Optimal cut-off values discriminating moderate and severe PH from no and mild PH were 1.24 (Sensitivity (Se) 60 %; Specificity (Sp) 90 %) for EId, 1.34 (Se 67 %; Sp 95 %) for EIs and 1.37 (Se 76 %; Sp 83 %) for EIm. CONCLUSIONS Left ventricular eccentricity indices are reproducible echocardiographic variables increasing with severity of PH. Dogs with moderate and severe PH can be discriminated from dogs with no or mild PH using EIs and EIm.
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Affiliation(s)
- M Lekane
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium.
| | - P Burnotte
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium
| | - K Gommeren
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium
| | - K Mc Entee
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, ULB, Route de Lennik, 808, 1070 Bruxelles, Belgium
| | - A-C Merveille
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium
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Wiegel PS, Nolte I, Mach R, Freise F, Bach JP. Reference ranges for standard-echocardiography in pugs and impact of clinical severity of Brachycephalic Obstructive Airway Syndrome (BOAS) on echocardiographic parameters. BMC Vet Res 2022; 18:282. [PMID: 35854376 PMCID: PMC9297600 DOI: 10.1186/s12917-022-03348-8] [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: 11/10/2021] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Echocardiographic measurements may be influenced by breed-specific characteristics. Therefore, this study aims to establish reference values for standard echocardiographic measurements in pugs by investigating the influence of age, sex, heart rate, body weight and Brachycephalic Obstructive Airway Syndrome (BOAS). Sixty-two privately owned pugs underwent physical examination, blood sample collection, non-invasive blood pressure measurements and echocardiography. Influences of independent variables on echocardiographic measurements were examined using a multiple linear regression analysis model. For the entire study population, 95% prediction intervals were generated. Further, reference ranges for subcategories of clinical severities of BOAS were provided. Selected echocardiographic measurements of pugs were compared to reference values of previous studies generated from various breeds. RESULTS In the study, a total of fifty-one privately owned pugs aged between two and 10 years were included for establishing reference ranges. Mainly body weight, but also age, sex and heart rate had influence on several echocardiographic parameters. The clinical grading of BOAS was conducted in 42 pugs. Except for pulmonic peak velocity (Pvel), which declined with increasing severity of BOAS, clinical symptoms of upper airway disease did not have significant impact on echocardiographic measurement results. Significant deviations, however, of left ventricular (LV) internal dimension (LVID), interventricular septum (IVS), LV posterior wall (LVPW), and tricuspid annular plane systolic motion excursion (TAPSE) compared to interbreed reference values were observed. CONCLUSIONS Breed-specific reference ranges for echocardiographic values with special regard to BOAS are provided to enable a more accurate assessment of cardiac health in pugs.
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Affiliation(s)
- Pia Saskia Wiegel
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Ingo Nolte
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Rebekka Mach
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Fritjof Freise
- Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Bünteweg 2, 30559, Hannover, Germany
| | - Jan-Peter Bach
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
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Suzuki R, Yuchi Y, Saito T, Teshima T, Matsumoto H, Koyama H. Investigation of Beraprost Sodium on Cardiac Function and Hemodynamics in Canine Models of Chronic Pulmonary Hypertension. Front Vet Sci 2022; 9:876178. [PMID: 35498754 PMCID: PMC9048895 DOI: 10.3389/fvets.2022.876178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/21/2022] [Indexed: 01/02/2023] Open
Abstract
Pulmonary hypertension (PH) is a life-threatening disease in dogs characterized by increased pulmonary arterial pressure (PAP) and/or pulmonary vascular resistance. No study has evaluated the utility of Beraprost sodium (BPS) in dogs with PH. This study aimed to evaluate the effect of BPS on cardiac function and hemodynamics and examine the optimal dose of BPS in canine models of chronic embolic PH. In this prospective crossover study, three doses of BPS (5, 15, and 25 μg/kg, twice a day) were examined in eight canine models of chronic embolic PH. All model dogs underwent invasive PAP measurement, echocardiography, and non-invasive systemic blood pressure measurement before and after continuous administration of oral BPS for 1 week. No side effects of BPS were observed in any dog during the study. All doses of BPS significantly decreased systolic PAP and pulmonary vascular impedance. Additionally, systemic vascular impedance significantly decreased with 15 and 25 μg/kg of BPS. The right ventricular stroke volume and longitudinal strain significantly decreased with all doses of BPS. The left ventricular stroke volume and circumferential strain decreased with 15 μg/kg BPS. BPS was well-tolerated in this study. A dose-dependent vasodilating effect on pulmonary vessels was observed in canine models of chronic PH. Additionally, 15 μg/kg BPS showed a balanced vasodilating effect on systemic and pulmonary vessels. Furthermore, with a decrease in systemic and pulmonary vascular impedance, the left and right ventricular functions were significantly improved. Our results suggest that BPS may be useful in the treatment of canine PH.
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Yuchi Y, Suzuki R, Teshima T, Matsumoto H, Koyama H. Investigation of the influence of manual ventilation-controlled respiration on right ventricular pressure-volume loops and echocardiographic variables in healthy anesthetized dogs. Am J Vet Res 2021; 82:865-871. [PMID: 34669489 DOI: 10.2460/ajvr.82.11.865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the influence of manual ventilation-controlled respiration on right ventricular (RV) pressure-volume loop-derived and echocardiographic variables in dogs. ANIMALS 8 healthy, anesthetized Beagles. PROCEDURES In a prospective experimental study, pressure-volume catheters were percutaneously inserted into the right ventricle of each dog, and manual ventilation was performed; RV pressure-volume loop (hemodynamic) data and conventional echocardiographic variables were assessed. Two-dimensional speckle tracking echocardiography-derived RV strain (RVS) and RV systolic strain rate (RVSR) were obtained with RV free wall-only analysis (free wall) and RV global analysis (RVGA; interventricular septum). Variables were compared between end-inspiratory and end-expiratory phases of respiration by statistical methods. Multiple regression analysis was used to assess associations between selected hemodynamic and echocardiographic variables. RESULTS The RV pressure significantly increased, and RV volume, stroke volume, tricuspid annular plane systolic excursion, RV fractional area change, peak myocardial systolic velocity of the lateral tricuspid annulus, and RV free wall only-assessed RVS and RVSR significantly decreased in the inspiratory phase, compared with the expiratory phase. There were no significant differences in end-systolic elastance or RVGA-assessed RVS or RVSR between respiratory phases. The RVGA-assessed RVSR was significantly associated with stroke volume and end-systolic elastance. CONCLUSIONS AND CLINICAL RELEVANCE Specific RV echocardiographic variables were significantly affected by respiration. In contrast, RVS and RVSR determined with RVGA were not affected by respiration and were associated with hemodynamic indicators of RV contractility.
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Affiliation(s)
- Yunosuke Yuchi
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Ryohei Suzuki
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Takahiro Teshima
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Hirotaka Matsumoto
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Hidekazu Koyama
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
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Vatne L, Dickson D, Tidholm A, Caivano D, Rishniw M. The effects of activity, body weight, sex and age on echocardiographic values in English setter dogs. J Vet Cardiol 2021; 37:26-41. [PMID: 34517274 DOI: 10.1016/j.jvc.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Breed-specific reference intervals improve echocardiographic interpretation and thereby reduce misdiagnoses, especially in athletic breeds. OBJECTIVES The objectives of the study were to examine transthoracic echocardiographic values in healthy adult English setter dogs and determine the effects of activity, body weight, sex and age on these values. ANIMALS, MATERIALS AND METHODS One hundred and one adult English setter dogs, recruited from local veterinary clinics and from the Norwegian English setter club, underwent routine transthoracic echocardiography. The population was stratified into two groups based on the reported level of activity. The effects of activity level, body weight, sex and age on echocardiographic variables were examined. Results were compared with published data from other breeds and from a pre-existing species-wide allometric model. RESULTS Of the 100 dogs between 19 months and 10 years of age included in the study, 72 were reported as very active and 28 as less active. Echocardiographic intervals were calculated for body size-independent echocardiographic variables. The upper limits of the intervals for left-atrial-to-aortic ratios and normalised left ventricular volumes exceeded those of various, previously published studies of other breeds. Normalised left ventricular dimensions exceeded published allometric 95th percentile upper reference values in 13% of dogs in diastole and 32% of dogs in systole. More active dogs had larger cardiac dimensions than less active dogs; however, the activity level did not predict echocardiographic variables when included in a multiple regression model. CONCLUSIONS The study provides breed specific transthoracic echocardiographic values for English setter dogs, thereby contributing to improve diagnostic assessment of cardiac health in this breed.
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Affiliation(s)
- L Vatne
- AniCura Oslo Animal Hospital, Hoffsveien 70C, 0377 Oslo, Norway.
| | | | - A Tidholm
- AniCura Albano Animal Hospital, Rinkebyvagan 21B, 182 36 Danderyd, Sweden
| | - D Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - M Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
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Yuchi Y, Suzuki R, Kanno H, Teshima T, Matsumoto H, Koyama H. Right Ventricular Myocardial Adaptation Assessed by Two-Dimensional Speckle Tracking Echocardiography in Canine Models of Chronic Pulmonary Hypertension. Front Vet Sci 2021; 8:727155. [PMID: 34485446 PMCID: PMC8415444 DOI: 10.3389/fvets.2021.727155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pulmonary hypertension (PH) is a life-threatening disease in dogs characterized by an increase in pulmonary arterial pressure (PAP) and/or pulmonary vascular resistance. Right ventricle adapts to its pressure overload through various right ventricular (RV) compensative mechanisms: adaptive and maladaptive remodeling. The former is characterized by concentric hypertrophy and increased compensatory myocardial contractility, whereas the latter is distinguished by eccentric hypertrophy associated with impaired myocardial function. Objectives: To evaluate the RV adaptation associated with the increase of PAP using two-dimensional speckle tracking echocardiography. Animals: Seven experimentally induced PH models. Methods: Dogs were anesthetized and then a pulmonary artery catheter was placed via the right jugular vein. Canine models of PH were induced by the repeated injection of microspheres through the catheter and monitored pulmonary artery pressure. Dogs were performed echocardiography and hemodynamic measurements in a conscious state when baseline and systolic PAP (sPAP) rose to 30, 40, 50 mmHg, and chronic phase. The chronic phase was defined that the sPAP was maintained at 50 mmHg or more for 4 weeks without injection of microspheres. Results: Pulmonary artery to aortic diameter ratio, RV area, end-diastolic RV wall thickness, and RV myocardial performance index were significantly increased in the chronic phase compared with that in the baseline. Tricuspid annular plane systolic excursion was significantly decreased in the chronic phase compared with that in the baseline. The RV longitudinal strain was significantly decreased in the sPAP30 phase, increased in the sPAP40 and sPAP50 phases, and decreased in the chronic phase. Conclusions: Changes in two-dimensional speckle tracking echocardiography-derived RV longitudinal strain might reflect the intrinsic RV myocardial contractility during the PH progression, which could not be detected by conventional echocardiographic parameters.
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Affiliation(s)
- Yunosuke Yuchi
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Ryohei Suzuki
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Haruka Kanno
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takahiro Teshima
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hirotaka Matsumoto
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hidekazu Koyama
- Laboratory of Veterinary Internal Medicine, Faculty of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Japan
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Ware WA, Cheney AB, Murphy S. Biventricular Pulsus Alternans in a Dog with Pulmonic Stenosis and Sepsis. CASE 2021; 5:105-109. [PMID: 33937597 PMCID: PMC8071959 DOI: 10.1016/j.case.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pulsus alternans is characterized by beat-to-beat variability in cardiac contractile strength. Besides severe LV failure, hypovolemia and tachycardia can provoke pulsus alternans. Right ventricular or biventricular alternans is reported only sporadically in people. The first biventricular pulsus alternans in the veterinary clinical literature is presented.
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Baron Toaldo M, Glaus T, Campagna I, Novo Matos J, Dennler M. Echocardiographic assessment of right ventricular systolic function in healthy Beagle dogs compared to high field cardiac magnetic resonance imaging. Vet J 2021; 271:105653. [PMID: 33840484 DOI: 10.1016/j.tvjl.2021.105653] [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: 10/12/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Abstract
Ten healthy Beagle dogs were used to compare selected echocardiographic parameters of right ventricular (RV) systolic function with high field cardiac magnetic resonance imaging (MRI). All dogs underwent complete transthoracic echocardiography before and during anesthesia, as well as cardiac MRI with determination of morphology-based ejection fraction, and phase contrast angiography-derived stroke volume. A correlation analysis was carried out between echocardiographic and MRI parameters. The values of fractional area change, tricuspid annular plane systolic excursion, tissue Doppler imaging derived peak velocity of the isovolumic contraction wave and systolic wave of the lateral tricuspid valve annulus showed lower values under general anesthesia. Of all echocardiographic parameters of RV systolic function, only fractional area change (r = 0.671, P = 0.034) and tissue Doppler imaging derived peak velocity of the systolic wave of the lateral tricuspid valve annulus (r = 0.768; P = 0.01), showed a significant correlation with MRI derived stroke volume. None of the echocardiographic parameters correlated with MRI derived ejection fraction. When evaluating the RV echocardiographically, fractional area change and peak velocity of the systolic wave of the lateral tricuspid valve annulus appear to be the most reliable predictors of RV systolic function when compared to MRI under anesthesia.
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Affiliation(s)
- M Baron Toaldo
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - T Glaus
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - I Campagna
- Department of Clinical Diagnostics and Services, Section of Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - J Novo Matos
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - M Dennler
- Department of Clinical Diagnostics and Services, Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Yuchi Y, Suzuki R, Teshima T, Matsumoto H, Koyama H. Utility of tricuspid annular plane systolic excursion normalized by right ventricular size indices in dogs with postcapillary pulmonary hypertension. J Vet Intern Med 2020; 35:107-119. [PMID: 33277735 PMCID: PMC7848373 DOI: 10.1111/jvim.15984] [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: 07/14/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background Tricuspid annular plane systolic excursion (TAPSE) is a common right ventricular (RV) function indicator. However, TAPSE was not decreased in dogs with myxomatous mitral valve disease (MMVD) and postcapillary pulmonary hypertension (PH) because of its load, angle, and body weight dependency, and TAPSE was considered a preload‐dependent index. Objectives To evaluate the utility of TAPSE normalized by RV size in dogs with postcapillary PH. Animals Twenty healthy dogs and 71 MMVD dogs with or without PH. Methods In this prospective observational study, end‐diastolic RV internal dimension (RVIDd), end‐diastolic and end‐systolic RV area, and end‐diastolic RV wall thickness were measured as RV size indices. The TAPSE was measured using B‐mode and M‐mode methods. Normalized TAPSE was calculated by dividing TAPSE by each RV size index. The RV strain was obtained as the detailed RV function using 2‐dimensional speckle tracking echocardiography. All indices were compared among the PH severity groups and in the presence of right‐sided congestive heart failure (R‐CHF). Results Although nonnormalized TAPSE was higher with PH severity progression, each normalized TAPSE showed a significant decrease in the severe PH group (P < .05). The TAPSEB‐mode/RVIDd ratio had high area under the curve to predict R‐CHF and had moderate correlation with RV strain (P < .05). The TAPSEB‐mode/RVIDd and left atrial‐to‐aortic diameter ratios were independent predictors for R‐CHF. Conclusions and Clinical Importance Normalized TAPSE could reflect RV systolic dysfunction in dogs with severe PH, which could not be detected by nonnormalized TAPSE. The TAPSEB‐mode/RVIDd ratio might predict R‐CHF with high sensitivity and reproducibility.
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Affiliation(s)
- Yunosuke Yuchi
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ryohei Suzuki
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Takahiro Teshima
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hirotaka Matsumoto
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hidekazu Koyama
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
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Saetang K, Surachetpong SD. Short-term effects of sildenafil in the treatment of dogs with pulmonary hypertension secondary to degenerative mitral valve disease. Vet World 2020; 13:2260-2268. [PMID: 33281365 PMCID: PMC7704324 DOI: 10.14202/vetworld.2020.2260-2268] [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: 05/22/2020] [Accepted: 09/25/2020] [Indexed: 11/21/2022] Open
Abstract
Background and Aim: Pulmonary hypertension (PH) is a common complication of degenerative mitral valve disease (DMVD). Sildenafil, a phosphodiesterase-5 inhibitor, has effects in reducing pulmonary arterial pressure by selectively dilating pulmonary vessels. The study aimed to evaluate the effects of sildenafil in combination with conventional therapy in dogs with PH caused by DMVD. Materials and Methods: Fourteen dogs diagnosed with PH secondary to DMVD Stage C on conventional therapy were randomly assigned to placebo (n=7) and sildenafil (n=7) groups. On day 0, the recruited dogs underwent physical examinations, clinical score assessments, electrocardiography, systolic blood pressure measurements, blood collection, thoracic radiography, and echocardiography for baseline. The dogs then received a combination of conventional therapy with sildenafil or placebo every 8 h for 1 week. On day 7, all dogs underwent the baseline evaluations again. Results: The sildenafil group experienced a significant decrease in estimated systolic pulmonary artery pressure (sPAP) (p=0.043) from day 0 to day 7. Moreover, the total clinical scores were decreased in dogs treated with sildenafil relative to those who received the placebo (p=0.007); however, the lung scores were not different between before and after treatment with sildenafil. Conclusion: Sildenafil had a synergistic effect with conventional therapy in reducing the estimated sPAP and clinical scores in dogs with PH secondary to DMVD.
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Affiliation(s)
- Karun Saetang
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Guglielmini C, Goncalves Sousa M, Baron Toaldo M, Valente C, Bentivoglio V, Mazzoldi C, Bergamin I, Drigo M, Poser H. Prevalence and risk factors for atrial fibrillation in dogs with myxomatous mitral valve disease. J Vet Intern Med 2020; 34:2223-2231. [PMID: 33031593 PMCID: PMC7694843 DOI: 10.1111/jvim.15927] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 12/02/2022] Open
Abstract
Background Atrial fibrillation (AF) is a common supraventricular arrhythmia more frequently observed in large breed dogs. Objectives Estimate the prevalence of AF in dogs with myxomatous mitral valve disease (MMVD) and identify risk factors for developing AF. Animals A total of 2194 client‐owned dogs with MMVD, including 1280, 588, 290, and 36 dogs in ACVIM stages B1, B2, C, and D, respectively. Methods Retrospective, cross‐sectional study. The medical databases of 3 veterinary teaching hospitals were reviewed. Inclusion criteria were a diagnosis of MMVD after complete cardiovascular evaluation and cardiac rhythm assessment using routine 2‐minute ECG or good quality ECG tracing during echocardiographic examination. Results Atrial fibrillation was diagnosed in 59 dogs with a prevalence of 2.7%. Univariate analysis showed that mixed breed, male sex, advanced ACVIM stage, left atrial and ventricular enlargement, fractional shortening (FS), and presence of pulmonary hypertension were significantly associated with development of AF. According to 2 multivariable models, the left atrium (LA)‐to‐aorta ratio (odds ratio [OR] = 14.011, 7.463‐26.304), early trans‐mitral velocity (OR = 2.204, 1.192‐4.076), body weight (OR = 1.094, 1.058‐1.130), and FS (OR = 0.899, 0.865‐0.934) and LA (OR = 5.28, 3.377‐8.092), advanced ACVIM stage (OR = 4.922, 1.481‐16.353), and FS (OR = 0.919, 0.881‐0.959) were significant predictors of AF for models 1 and 2, respectively. Conclusions and Clinical Importance Atrial fibrillation is an uncommon complication of MMVD and is significantly associated with the more advanced stage of the disease, increased LA dimension and body weight, and decreased FS.
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Affiliation(s)
- Carlo Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | | | - Marco Baron Toaldo
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Carlotta Valente
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Vinicius Bentivoglio
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Brazil
| | - Chiara Mazzoldi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Ilaria Bergamin
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Michele Drigo
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Helen Poser
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
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Visser LC, Wood JE, Johnson LR. Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension. J Vet Intern Med 2020; 34:1379-1388. [PMID: 32501601 PMCID: PMC7379050 DOI: 10.1111/jvim.15826] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The clinical relevance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension (PH) is unknown. OBJECTIVE To determine if echocardiographic measurements of right heart size and right ventricular (RV) function are associated with survival times in dogs with PH. ANIMALS Eighty-two client-owned dogs. METHODS Retrospective study where data from medical records and baseline echocardiographic examinations were collected and measured in a standardized manner. Owners or primary veterinarians were contacted for outcome data. RESULTS Enlargement of the right atrium (88%), RV (69%), and pulmonary artery (72%) was common. One-third of the cases had reduced RV function quantified by two-dimensional echocardiography-derived tricuspid annular plane systolic excursion (TAPSE). Decreased TAPSE was significantly (P = .008) more common in dogs with PH not secondary to left heart disease (LHD; 43%) compared to dogs with PH secondary to LHD (14%) but median survival times (182, 95% confidence interval [CI] = 39-309 versus 298, 95% CI = 85-314 days, respectively) were not significantly different (P = .78). Right atrial area (hazard ratio [HR] = 2.72, 95% CI = 1.58-4.70), TAPSE < 3.23 mm/kg0.284 (HR = 2.19, 95% CI = 1.28-3.74), and right heart failure (HR = 2.05, 95% CI = 1.18-3.57) were independently associated with shorter survival time (P ≤ .04). CONCLUSIONS AND CLINICAL IMPORTANCE Right atrial area, RV function (TAPSE < 3.23 mm/kg0.284 ), and right heart failure offer clinically relevant prognostic information in dogs with PH. Results support the quantitative assessment of right heart size and function in dogs with PH.
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Affiliation(s)
- Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - James E Wood
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Lynelle R Johnson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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15
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Vatnikov YA, Rudenko AA, Usha BV, Kulikov EV, Notina EA, Bykova IA, Khairova NI, Bondareva IV, Grishin VN, Zharov AN. Left ventricular myocardial remodeling in dogs with mitral valve endocardiosis. Vet World 2020; 13:731-738. [PMID: 32546918 PMCID: PMC7245723 DOI: 10.14202/vetworld.2020.731-738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/06/2020] [Indexed: 01/19/2023] Open
Abstract
Background and Aim: Left ventricular myocardial remodeling could play an important role in the progression of chronic heart failure (CHF) syndrome in dogs with mitral valve endocardiosis. The aim of this study was to evaluate the left ventricular myocardial remodeling in dogs with mitral valve endocardiosis and to study the dependence of the incidence of this pathological phenomenon on the functional class (FC) of progression of the CHF syndrome. Materials and Methods: A total of 108 afflicted dogs and 36 clinically healthy dogs were examined using transthoracic echocardiography. The following structural and geometric parameters of the left ventricular remodeling were evaluated: Myocardial mass and its index, sphericity index at the end of systole and diastole, end-systolic and end-diastolic relative wall thickness, and integral remodeling index. Results: In all clinically healthy dogs, a normal type of the left ventricular chamber geometry was revealed, whereas, in dogs with mitral valve endocardiosis, the normal geometry of the left ventricle occurred in 56.4%, eccentric hypertrophy in 24.1%, concentric remodeling in 10.2%, and concentric hypertrophy in 9.3% of the cases. In patients with endocardiosis, there was no dilatation type of cardiac remodeling observed. Conclusion: When compared to the clinically healthy animals, the dogs with mitral valve endocardiosis presented with indicators of structural and geometric remodeling, such as increased myocardial mass, myocardial mass index, and sphericity index at the end of systole and diastole, as well as relatively reduced integral systolic index of remodeling and systolic relative thickness of the walls of the heart. The parameters of the left ventricular myocardial remodeling correlated significantly with the FC of CHF syndrome.
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Affiliation(s)
- Yury A Vatnikov
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Andrey A Rudenko
- Department of Veterinary Medicine, Moscow State University of Food Production, 125080 Moscow, Russia
| | - Boris V Usha
- Department of Veterinary Medicine, Moscow State University of Food Production, 125080 Moscow, Russia
| | - Evgeny V Kulikov
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Elena A Notina
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Irina A Bykova
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Nadiya I Khairova
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Irina V Bondareva
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Victor N Grishin
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Andrey N Zharov
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
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Reinero C, Visser LC, Kellihan HB, Masseau I, Rozanski E, Clercx C, Williams K, Abbott J, Borgarelli M, Scansen BA. ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. J Vet Intern Med 2020; 34:549-573. [PMID: 32065428 PMCID: PMC7097566 DOI: 10.1111/jvim.15725] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/30/2020] [Indexed: 01/01/2023] Open
Abstract
Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.
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Affiliation(s)
- Carol Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Heidi B Kellihan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin
| | - Isabelle Masseau
- Department of Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, Medford, Massachusetts
| | - Cécile Clercx
- Department of Clinical Sciences of Companion Animals and Equine, University of Liège, Liège, Belgium
| | - Kurt Williams
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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Caivano D, Rishniw M, Birettoni F, Petrescu VF, Porciello F. Transverse Right Ventricle Strain and Strain Rate Assessed by 2-Dimensional Speckle Tracking Echocardiography in Dogs with Pulmonary Hypertension. Vet Sci 2020; 7:E19. [PMID: 32046130 PMCID: PMC7157588 DOI: 10.3390/vetsci7010019] [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: 12/19/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 11/23/2022] Open
Abstract
Right ventricular (RV) strain analysis using 2-dimensional speckle tracking echocardiography (2D STE) permits practitioners to assess regional and global deformation of the myocardium. Recently, assessment of the longitudinal right ventricle (RV) strain and strain rate using 2D STE has been reported in dogs. Although longitudinal deformation is the dominant component of the RV systole, RV myocardial fibers of the superficial layer are oriented circumferentially and these contribute to the RV pump function (radial deformation). Because this strain component has not been investigated in dogs, we have assessed radial RV strain and strain rate using 2D STE in healthy dogs and dogs with pulmonary hypertension (PH). We have recruited 74 dogs (40 healthy dogs and 34 dogs with PH) in which we have analyzed radial RV free wall strain and strain rate using XstrainTM software. We have used the left apical 4-chamber view optimized for the RV for analysis of the radial strain and strain rate variables (XstrainTM software denoted radial strain as "transverse"). Seven dogs were excluded during the analysis for low quality images. Transverse strain and strain rate obtained in healthy dogs showed no relationship with heart rate, body weight or age (r2 < 0.09 and p > 0.05 for all variables). Moreover, no relationship between transverse strain/strain rate variables and left atrial-to-aortic ratios was observed (r2 < 0.06 and p = 0.2, for both). Transverse strain and strain rate obtained in dogs with PH, showed weak negative relationships with tricuspid regurgitation velocity (r2 < 0.25 and p = 0.006, for both). Transverse RV strain and strain rate using 2D STE is feasible in most dogs and decrease with worsening of the PH, but these advanced echocardiographic indices do not help in identifying dogs with PH.
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Affiliation(s)
- Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
| | - Mark Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA;
| | - Francesco Birettoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
| | - Vasilica-Flory Petrescu
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
| | - Francesco Porciello
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
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Caivano D, Rishniw M, Birettoni F, Patata V, Giorgi M, Dei K, Porciello F. Right ventricular outflow tract fractional shortening: an echocardiographic index of right ventricular systolic function in dogs with pulmonary hypertension. J Vet Cardiol 2018; 20:354-363. [DOI: 10.1016/j.jvc.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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