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Wolf M, Lucina SB, Silva VBC, Silveira MF, Silva VG, Sarraff AP, Custódio CC, Sousa MG. Assessment of left and right ventricular systolic function in dogs with multicentric lymphoma. Top Companion Anim Med 2024; 60:100858. [PMID: 38527726 DOI: 10.1016/j.tcam.2024.100858] [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: 11/13/2021] [Revised: 01/06/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVE Myocardial dysfunction in cardio-oncology is generally thought to be related to the cardiotoxicity of chemotherapy treatment. However, it is known that some tumors have direct effects on myocardial function. These effects have already been studied in man, but there are no publications of these of the effects in dogs. Novel advanced echocardiographic techniques may allow early detection of myocardial dysfunction when compared to conventional echocardiographic techniques. This study aims to assess myocardial systolic function in dogs with multicentric lymphoma prior to initiation of chemotherapy. ANIMALS Fifteen dogs with multicentric lymphoma and nineteen healthy dogs. METHODS Case-control study. Dogs with multicentric lymphoma and healthy control dogs underwent physical examination, electrocardiography, systolic blood pressure measurement, standard and speckle tracking echocardiography to assess biventricular systolic function. RESULTS There were no differences between groups in terms of ejection fraction, fractional shortening, left ventricular systolic and diastolic diameter, tricuspid annular plane systolic excursion, mitral annular plane systolic excursion and fractional area change of the right ventricle (RV). However, there was a reduction in the values of global circumferential strain (p = 0.0003), RV strain (p = 0.01) and RV tissue motion annular displacement (p < 0.05) in the dogs with lymphoma when compared to the control group. CONCLUSIONS Speckle tracking techniques appear to demonstrate early systolic dysfunction, primarily affecting the RV, in dogs with lymphoma prior to chemotherapy treatment.
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Affiliation(s)
- Marcela Wolf
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil.
| | - Stephany B Lucina
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Vinícius B C Silva
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Matheus F Silveira
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Victória G Silva
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Ana P Sarraff
- School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba campus, Curitiba, Paraná, Brazil
| | | | - Marlos G Sousa
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
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Ji X, Zhang Y, Xie Y, Zhao R, Li Y, Xie M, Zhang L. Feasibility and prognostic value of tissue motion annular displacement in patients with heart transplantation. Echocardiography 2024; 41:e15809. [PMID: 38581298 DOI: 10.1111/echo.15809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Tissue motion of mitral annular displacement (TMAD) assessment has proved to be an effective method for several cardiovascular diseases including hypertrophic cardiomyopathy, heart failure, non-ST-elevation myocardial infarction, etc. However, there are no studies exploring the feasibility of TMAD in heart transplantation (HT) recipients, and the predictive value of this parameter for adverse outcomes in these patients remains unknown. Consequently, this study aimed to evaluate the feasibility of TMAD in the evaluation of left ventricular (LV) systolic function in clinically well adult HT patients, and further investigate the prognostic value of TMAD. METHODS Echocardiography was performed in 155 adult HT patients and 49 healthy subjects. All the subjects were examined by conventional transthoracic two-dimensional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE) with evaluation of the LV end-diastolic diameter, LV end-diastolic volume index, LV end-systolic volume index, interventricular septal thickness, left atrial diameter, mitral annular plane systolic excursion (MAPSE), LV ejection fraction (LVEF), TMAD and LV global longitudinal strain (LVGLS). The end point was defined as all-causes mortality or posttransplant related hospitalization during follow up. Cox proportional hazards regression was performed to evaluate the prognostic value of the parameters for predicting poor outcomes in HT patients. RESULTS A significant positive correlation was found between the measurements of TMAD and LVGLS (r = .714, p < .001). TMAD obtained by 2D-STE had good reproducibility. The LVGLS and TMAD were significantly lower in HT group than in control group (both p < .001). In HT patients, compared with event free group, adverse outcome group displayed reduced TMAD and LVGLS, and elevated age (p < .001, < .001, = .017, respectively). Patients with higher TMAD (> 9.1 mm) had comparatively better survival when stratified by cutoff value (log-rank p < .001). LVGLS and TMAD were independently associated with adverse outcomes in multivariable analysis (both p < .001). CONCLUSION Assessment of TMAD is effective for evaluating LV longitudinal systolic function and predicting adverse outcomes in clinically well adult HT patients.
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Affiliation(s)
- Xiang Ji
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yiwei Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuji Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Ruohan Zhao
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuman Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mingxing Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Matos JI, García-Rodríguez SN, Costa-Rodríguez N, Caro-Vadillo A, Carretón E, Montoya-Alonso JA. Right Ventricle Strain Assessed by 2-Dimensional Speckle Tracking Echocardiography (2D-STE) to Evaluate Pulmonary Hypertension in Dogs with Dirofilaria immitis. Animals (Basel) 2023; 14:26. [PMID: 38200757 PMCID: PMC10778325 DOI: 10.3390/ani14010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Echocardiographic assessment of the right ventricle is helpful for analysing the pathophysiology of heartworm disease and detecting pulmonary hypertension (PH) in dogs. In veterinary cardiology, the study of myocardial deformation using two-dimensional speckle tracking (2D-STE) echocardiography has become increasingly acknowledged as useful for quantifying right ventricular function. The aim of this study was to evaluate the usefulness of myocardial deformation strain of the right ventricular free wall (FWS), global deformation strain of the right ventricle, including the interventricular septum (GS), and tissue motion annular displacement of the tricuspid valve (TMAD) in a cohort of dogs with heartworm (Dirofilaria immitis) disease and to determine cut-off values for detecting the presence of PH. Out of the 93 dogs tested, 71% were diagnosed with heartworm infection. PH was identified in 41% of the infected dogs following the American College of Veterinary Internal Medicine (ACVIM) guidelines, based on the peak tricuspid regurgitation velocity to calculate the tricuspid regurgitation pressure gradient (TRPG), while other routine measurements were used, including the right pulmonary artery distensibility index (RPADi). The 2D-STE mode measurements were determined using Right Ventricular Automated Function Imaging (RV AFI®) software. The statistical analysis showed significant differences in the studied parameters among dogs with and without PH. Additionally, sensitivity (sen) and specificity (sp) cut-off values were obtained (GS ≥ -21.25%, sen 96%, sp 86.4%; FWS ≥ -21.95%, sen 92.56%, sp 95.5%; TMAD ≤ 0.85 cm, sen 70.4%, sp 83.3%). These results demonstrated that GS, FWS, and TMAD could be used as supplementary and alternative variables to conventional echocardiographic measurements when detecting PH in dogs with heartworm disease.
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Affiliation(s)
- Jorge Isidoro Matos
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - Sara Nieves García-Rodríguez
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - Noelia Costa-Rodríguez
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - Alicia Caro-Vadillo
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
- Hospital Clínico Veterinario, Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain
| | - Elena Carretón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - José Alberto Montoya-Alonso
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
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Wang Z, Hu Y, Ou H, Feng J, Dong S, Ren S, Lu G, Li J. Speckle tracking tissue motion mitral annulus displacement to assess early changes in the left ventricle and its association with lung function in patients with chronic obstructive pulmonary disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1439-1448. [PMID: 37883119 DOI: 10.1002/jcu.23568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To evaluate the early changes in left ventricular (LV) in patients with chronic obstructive pulmonary disease (COPD) by measuring tissue motion mitral annulus displacement (TMAD) and three-dimensional (3D) parameters using speckle tracking imaging (STI), and to explore its correlation with lung function. METHODS Forty two COPD patients (GOLD I, GOLD II, GOLD III) and 30 healthy individuals (control group) were included. STI was used to assess the changes in LV structure and systolic function. Receiver operating characteristic (ROC) curves were drawn, and correlations among TMAD parameters, LV systolic function, structural, pulmonary artery systolic pressure (PASP), and lung function were analyzed. RESULTS Compared to the control group, COPD patients were able to undergo LV remodeling, with a decrease in the absolute value of global longitudinal strain (GLS) and TMAD, but no significant modification of LVEF. Correlation analysis showed that TMAD was positively related to the absolute value of GLS (r > 0.51, P < 0.01) and predicted forced expiratory volume in the first second (FEV1%) (r > 0.56, P < 0.01), and negatively to PASP (r < -0.52, P < 0.01). The LV posterior wall thickness (LVPWd), relative wall thickness (RWT), end-diastolic volume (LVEDV) and PASP negatively correlated with FEV1%. CONCLUSION The LV geometric changes and systolic function impairment in COPD patients were found to correlate with airflow restriction (FEV1%). TMAD aided in detection of early changes in LV systolic function in COPD patients. It negatively correlated with PASP and positively with FEV1%. Moreover, it was more convenient than GLS.
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Affiliation(s)
- Zijing Wang
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Yunhua Hu
- School of Medicine, Shihezi University, Shihezi, China
| | - Huajing Ou
- Department of Respiratory Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Jia Feng
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Shanshan Dong
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Shan Ren
- Department of Critical Care Medicine, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Guilin Lu
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Jun Li
- Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China
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Song J, Yao Y, Lin S, He Y, Zhu D, Zhong M. Feasibility and discriminatory value of tissue motion annular displacement in sepsis-induced cardiomyopathy: a single-center retrospective observational study. Crit Care 2022; 26:220. [PMID: 35851427 PMCID: PMC9295263 DOI: 10.1186/s13054-022-04095-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is no formal diagnostic criterion for sepsis-induced cardiomyopathy (SICM), but left ventricular ejection fraction (LVEF) < 50% was the most commonly used standard. Tissue motion annular displacement (TMAD) is a novel speckle tracking indicator to quickly assess LV longitudinal systolic function. This study aimed to evaluate the feasibility and discriminatory value of TMAD for predicting SICM, as well as prognostic value of TMAD for mortality.
Methods
We conducted a single-center retrospective observational study in patients with sepsis or septic shock who underwent echocardiography examination within the first 24 h after admission. Basic clinical information and conventional echocardiographic data, including mitral annular plane systolic excursion (MAPSE), were collected. Based on speckle tracking echocardiography (STE), global longitudinal strain (GLS) and TMAD were, respectively, performed offline. The parameters acquisition rate, inter- and intra-observer reliability, time consumed for measurement were assessed for the feasibility analysis. Areas under the receiver operating characteristic curves (AUROC) values were calculated to assess the discriminatory value of TMAD/GLS/MAPSE for predicting SICM, defined as LVEF < 50%. Kaplan–Meier survival curve analysis was performed according to the cutoff values in predicting SICM. Cox proportional hazards model was performed to determine the risk factors for 28d and in-hospital mortality.
Results
A total of 143 patients were enrolled in this study. Compared with LVEF, GLS or MAPSE, TMAD exhibited the highest parameter acquisition rate, intra- and inter-observer reliability. The mean time for offline analyses with TMAD was significantly shorter than that with LVEF or GLS (p < 0.05). According to the AUROC analysis, TMADMid presented an excellent discriminatory value for predicting SICM (AUROC > 0.9). Patients with lower TMADMid (< 9.75 mm) had significantly higher 28d and in-hospital mortality (both p < 0.05). The multivariate Cox proportional hazards model revealed that BMI and SOFA were the independent risk factors for 28d and in-hospital mortality in sepsis cases, but TMAD was not.
Conclusion
STE-based TMAD is a novel and feasible technology with promising discriminatory value for predicting SICM with LVEF < 50%.
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Ruviaro Tuleski GL, Silveira MF, Bastos RF, Pscheidt MJGR, Prieto WDS, Sousa MG. Behavioral and cardiovascular effects of a single dose of gabapentin or melatonin in cats: a randomized, double-blind, placebo-controlled trial. J Feline Med Surg 2022; 24:e524-e534. [PMID: 36350565 PMCID: PMC10812368 DOI: 10.1177/1098612x221124359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this study was to verify whether a single oral dose of gabapentin (100 mg) or melatonin (3 mg) given 60 mins before a cardiac evaluation would reduce anxiety without interfering with heart rate (HR), systemic blood pressure (SBP), electrocardiogram (ECG) and echocardiographic indexes. METHODS Seventy-five client-owned healthy cats underwent two sets of cardiac assessments 60 mins apart, randomly divided into gabapentin, melatonin and placebo groups. The interval between treatment and the second ECG and SBP measurement was 60 mins, and 70 mins for echocardiography. A compliance score (CS) classified the behavior, focusing on the ease of handling. RESULTS Most variables did not change between the examinations. The placebo group showed more significant changes (SBP, tricuspid annular plane systolic excursion, HR during echocardiography, aortic flow velocity, S' wave from lateral mitral annulus), but they were not considered to be hemodynamically relevant. Gabapentin and melatonin significantly increased the cats' compliance without interfering with cardiac assessment. Eight cats presented with mild sedation, seven after gabapentin and one after melatonin. No major side effects were observed. CONCLUSIONS AND RELEVANCE Gabapentin tranquilized the cats when it was given 60 mins prior to ECG and SBP measurement, and 70 mins prior to echocardiography, without interfering with systolic echocardiographic indexes. Melatonin also decreased the CS, but without sedation in most cases. The waiting period may have relaxed the cats in the placebo group, resulting in lower SBP measurements. However, this tranquility did not last as some echocardiographic changes signaled a sympathetic predominance.
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Affiliation(s)
- Giovana Lais Ruviaro Tuleski
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Matheus Folgearini Silveira
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Rodrigo Franco Bastos
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | | | - Wiliam da Silva Prieto
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Marlos G Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
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Tuleski GLR, Pscheidt MJGR, dos Santos JP, Sousa MG. Timolol 0.5% ophthalmic solution influences cardiac function in healthy cats. J Feline Med Surg 2022; 24:e57-e69. [PMID: 35470745 PMCID: PMC11104227 DOI: 10.1177/1098612x221083372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to ascertain the effect of a drop of timolol 0.5% ophthalmic solution on the systolic function of the left ventricle (LV) and left atrium (LA), and to confirm if timolol helped appraisal of diastolic function by reducing heart rate (HR) and separating the transmitral outflow waves from tissue Doppler imaging (TDI). METHODS A total of 41 client-owned healthy cats underwent two echocardiograms 20 mins apart. The timolol group (33 cats) received a drop of timolol solution after the first examination. Standard and speckle-tracking echocardiography evaluated the LV and LA function of both groups at the two time points evaluated. RESULTS Timolol reduced HR (19%), and fractional shortening from LV (20.3%) and LA (16.6%). Septal S' decreased by 51% (from 7.7 to 5.2 cm/s) and lateral S' dropped by 43.1% (7.3 to 5.1 cm/s). Most longitudinal techniques did not change after timolol, including the mitral annular plane systolic excursion from the interventricular annulus, tricuspid annular plane systolic excursion, LV longitudinal strain and LV tissue motion annular displacement. The isovolumic relaxation time increased by 15.2% (from 54 to 64.6 ms), with most cats presenting this variable above the reference (>60 ms). Timolol did not support diastolic assessment, enabling evaluation in only 2/11 cats when using lateral TDI and 1/9 cats using septal TDI. Regarding side effects, miosis occurred in 18 cats (54.5%). CONCLUSIONS AND RELEVANCE Timolol reduced systolic function, decreasing standard echocardiographic variables. Regarding diastolic evaluation, although timolol decreased HR, it did not separate the mitral diastolic waves, as expected.
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Affiliation(s)
- Giovana LR Tuleski
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | | | - Júlio Pereira dos Santos
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Marlos Gonçalves Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
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Tissue motion annular displacement to assess the left ventricular systolic function in healthy cats. Vet Res Commun 2022; 46:823-836. [PMID: 35258757 DOI: 10.1007/s11259-022-09907-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/16/2022] [Indexed: 10/18/2022]
Abstract
The tissue motion annular displacement (TMAD) measures the longitudinal displacement of the mitral annulus during systole, using speckle-tracking echocardiography (STE). The main objective was to determine the TMAD means in healthy cats, exploring the correlations with systolic surrogates. The influence of age, body surface area (BSA), heart rate, and systemic blood pressure on the indices was also analyzed. One hundred ninety-three healthy, client-owned cats participated in this prospective, cross-sectional observational study undergoing conventional and STE. Apical four-chamber (AP4) and two-chamber (AP2) images were recorded for offline calculations. Mean TMAD values were similar to mitral annulus plane systolic excursion (MAPSE), varying between 4 to 4.8 mm depending on the annulus and image used. No significant differences between age and BSA categories were detected, except for AP4 MP%, reduced in the heavier group. TMAD variables showed moderate correlation with longitudinal strain (LSt) and MAPSE, but not with fraction shortening (FS) and ejection fraction (EF). The median time required for the offline calculation was 12.2 s for AP4 and 11.8 s for AP2. The technique showed moderate inter and intraobserver variation, proving a reliable tool for assessing left ventricular longitudinal systolic function in cats.
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Wolf M, Lucina SB, Silva VBC, Tuleski GLR, Sarraff AP, Komatsu EY, Sousa MG. Assessment of longitudinal systolic function using tissue motion annular displacement in dogs with degenerative mitral valve disease. J Vet Cardiol 2021; 38:44-58. [PMID: 34800922 DOI: 10.1016/j.jvc.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Although degenerative mitral valve disease (DMVD) is essentially a disorder of the valve, the progression of the disease leads to structural myocardial changes that may compromise left ventricular systolic function. Tissue motion annular displacement (TMAD) is a surrogate for longitudinal fiber function based on speckle tracking assessment of the movement of the mitral annulus toward the apex during systole. The aim of this study was to evaluate longitudinal systolic function with TMAD in dogs with DMVD. ANIMALS Ninety-four dogs with DMVD and 32 healthy dogs. METHODS Prospective cross-sectional observational study. Dogs with DMVD of various American College of Veterinary Internal Medicine classification stages and healthy control dogs underwent physical examination, electrocardiography, systolic blood pressure measurement, as well as a standard and speckle tracking echocardiography. Global longitudinal strain (GLS) and TMAD were used to assess longitudinal systolic function. RESULTS The global TMADmm and global TMAD% were higher in American College of Veterinary Internal Medicine B2 animals than in the stage CD. Global TMAD (mm/kg,mm/bodyweight3, mm/m2) were correlated with GLS and ejection fraction. Global TMAD (mm/kg,mm/m2,%) and GLS were influenced by sex. In addition, systolic blood pressure influenced GLS (P < 0.01; r = -0.23), global TMADmm/kg (P = 0.017; r = -0.21) and global TMADmm/m2 (P = 0.031; r = -0.19). Tissue motion annular displacement was fast to be performed and produced good repeatability in dogs with DMVD. CONCLUSIONS Global TMAD (mm,%), was reduced in DMVD dogs with clinical signs of heart failure compared with stage B2. Tissue motion annular displacement was shown to be a repeatable technique for evaluation of longitudinal systolic function in dogs with DMVD.
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Affiliation(s)
- M Wolf
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil.
| | - S B Lucina
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - V B C Silva
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - G L R Tuleski
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - A P Sarraff
- School of Life Sciences, Pontifical Catholic University of Paraná (PUC-PR), Rua Rockfeller 1311, Curitiba, 80230-130, Brazil
| | - E Y Komatsu
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - M G Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
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Bonagura JD, Visser LC. Echocardiographic assessment of dilated cardiomyopathy in dogs. J Vet Cardiol 2021; 40:15-50. [PMID: 34750089 DOI: 10.1016/j.jvc.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/27/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
Dilated cardiomyopathy (DCM) is a frequent cause of cardiac disability, congestive heart failure (CHF), and arrhythmic death in dogs. The etiology of DCM is usually idiopathic/genetic, but some causes of a DCM phenotype are reversible. The disease is classified into preclinical (occult) and clinical (overt) stages; the latter stems from heart failure with reduced ejection fraction. DCM is further characterized by clinical, electrocardiographic, circulating biomarker, and imaging abnormalities. The diagnosis of clinical DCM with CHF is straightforward; however, identification of the preclinical stage can be challenging. Echocardiography is central to the diagnosis of both stages and characterized by left ventricular (LV) systolic dysfunction with progressive chamber dilation and variable enlargements of the left atrium and right-sided chambers. Left ventricular dilation is defined by increased LV end-diastolic volumes, areas, and internal dimensions normalized to body size or indexed to the aorta. Systolic dysfunction is characterized by decreased LV ejection fraction, increased end-systolic volume, and reduced shortening across minor and longitudinal LV axes. Dyssynchrony can confound the interpretation of linear indices of systolic function. A comprehensive echocardiogram in DCM includes two-dimensional and M-mode studies, spectral and tissue Doppler imaging, and potentially three-dimensional echocardiography and myocardial strain imaging. Echocardiographic findings should be interpreted within the context of identifiable risks and comorbidities, physical diagnosis, complementary diagnostic testing, and limitations of current reference intervals. Ambiguous examinations should be repeated. Specific echocardiographic criteria for the diagnosis of DCM are proposed to encourage discussion and additional outcome and breed-specific echocardiographic studies of canine DCM.
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Affiliation(s)
- John D Bonagura
- Departments of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr, Raleigh, NC, 27606, USA; Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
| | - Lance C Visser
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, One Shields Ave, Davis, CA, 95616, USA
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Silva VBC, Wolf M, Lucina SB, Sarraff-Lopes AP, Sousa MG. Assessment of right ventricular systolic function by tissue motion annular displacement in healthy dogs. J Vet Cardiol 2020; 32:40-48. [PMID: 33137658 DOI: 10.1016/j.jvc.2020.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION/OBJECTIVES There are few parameters for assessment of right ventricular (RV) systolic function on echocardiographic examination. Morphofunctional studies are limited by the irregular shape of the RV. Recently, tissue motion annular displacement (TMAD), a technique that evaluates valve annulus displacement toward the cardiac apex, has shown a good correlation with left ventricular global longitudinal strain (GLS) in healthy dogs. Therefore, the aim of this study was to evaluate the longitudinal systolic function of the RV of healthy dogs using TMAD. ANIMALS A hundred healthy client-owned dogs. MATERIALS AND METHODS Cross-sectional study. Physical examination, electrocardiogram, blood pressure measurement, and echocardiography were recorded. The systolic function of the RV was evaluated by GLS free wall and TMAD. Data were compared with those derived from conventional echocardiography. RESULTS TMAD values varied according to body weight. There was a correlation of TMAD in millimeters with all indices of RV systolic function, including GLS free wall (R:-0.239; p:0.017). TMAD had a correlation with age and heart rate; whereas there was no relationship with sex and blood pressure. The coefficient of variation for the intraobserver evaluation was lower for the TMAD in millimeters (9.9%) compared with the GLS free wall (17.9%). In addition, the mean time to perform TMAD (8.1 s) was lower than that of the GLS free wall (37.7 s). CONCLUSIONS TMAD is a fast, reproducible, and promising method for assessing RV systolic function in healthy dogs. However, further studies are needed to understand the applicability of this technique in patients with heart disease.
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Affiliation(s)
- V B C Silva
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil.
| | - M Wolf
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - S B Lucina
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
| | - A P Sarraff-Lopes
- School of Life Sciences, Pontifical Catholic University of Paraná (PUC-PR), Rua Rockfeller 1311, Curitiba, 80230-130, Brazil
| | - M G Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Rua dos Funcionários 1540, Curitiba, 80035-050, Brazil
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Hausner EA, Chi X. Echocardiography in nonclinical studies: Where are we? Regul Toxicol Pharmacol 2020; 112:104615. [PMID: 32057774 DOI: 10.1016/j.yrtph.2020.104615] [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: 11/18/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 11/19/2022]
Abstract
Echocardiography is a powerful, noninvasive tool used both in clinical and nonclinical settings, including in drug development. When used appropriately, it can provide valuable translational information about pharmacodynamics, safety pharmacology, or toxicology, helping to define no-observed-adverse-effect levels and providing guidance for clinical monitoring and dose selection. Echocardiography is advantageous in conducting longitudinal studies and reducing the number of animals used in safety assessments. To this end, there has been no clear enunciation of what constitutes appropriate use of this imaging technology in a nonclinical drug development setting. In this review, we describe the use of echocardiography in nonclinical studies in regulatory submissions to the US Food and Drug Administration Center for Drug Evaluation and Research. In addition, we discuss three main areas: the operator, image acquisition, and image analysis, where variability may affect the reliability of information generated in an echocardiography study. As a path forward, our recommendation is for a multi-disciplinary expert working group to establish guidelines for education and credentialing of nonclinical echocardiographers as well as quality assurance standards for nonclinical echocardiography labs.
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Affiliation(s)
- Elizabeth A Hausner
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research (CDER), United States Food and Drug Administration (FDA), USA.
| | - Xuan Chi
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research (CDER), United States Food and Drug Administration (FDA), USA
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