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Grosso G, Tognetti R, Domenech O, Marchesotti F, Patata V, Vezzosi T. Echocardiographic reference intervals of the dimensions of the main pulmonary artery and the right pulmonary artery: a prospective study in 269 healthy dogs. J Vet Cardiol 2023; 50:29-38. [PMID: 37918089 DOI: 10.1016/j.jvc.2023.09.003] [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: 12/17/2022] [Revised: 08/15/2023] [Accepted: 09/15/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION No data are available on the echocardiographic reference intervals (RIs) for the main pulmonary artery (MPA) and right pulmonary artery (RPA) dimensions in a large sample of dogs. Therefore, we aimed to describe the echocardiographic RIs of the MPA and RPA dimensions in normal dogs. ANIMALS, MATERIALS, AND METHODS Two hundred and sixty nine healthy dogs of different breeds, age and body weight (BW) were prospectively enrolled in this multicenter, observational study. The MPA diameter, RPA maximum diameter (RPAmax), and RPA minimum diameter (RPAmin) were measured from the right parasternal short axis view. Prediction intervals (PIs) for MPA, RPAmax and RPAmin were generated using allometric scales. Reference intervals (RI) of MPA indexed to the ascending aorta (MPA/AO), and RPAmax and RPAmin indexed to the aortic annulus (RPAmax/Aod and RPAmin/Aod), were defined. RESULTS A positive linear relationship between MPA, RPAmax, RPAmin and BW was evident after logarithmic transformation (R2 = 0.859, R2 = 0.787 and R2 = 0.725, respectively; P<0.0001). According to allometric scales, the PI for the MPA normalized for BW (MPA_N) was between 5.50 and 8.07, the PI for the RPAmax normalized for BW (RPAmax_N) was between 3.23 and 5.62, while the PI for the RPAmin normalized for BW (RPAmin_N) was between 1.62 and 3.30. The median MPA/AO was 0.92 (RI, 0.78-1.01), the median RPAmax/Aod was 0.70 (RI, 0.53-0.98) and the median RPAmin/Aod was 0.40 (RI, 0.29-0.61). DISCUSSION AND CONCLUSIONS The reported RIs of the MPA and RPA dimensions in normal dogs could increase the diagnostic accuracy of transthoracic echocardiography in the identification of pulmonary artery enlargement in dogs.
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Affiliation(s)
- G Grosso
- Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122 San Piero a Grado, Pisa, Italy.
| | - R Tognetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122 San Piero a Grado, Pisa, Italy
| | - O Domenech
- Department of Cardiology, Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - F Marchesotti
- Department of Cardiology, Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - V Patata
- Department of Cardiology, Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - T Vezzosi
- Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122 San Piero a Grado, Pisa, Italy
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Matos JI, Caro-Vadillo A, Falcón-Cordón Y, García-Rodríguez SN, Costa-Rodríguez N, Carretón E, Montoya-Alonso JA. Echocardiographic Assessment of the Pulmonary Vein to Pulmonary Artery Ratio in Canine Heartworm Disease. Animals (Basel) 2023; 13:ani13040703. [PMID: 36830490 PMCID: PMC9952531 DOI: 10.3390/ani13040703] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/19/2023] Open
Abstract
Background:Dirofilaria immitis produces proliferative pulmonary endarteritis and pulmonary thromboembolism in infected dogs. The pulmonary vascular lesions lead to irreversible and persistent structural damage and, as a consequence, sustained precapillary pulmonary hypertension (PH). The purpose of this study was to assess the diagnostic value of the pulmonary vein to pulmonary artery ratio (PV:PA ratio) to determine moderate or severe PH (>50 mmHg) in dogs with heartworm disease. METHODS A total of 151 naturally heartworm-infected and 66 healthy dogs were included in the study. The presence/absence of PH was based on the right pulmonary artery distensibility index (RPAD index < 29.5%), and the PV:PA ratio was echocardiographically measured by the time-motion mode (M mode) and two-dimensional mode (2D mode). Other echocardiographic parameters were also assessed (pulmonary trunk to aorta ratio, tricuspid regurgitation pressure gradient, and AT:ET ratio). RESULTS The results of the PV:PA ratio showed a highly positive correlation between the M and 2D modes (r = 0.928). The PV:PA ratio obtained by the M mode was identified as the strongest predictor for RPAD index (R2 0.628, p < 0.0001) with a good diagnostic accuracy (AUC = 0.99). The results of PV/PA by the 2D mode showed a similar prediction for the RPAD index (R2 0.606, p < 0.0001) with a good diagnostic accuracy (AUC = 0.98). Both of the 2D and M modes' PV:PA ratios decreased significantly with the presence of PH. A cut-off value of ≤0.845 showed high sensitivity and specificity for the M mode (97% and 94%, respectively) and the 2D mode (96% and 93%, respectively). CONCLUSIONS The PV:PA ratio may be useful as a complementary diagnostic method for the estimation of moderate or severe PH in dogs with heartworm.
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Affiliation(s)
- Jorge Isidoro Matos
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | - Alicia Caro-Vadillo
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
- Hospital Clínico Veterinario, Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain
| | - Yaiza Falcón-Cordón
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | - Sara Nieves García-Rodríguez
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | - Noelia Costa-Rodríguez
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | - Elena Carretón
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
- Correspondence:
| | - José Alberto Montoya-Alonso
- Internal Medicine, Veterinary Medicine and Therapeutic Research Group, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
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Diana A, Perfetti S, Valente C, Baron Toaldo M, Pey P, Cipone M, Poser H, Guglielmini C. Radiographic features of cardiogenic pulmonary oedema in cats with left-sided cardiac disease: 71 cases. J Feline Med Surg 2022; 24:e568-e579. [PMID: 36350302 PMCID: PMC10812342 DOI: 10.1177/1098612x221121922] [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: 11/10/2022]
Abstract
OBJECTIVES The aims of this study were to describe the radiographic features of cardiogenic pulmonary oedema (CPE) in a large group of cats with left-sided cardiac disease, and to determine the association between the radiographic features of CPE and the underlying cardiac disease. METHODS Thoracic radiographs of cats with CPE and echocardiographic evidence of left-sided cardiac disease and left atrial enlargement (LAE) were reviewed, and cardiac silhouette, pulmonary vessels and pulmonary parenchyma evaluation were performed. Interstitial and/or alveolar patterns were classified according to their distribution (ie, diffuse, multifocal or focal) and location (ie, craniodorsal, cranioventral, caudodorsal, caudoventral and perihilar). A Student's t-test and Mann-Whitney U-test, or the two-proportion z-test, were used to compare continuous or categorical variables, respectively, between cats affected by the two most represented cardiac diseases, namely hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM). RESULTS Seventy-one cats were included; among them, 46 (64.7%) and 13 (18.3%) had presented for HCM and RCM, respectively. Subjective and objective cardiomegaly, and subjective and objective LAE were detected in 97.2% and 91.9% of cats and in 80.3% and 40.6% of cats, respectively. Pulmonary artery abnormalities, in particular caudal pulmonary artery dilation, were found in 77.5% of cats. Pulmonary artery to pulmonary vein ratio = 1 was found in 71.8% and 55% cats on right lateral and ventrodorsal or dorsoventral views, respectively. Interstitial (57.8%) and mixed interstitial-alveolar (38%) pattern, multifocal (84.5%) and symmetrical (75%) distribution with prevalent ventrocaudal (65.6% of cats) and ventrocranial (60.9% of cats) locations were most frequently observed. No difference was found for any of these radiographic features between cats with HCM and RCM. CONCLUSIONS AND RELEVANCE Moderate-to-severe cardiomegaly and LAE, caudal pulmonary artery and vein dilation, as well as a ventral, multifocal and symmetrical interstitial pulmonary pattern, were the main radiographic features of CPE in evaluated cats. Underlying cardiac disease did not influence the aforementioned radiographic features.
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Affiliation(s)
- Alessia Diana
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Simone Perfetti
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Carlotta Valente
- 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
- Current address: Klinik für Kleintiermedizin, Universität Zürich – Vetsuisse-Fakultät, Zurich, Switzerland
| | - Pascaline Pey
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
- Current address: Antech Imaging Services, Irvine, CA, USA
| | - Mario Cipone
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Helen Poser
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Carlo Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
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Kim J, Kim DH, Kim K, Oh D, Choi J, Yoon J. Evaluation of the pulmonary vein ostia during the cardiac cycle using electrocardiography-gated cardiac computed tomography in cats. Front Vet Sci 2022; 9:1013963. [PMID: 36238436 PMCID: PMC9552931 DOI: 10.3389/fvets.2022.1013963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/05/2022] [Indexed: 12/04/2022] Open
Abstract
Several studies in humans have provided detailed descriptions of the anatomy of the pulmonary veins (PVs) and their ostia for the implementation of thoracic interventions, such as radiofrequency ablation, for patients with atrial fibrillation. These studies have shown that electrocardiography (ECG)-gated multidetector computed tomography (MDCT) can evaluate the dimensional variations in the PVs or ostium according to the cardiac cycle. However, few studies have examined the PVs or ostia using MDCT in veterinary medicine. Therefore, this study investigated the variation in the diameter of the PV ostium in cats during the cardiac cycle using ECG-gated MDCT and determined the correlation between the size of the heart or left atrium (LA) and diameter of the PV ostium. This study included six cats, including five normal animals and one cat with hypertrophic cardiomyopathy. The PVs were found to drain into the LA via three ostia, i.e., the right cranial ostium, left cranial ostium, and caudodorsal ostium. Moreover, a diametric variation was observed in all PV ostia according to the cardiac cycle phase on ECG-gated MDCT: the maximal diameter was observed at the end of ventricular systole, and the minimal diameter was observed at the end of ventricular diastole for each PV ostium. There were no significant correlations between the heart or LA size and maximal or minimal diameter of each of the three PV ostia (p > 0.05); however, the enlargement of each PV ostium at the end of ventricular systole differed significantly from that at the end of ventricular diastole. This study suggested the clinical feasibility of ECG-gated MDCT in providing more detailed anatomical information about the PVs, including the dimensional changes during the cardiac cycle in cats. Based on this study, knowledge of the variations in the PV ostium offers interesting avenues for research into the effect of PV function. Furthermore, ECG-gated MDCT could allow for greater clinical application of interventional procedures in animals with various cardiac diseases.
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Affiliation(s)
- Junyoung Kim
- Medical Imaging, Helix Animal Medical Center, Seoul, South Korea
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Dae-Hyun Kim
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Kitae Kim
- Medical Imaging, BIEN Animal Medical Center, Bucheon, South Korea
| | - Dayoung Oh
- Medical Imaging, BIEN Animal Medical Center, Bucheon, South Korea
| | - Jihye Choi
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Junghee Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
- *Correspondence: Junghee Yoon
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Suzuki R, Saito T, Yuchi Y, Kanno H, Teshima T, Matsumoto H, Koyama H. Detection of Congestive Heart Failure and Myocardial Dysfunction in Cats With Cardiomyopathy by Using Two-Dimensional Speckle-Tracking Echocardiography. Front Vet Sci 2021; 8:771244. [PMID: 34869741 PMCID: PMC8634135 DOI: 10.3389/fvets.2021.771244] [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: 09/06/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Congestive heart failure (CHF) is a life-threatening condition in cats with cardiomyopathy. We hypothesized that myocardial dysfunction may induce progression to CHF pathophysiology in cats with cardiomyopathy. However, no previous studies have evaluated the involvement of myocardial dysfunction in cats with CHF. In this study, we aimed to evaluate the relationship between CHF and myocardial function assessed using two-dimensional speckle-tracking echocardiography (2D-STE). Sixteen client-owned healthy cats and 32 cats with cardiomyopathy were enrolled in this study. Cats were classified into three groups: healthy cats, cardiomyopathy without CHF (CM group), and cardiomyopathy with CHF (CHF group). Left ventricular (LV) longitudinal and circumferential strains (SL and SC, respectively), and right ventricular (RV) SL were measured using 2D-STE. Logistic regression analysis was performed to assess the relationship between CHF and echocardiographic variables, including 2D-STE. Results comparing the healthy cats and CM vs. CHF groups showed that increased left atrial to aortic diameter ratio and decreased LV apical SC were significantly associated with the existence of CHF (odds ratio [95% confidence interval]: 1.40 [1.16-1.78] and 1.59 [1.06-2.36], respectively). Results comparing the CM vs. CHF group showed that increased end-diastolic RV internal dimension and decreased RV SL were significantly associated with the existence of CHF (odds ratio: 1.07 [1.00-1.13] and 1.34 [1.07-1.68], respectively). Left atrial enlargement and depressed LV apical myocardial function may be useful tools for predicting the progression to CHF in cats. Furthermore, RV enlargement and dysfunction may lead to the onset of CHF in asymptomatic cats with cardiomyopathy.
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Affiliation(s)
- Ryohei Suzuki
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takahiro Saito
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Yunosuke Yuchi
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Haruka Kanno
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takahiro Teshima
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hirotaka Matsumoto
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hidekazu Koyama
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Morita T, Nakamura K, Osuga T, Takiguchi M. Repeatability, reproducibility, and reference intervals for indices of right atrial longitudinal strain derived from speckle-tracking echocardiography in healthy dogs. Am J Vet Res 2021; 82:274-279. [PMID: 33764827 DOI: 10.2460/ajvr.82.4.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine repeatability, reproducibility, and reference intervals of indices of right atrial longitudinal strain (RALS) derived from speckle-tracking echocardiography (STE) in dogs without heart disease. ANIMALS 110 client-owned dogs and 10 laboratory Beagles. PROCEDURES To determine intraobserver within-day (repeatability) and interobserver (reproducibility) coefficients of variation, RALS during ventricular systole (ϵS), ventricular early diastole (ϵE), and atrial systole (ϵA), as derived with STE, were obtained by 2 investigators for 5 randomly selected client-owned dogs and analyzed by linear regression. Reference intervals were estimated from the results of all dogs. Correlations between RALS indices (ϵS, ϵE, and ϵA) and sex, age, body weight, heart rate, and blood pressure were determined. RESULTS RALS derived from STE showed good intraobserver within-day repeatability and interobserver reproducibility, with coefficients of variation of < 20%. Both ϵS and ϵE were significantly negatively correlated with age, but ϵA was not correlated with age. Indices were not correlated with sex, body weight, or blood pressure. CONCLUSIONS AND CLINICAL RELEVANCE RALS indices derived from STE were repeatable and reproducible and were affected by the age of dogs without heart disease. Age should be considered in the interpretation of RALS indices in clinical settings. Further studies are needed to apply RALS indices for assessing dogs with heart disease.
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Corda A, Corda F, Caivano D, Saderi L, Sotgiu G, Mollica A, Birettoni F, Porciello F, Pinna Parpaglia ML. Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs. J Vet Intern Med 2020; 34:2337-2344. [PMID: 32949191 PMCID: PMC7694867 DOI: 10.1111/jvim.15891] [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: 03/15/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
Background Systemic hypertension (SH) is a persistent and pathological increase in arterial blood pressure (BP). Chronic SH leads to an increase in aortic (Ao) stiffness, and measuring Ao elasticity is useful for estimating Ao stiffness in humans. Currently, no literature in veterinary medicine describes noninvasive assessment of abdominal Ao elasticity in dogs with SH. Objective Compare ultrasonographic‐derived abdominal Ao strain (AoSt) between hypertensive (HT) and normotensive (NT) dogs. Animals Fifty privately‐owned dogs with clinical signs, conditions, or both potentially associated with SH. Methods Prospective observational case‐control study. Aortic stiffness was estimated by calculating AoSt as follows: AoSt = ([AoDs − AoDd]/AoDd) × 100, where AoDs and AoDd are the Ao diameter in systole and in diastole, respectively. Aortic stiffness was calculated from 2 different Ao transverse sections, the first caudal to the left renal artery (K_AoSt), and the second cranial to the external iliac arteries (I_AoSt). Results Thirty‐two dogs were included in the HT group and 18 in the NT group. Both K_AoSt and I_AoSt in HT dogs were significantly lower (P < .05) than in NT dogs (7.4 ± SD 3.6) vs 10.3 (±3.8) and 5.7 (interquartile range [IQR], 3.9‐7.5) vs 8.1 (IQR, 7‐10.3), respectively. Only K_AoSt was significantly influenced by age. Conclusions and Clinical Importance Ultrasonographic Ao elasticity assessment was feasible to compare HT and NT dogs. Results indicated that K_AoSt and I_AoSt indices can be used to assess SH‐related Ao stiffness, especially when indirect BP measurements are inconsistent or inaccurate. Additional studies to assess the AoSt in healthy dogs of various ages are needed.
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Affiliation(s)
- Andrea Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Francesca Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Domenico Caivano
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Laura Saderi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Mollica
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Francesco Birettoni
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Francesco Porciello
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
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Caivano D, Rishniw M, Baiona L, Birettoni F, Nisini N, Porciello F. Assessment of Longitudinal Left Ventricle Deformation by 2-Dimensional Speckle Tracking Echocardiography Obtained from Different Views in Cats. Vet Sci 2020; 7:vetsci7030104. [PMID: 32781537 PMCID: PMC7558847 DOI: 10.3390/vetsci7030104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/26/2020] [Accepted: 08/05/2020] [Indexed: 11/29/2022] Open
Abstract
Two-dimensional speckle tracking echocardiography (STE) is a novel, angle-independent imaging technique useful to assess myocardial function by strain and strain rate analysis in human and veterinary medicine. Commonly, the left apical four-chamber (LAP4Ch) view is used to assess left ventricular (LV) longitudinal deformation in dogs and cats. However, the right parasternal four-chamber (RP4Ch) view is often more easily obtained than the LAP4Ch view in cats. No studies exist comparing longitudinal strain and strain rate values using STE from different echocardiographic views in cats. Therefore, we examined the agreement between RP4Ch and LAP4Ch for assessment of LV longitudinal strain and strain rate in cats. We acquired 2D echocardiographic cineloops from RP4Ch and LAP4Ch views and analyzed LV longitudinal strain and strain rate in 50 cats (31 healthy cats and 19 cats with different disease states) using XstrainTM software. Peak systolic strain and strain rate values of endocardial and epicardial border were used for the analysis. The two echocardiographic views were compared using limits-of-agreement analyses and intra-observer measurement variability was assessed. We could obtain longitudinal strain and strain rate from the RP4Ch view in all cats. Strain, but not strain rate, had good intra-observer measurement variability (<10% vs. <20%). However, only endocardial strain values obtained with the two views agreed sufficiently to be used interchangeably (95% limits of agreement: −3.28, 2.58). Epicardial strain/strain rate and endocardial strain rate values did not agree sufficiently to be used interchangeably (95% limits of agreement: −11.58, 9.19; −2.28, 1.74; −1.41, 1.36, respectively). Our study suggests that RP4Ch view was feasible for assessment of the LV longitudinal deformation analysis by STE in cats, but only endocardial longitudinal strain values obtained from the two different views were interchangeable.
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Affiliation(s)
- Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (L.B.); (N.N.); (F.P.)
- Correspondence: (D.C.); (F.B.); Tel.: +39-075-5857613 (D.C.); +39-075-5857608 (F.B.)
| | - Mark Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA;
| | - Lucia Baiona
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (L.B.); (N.N.); (F.P.)
| | - Francesco Birettoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (L.B.); (N.N.); (F.P.)
- Correspondence: (D.C.); (F.B.); Tel.: +39-075-5857613 (D.C.); +39-075-5857608 (F.B.)
| | - Noemi Nisini
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (L.B.); (N.N.); (F.P.)
| | - Francesco Porciello
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (L.B.); (N.N.); (F.P.)
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Rauch J, Fehr M, Beyerbach M, Hungerbuehler SO. Comparative assessment of left atrial volume in healthy cats by two-dimensional and three-dimensional echocardiography. BMC Vet Res 2020; 16:263. [PMID: 32727447 PMCID: PMC7391821 DOI: 10.1186/s12917-020-02473-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 07/13/2020] [Indexed: 12/03/2022] Open
Abstract
Background The left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats. Its size is currently measured in one-dimensional methods, while human medicine considers two- and three-dimensional echocardiography as standard. The objectives of this study were to compare monoplane, biplane, triplane and real-time three dimensional echocardiography for volumetric measurement of the left atrium in healthy cats and establish a reference interval for further studies on cats with heart disease. Additionally, the influence of age, sex and weight on left atrial volume (LAV) was tested. Results One dimensional monoplane Simpson method of discs (SMOD) in the right parasternal four chamber view (r4) and the left apical 2 chamber view (l2) as well as biplane SMOD had no significant difference for left atrial maximum volume (LAMax). They can be used as equivalent in future studies and one common reference range was set up (1.96 ± 0.54 ml). Those three methods produced significantly higher volumes than triplane echocardiography (RTTPE) and real time three dimensional echocardiography (RT3DE) using TomTec® software. LA volumetry with RTTPE and RT3DE-TomTec™ was more feasible than expected, but low RT3DE image quality was the main reason for excluding patients. Neither age nor weight had an influence on LA volume in healthy cats. Male LAV results were only slightly, but in 2D and RTTPE significantly higher than those of female cats with a range of + 10.46% to + 19.58%. Conclusions Monoplane, biplane, triplane and real-time three dimensional echocardiography were feasible for LA volumetry in healthy cats and showed acceptable intra- and interobserver variability. One common LAMax reference range for monoplane r4, l2 and biplane SMOD was set up. Raw data can be used for LA volumes and does not need to be correlated with the cat’s weight or age. Male cats have only slightly but significantly larger atria than females in 2D and RTTPE. Therefore, under reservation, also sex related limit values were defined.
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Affiliation(s)
- Janina Rauch
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany.
| | - Michael Fehr
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany
| | - Martin Beyerbach
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 2, D-30559, Hannover, Germany
| | - Stephan O Hungerbuehler
- Tiergesundheitszentrum Hungerbühler, Tierärztliche Klinik für Kleintiere Salzgitter, Gerichtsweg 3, 38229, Salzgitter, Germany
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