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Lo Feudo CM, Stucchi L, Stancari G, Alberti E, Conturba B, Zucca E, Ferrucci F. Associations between Exercise-Induced Pulmonary Hemorrhage (EIPH) and Fitness Parameters Measured by Incremental Treadmill Test in Standardbred Racehorses. Animals (Basel) 2022; 12:ani12040449. [PMID: 35203157 PMCID: PMC8868235 DOI: 10.3390/ani12040449] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Exercise-induced pulmonary hemorrhage (EIPH) frequently affects racehorses worldwide and has been widely associated with poor performance; however, scientific evidence supporting this observation is low. The present retrospective study aims to evaluate objectively whether the presence and grade of EIPH could affect some fitness parameters, measured during an incremental treadmill test, in poorly performing Standardbred racehorses. For this purpose, the association between EIPH and the results of a treadmill metabolic test (including blood lactate analysis and venous blood gas analysis) were evaluated in 81 Standardbred racehorses. No relationship between EIPH and aerobic/anaerobic capacity was observed, suggesting that EIPH may affect performance in a different manner. However, EIPH-affected horses were shown to reach higher hematocrit values during exercise compared to EIPH-negative horses; therefore, it may be hypothesized that hemoconcentration may take part in the pathogenesis of EIPH by increasing the pulmonary capillary pressure. Abstract Exercise-induced pulmonary hemorrhage (EIPH) is a condition affecting up to 95% of racehorses, diagnosed by detecting blood in the trachea after exercise and/or the presence of hemosiderophages in the bronchoalveolar lavage fluid (BALf). Although EIPH is commonly associated with poor performance, scientific evidence is scarce. The athletic capacity of racehorses can be quantified through some parameters obtained during an incremental treadmill test; in particular, the speed at a heart rate of 200 bpm (V200), and the speed (VLa4) and the heart rate (HRLa4) at which the blood lactate concentration reaches 4 mmol/L are considered good fitness indicators. The present retrospective study aims to evaluate whether EIPH could influence fitness parameters in poorly performing Standardbreds. For this purpose, data from 81 patients regarding their V200, VLa4, HRLa4, peak lactate, maximum speed, minimum pH, and maximum hematocrit were reviewed; EIPH scores were assigned based on tracheobronchoscopy and BALf cytology. The association between the fitness parameters and EIPH was evaluated through Spearman’s correlation analysis. No relationship between EIPH and V200, VLa4, and HRLa4 was observed. Interestingly, EIPH-positive horses showed higher hematocrit values (p = 0.0072, r = 0.47), suggesting the possible influence of the hemoconcentration on the increase of pulmonary capillary pressure as a part of the pathogenesis of EIPH.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
| | - Luca Stucchi
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (L.S.); (G.S.); (B.C.)
| | - Giovanni Stancari
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (L.S.); (G.S.); (B.C.)
| | - Elena Alberti
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
| | - Bianca Conturba
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (L.S.); (G.S.); (B.C.)
| | - Enrica Zucca
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
- Correspondence: ; Tel.: +39-0250334146
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Abstract
Equine heart diseases can be categorized with morphologic, etiologic, and physiologic diagnoses and classified anatomically as diseases of the pericardium, myocardium, valves (endocardium), and great vessels. An appreciation of normal and pathologic physiology is a key to understanding diagnosis and therapy of heart disease. Pathophysiologic diagnoses include arrhythmias, congestive heart failure, and pulmonary hypertension. Heart rhythm disturbances can occur in isolation or with structural disease. Heart failure stems from arterial filling owing to insufficient cardiac output. Pulmonary hypertension is associated with strenuous exercise, left heart failure, bronchopulmonary diseases, and pulmonary arteriopathies. The etiopathogenesis of these disorders are incompletely understood.
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Affiliation(s)
- John D Bonagura
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27606, USA; Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
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Abstract
Respiratory and cardiac diseases are common in older horses. Advancing age is a specific risk factor for cardiac murmurs and these are more likely in males and small horses. Airway inflammation is the most common respiratory diagnosis. Recurrent airway obstruction can lead to irreversible structural change and bronchiectasis; with chronic hypoxia, right heart dysfunction and failure can develop. Valvular heart disease most often affects the aortic and/or the mitral valve. Management of comorbidity is an essential element of the therapeutic approach to cardiac and respiratory disease in older equids.
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Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB, van Loon G. Risk factors for recurrence of atrial fibrillation in horses after cardioversion to sinus rhythm. J Vet Intern Med 2015; 29:946-53. [PMID: 25917409 PMCID: PMC4895430 DOI: 10.1111/jvim.12606] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 02/13/2015] [Accepted: 03/31/2015] [Indexed: 11/29/2022] Open
Abstract
Background Although atrial fibrillation (AF) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence. Objectives To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for AF recurrence in horses. Animals 117 horses treated for AF at 4 referral centers. Methods Retrospective study. Inclusion criteria were successful cardioversion, echocardiography at 24 hours after cardioversion and ≥4 months follow‐up. To determine factors associated with AF recurrence, a multivariable survival model was built. Results 133 AF episodes in 117 horses were included. AF recurred in 36/100 horses with a first AF episode and in 57/133 AF episodes overall. Factors associated with recurrence in horses with a first episode were previous unsuccessful treatment attempt (hazard ratio HR 2.36, 95% confidence interval CI 1.11–4.99, P = .025) and mild or moderate mitral regurgitation (HR 2.70, 95% CI 1.23–5.91, P = .013). When the last AF episode of all horses was included, previous AF (HR 2.53, 1.33–4.82, P = .005) and active left atrial fractional area change ≤9.6% (HR 3.43, 1.22–9.67, P = .020) were significant predictors. Conclusions and Clinical Importance The only echocardiographic variable of left atrial function with significant prognostic value for recurrence was low active left atrial fractional area change. Further research is necessary to evaluate whether echocardiography at a later timepoint could provide more prognostic information.
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Affiliation(s)
- A Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, 9820, Belgium
| | - C C Schwarzwald
- Clinic for Equine Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, 8057, Switzerland.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, 43210
| | - D De Clercq
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, 9820, Belgium
| | - N Van Der Vekens
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, 9820, Belgium
| | - B Pardon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, 9820, Belgium
| | - V B Reef
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, 19348
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, 9820, Belgium
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ZUCCA E, FERRUCCI F, STANCARI G, SAPORITI T, FERRO E. The Prevalence of Cardiac Murmurs among Standardbred Racehorses Presented with Poor Performance. J Vet Med Sci 2010; 72:781-5. [DOI: 10.1292/jvms.09-0217] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Enrica ZUCCA
- Department of Veterinary Clinical Sciences, Equine Internal Medicine and Sports Medicine Service, Large Animal Veterinary Hospital, University of Milan
| | - Francesco FERRUCCI
- Department of Veterinary Clinical Sciences, Equine Internal Medicine and Sports Medicine Service, Large Animal Veterinary Hospital, University of Milan
| | - Giovanni STANCARI
- Department of Veterinary Clinical Sciences, Equine Internal Medicine and Sports Medicine Service, Large Animal Veterinary Hospital, University of Milan
| | - Tiziana SAPORITI
- Department of Veterinary Clinical Sciences, Equine Internal Medicine and Sports Medicine Service, Large Animal Veterinary Hospital, University of Milan
| | - Elisabetta FERRO
- Department of Veterinary Clinical Sciences, Equine Internal Medicine and Sports Medicine Service, Large Animal Veterinary Hospital, University of Milan
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Abstract
The mediastinum of eight normal research dogs was examined by transesophageal ultrasonography with a 5 MHz frequency transducer to establish a baseline for future use of this new imaging modality as a diagnostic tool. Each examination consisted of 360 degree scans in both transverse and sagittal planes from the thoracic inlet to the esophageal hiatus. Dissections of four of these research dogs were then performed to confirm transesophageal ultrasonography findings. Transesophageal ultrasonography of the mediastinum was a good imaging modality for the evaluation of the heartbase, the major cranial mediastinal vessels, the descending aorta, and occasionally part of the azygos vein. Anatomic orientation was best obtained by beginning the examination at the heart base. Lymph nodes and smaller caliber vessels could not be distinguished from surrounding tissues; however, Doppler ultrasound was useful for identifying the smaller vessels. Although a 5 MHz frequency transducer is preferred for transesophageal echocardiography, a higher frequency transducer would improve the resolution of the images of small near-field structures and may be more appropriate for mediastinal imaging.
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Affiliation(s)
- R S St-Vincent
- Department of Veterinary Anesthesiology, Radiology and Surgery, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
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Marr CM, Reef VB, Reimer JM, Sweeney RW, Reid SW. An echocardiographic study of atrial fibrillation in horses: before and after conversion to sinus rhythm. J Vet Intern Med 1995; 9:336-40. [PMID: 8531180 DOI: 10.1111/j.1939-1676.1995.tb01094.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Two-dimensional and M-mode echocardiograms were recorded from 41 horses before they were successfully treated for atrial fibrillation. In addition, these examinations were performed in a subgroup of 20 horses after treatment, and the results were compared with pretreatment values. Atrial fibrillation in this group of horses was associated with a reduction of mean left ventricular fractional shortening (mean 31% +/- 5.24%), and 22 of the 41 horses were below the reference range. The remaining mean M-mode variables were within the normal reference range, although 12 horses had increased left ventricular lumen dimensions in systole, and 8 horses had decreased left ventricular ejection times. Abnormal motion of the mitral valve was present in all horses and was characterized by the absence of A peaks, which were replaced by small diastolic undulations in 55% of the horses. In horses 1 to 20, after conversion to sinus rhythm, the mean fractional shortening increased (35.34% +/- 5.4%, P = .004), but there were no significant differences in heart rate or left ventricular lumen diameters in systole or diastole. These results suggest that ventricular function may be compromised by the presence of atrial fibrillation. However, this improved after correction of the arrhythmia.
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Affiliation(s)
- C M Marr
- Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, USA
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Marr CM. Equine echocardiography--sound advice at the heart of the matter. THE BRITISH VETERINARY JOURNAL 1994; 150:527-45. [PMID: 7850443 DOI: 10.1016/s0007-1935(94)80036-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Echocardiography is an extremely versatile tool for both the equine clinician and physiologist. There are three useful forms of echocardiography, B mode, M mode and Doppler. Together they provide complementary information on cardiac disease and haemodynamic status. B mode is used to image the cardiac chambers, valves, myocardium and pericardium. M mode allows determination of motion of cardiac structures; it is superior to B mode for timing of events and it is used to make precise measurements of the heart. Doppler echocardiography can assess intracardiac blood flow and its velocity. Echocardiography has applications in all forms of equine cardiac disease. In this article the principles of, and imaging techniques used in, B mode, M mode and Doppler echocardiography in the horse are reviewed. Normal findings and abnormalities seen in association with valvular lesions, congenital cardiac disease, myocardial and pericardial diseases are discussed. Recent developments in echocardiographic techniques for assessment of ventricular function are described.
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Affiliation(s)
- C M Marr
- Department of Clinical Veterinary Medicine, University of Cambridge, UK
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