M-MODE ECHOCARDIOGRAPHIC PARAMETERS AND INDICES IN THE NORMAL GERMAN SHEPHERD DOG

Echocardiographic findings in apparently healthy Czechoslovakian wolfdogs

INTRODUCTION

To echocardiographically evaluate a large number of apparently healthy Czechoslovakian wolfdogs (CWDs) to identify possible subclinical cardiac abnormalities and to generate reference intervals.

ANIMALS

One-hundred and seventeen apparently healthy client-owned CWDs.

MATERIALS AND METHODS

Standard two-dimensional, M-mode, and Doppler echocardiographic measurements were obtained on non-sedated, manually restrained standing dogs. Animals with no relevant echocardiographic abnormalities were used to generate reference intervals. Echocardiographic variables were compared between males and females and between dogs with and without mitral regurgitation (MR).

RESULTS AND DISCUSSION

Among the 117 CWDs, 103 dogs were used to generate reference intervals. The 14 dogs with abnormalities had more than trivial MR (12 dogs), subaortic stenosis (one dog), and equivocal subaortic stenosis (one dog). The 44 males were heavier than 59 females (P<0.001) and had a larger maximum left atrial dimension (P=0.015), left ventricular internal dimension at end-diastole (P<0.001) and systole (P<0.001), and thicker interventricular septum thickness at end-diastole (P=0.016). A positive linear correlation was identified between bodyweight and aortic root and left atrial diameters and left ventricular dimensions and between age and aortic root and left atrial diameter and peak late transmitral flow velocity. A negative linear correlation was identified between age and peak early transmitral flow velocity and the ratio between peak early and late transmitral flow velocities. No differences in echocardiographic-derived cardiac dimensions were detected between healthy dogs and dogs with more than trivial MR.

CONCLUSIONS

In this population of CWDs, subclinical cardiac abnormalities were uncommon, and they were mainly classified as MR.

M-Mode Echocardiography in Canine Veterinary Practice: A Comprehensive Review of Left Ventricular Measurements in 44 Different Dog Breeds

This review article focuses on the use of canine M-mode in veterinary medicine, specifically in assessing the left ventricle measurements in several breeds. It traces the historical development of echocardiography techniques, including A-mode, B-mode, and motion mode (M-mode), which provide accurate unidimensional records of cardiac structures. This article highlights the significance of M-mode measurements in diagnosing stage B2 of MMVD, where left ventricular end-diastolic internal diameter corrected with body weight (LVIDdN) is essential for identifying cardiac enlargement. It also explains the role of M-mode in diagnosing DCM, outlining criteria such as left ventricular dilatation. The authors emphasize the importance of breed-specific reference values for echocardiographic measurements due to variations in somatotype among dogs. This review provides a comprehensive table summarizing M-mode measurements of the left ventricle for 44 different dog breeds, including interventricular septum thickness, left ventricular internal diameter, and left ventricular posterior wall thickness during systole and diastole. This review's methodology involves compiling data from various scientific literature sources, providing an extensive tabular representation of M-mode measurements for different breeds, ages, and sexes. Overall, this review highlights the critical role of M-mode echocardiography in diagnosing and managing cardiac diseases in dogs, underscores the importance of breed-specific reference values, and presents a comprehensive summary of M-mode measurements for various dog breeds, aiding both clinicians and researchers.

Thoracic Vertebral Length-to-Height Ratio, a Promising Parameter to Predict the Vertebral Heart Score in Normal Welsh Corgi Pembroke Dogs

The vertebral heart score (VHS) is the sum of the ratio of the cardiac dimensions to the number of thoracic vertebrae, starting from the fourth thoracic vertebra (T4) to the intervertebral disk space (IVS). Breed-specific VHSs, in most cases, were different from the original reference value. Characteristics of the thoracic vertebrae and IVS may influence this variation. This study was conducted to investigate the characteristics of the T4 and IVS on the thoracic radiographs of Corgis in comparison with other small-to-medium breed dogs to evaluate the Corgi-specific VHSs in healthy dogs. The ratio of the T4's length/height (T4L/H) was significantly different among dog breeds but not the IVS between the T4 and T5. The T4L/H was highest in the Shih Tzu and lowest in Beagle dogs. The Corgi-specific VHS obtained from the ventrodorsal radiograph was significantly higher than that from the dorsoventral radiograph, but a significant difference was not observed between the right and left lateral radiographs. In contrast, the Corgi-specific VHS derived from the right lateral thoracic radiograph was significantly lower than the reference value. This may be correlated with the characteristics of the thoracic vertebrae of Corgis, which were slightly higher than those of the other breeds.

Echocardiographic evaluation of working dogs of the Military Police of Rio de Janeiro: effects of the breed and body weight

The Military Police of Rio de Janeiro state use dogs as a decisive tool for patrol and detection of drugs, weapons, and explosives. Complementary tests, such as echocardiography, are essential to maintain the integrity of these animals. This study aimed to evaluate the echocardiographic parameters of the working dogs belonging to the Military Police of Rio de Janeiro and compare them with the available data. Echocardiographic evaluation was performed on 48 healthy adult dogs from the Canine Action Battalion of the Military Police of Rio de Janeiro, Brazil. The sample consisted of 13 Labrador Retrievers, 12 Malinois Belgian Shepherds, 10 German Shepherds, 8 Dobermann Pinschers, and 5 Dutch Shepherds. Echocardiographic variables were correlated with body weight (BW). A positive correlation (P=0.0142, r=0.6837) between BW and the diameter of the left atrium was found in Malinois Belgian Shepherds. In German Shepherds, a positive correlation between BW and the internal diameter of the right ventricle during diastole (P=0.0320, r=0.6757) was observed; in addition, a positive correlation between BW and left ventricular internal diameter (P=0.0344, r=0.6689) during diastole was also found. Echocardiographic evaluations of these working dogs differed slightly from those previously established for similar-sized dog breeds.

Echocardiographic parameters and indices in 23 healthy Maltese dogs

BACKGROUND

Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease.

OBJECTIVES

To establish the normal echocardiographic parameters for Maltese dogs.

METHODS

In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis.

RESULTS

The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight.

CONCLUSION

This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.

An echocardiographic study of breed-specific reference ranges in healthy French Bulldogs

Echocardiography is a standard diagnostic tool for assessment of cardiac functions and cardiovascular diseases in dogs, however published echocardiographic measurements have varied widely based on dog breeds. The objective of this prospective reference interval study was to provide breed-specific echocardiographic values for healthy French Bulldogs. A total of 42 healthy French Bulldogs of both sexes (23 females and 19 males) were sampled. Furthermore, measurements for a control group (n = 16) were also conducted in four other dog breeds (Cocker Spaniel [n = 2], Cavalier King Charles Spaniel [n = 4], Terrier [n = 5], and Crossbreed [n = 5]). Standard M-mode, two-dimensional (2D), pulse wave (PW) Doppler, and tissue Doppler imaging (TDI) echocardiographic measurements were obtained from healthy French Bulldogs. The M-mode echocardiographic data obtained from French Bulldogs were compared to the data obtained from the control group. The left ventricular internal dimension at end-diastole (LVIDd; cm)/body surface area (BSA) (m² ) ratio for the study group was 3.35/0.53 = 6.32. Left ventricular measurements for French bulldogs and internal dimension at end-systole (21.23 ± 3.50 mm) and at end-diastole (33.50 ± 4.12 mm) were found to be significantly higher (P < .001) compared to control group values (left ventricular internal dimension at end-systole [LVIDs]; 17.46 ± 2.85 mm, LVIDd; 27.16 ± 4.20 mm, respectively). A significantly positive correlation in the French Bulldog group was noted between body weight and M-mode measurements (EPSS, IVSd, IVSs, LVIDd, LVIDs, and LVPWd). French bulldogs had a greater systolic and diastolic left ventricular volume than the control group. As a result, values reported in this study could be used as specific reference ranges in French Bulldogs.

Echocardiographic reference intervals for volumetric measurements of the left ventricle using the Simpson's method of discs in 1331 dogs

Background

Echocardiographic measurements play an important role in detecting cardiac enlargement and assessing cardiac function. In human cardiology, M‐mode measurements have been widely replaced by volumetric measurements of the left ventricle (LV) using Simpson's method of disc (SMOD). In veterinary cardiology, more large‐scale studies are necessary to generate reference intervals (RIs) for SMOD LV volume measurements.

Objective

To generate body size independent RIs for LV volume measurements in dogs.

Animals

Healthy adult dogs (n = 1331) of variable size and somatotype.

Methods

Prospective study. The SMOD was measured from the right parasternal long axis and the left apical 4‐chamber view in clinically healthy dogs. The SMOD measurements were normalized to various allometric scales (kg, kg^2/3, or kg^1/3). RIs for LV end‐diastolic volume (LVEDV) and LV end‐systolic volume (LVESV) using SMOD were estimated as prediction intervals of both a linear and an additive regression model. Additionally, after normalization to body weight, 95% RIs were determined using nonparametric methods with 2.5 and 97.5 percentiles serving as the lower and upper limits. Separate analyses were performed for 120 sighthound breeds and 1211 other breeds.

Results

Echocardiographic LV volumes correlated best with weight in kilograms. The additive model proved to be more flexible and accurate than the other 2 methods to generate RIs. Separate RIs for sighthound and all other breeds are provided.

Conclusions and Clinical Importance

Body size and breed‐independent RIs for LV volume measurements using SMOD were generated prospectively from a large and diverse population of dogs and are available for clinical use.

Two-dimensional echocardiographic measures of left ventricular dimensions agree with M-mode measurements in dogs

INTRODUCTION

Clinicians measure left ventricular dimensions in dogs from both M-mode and two-dimensional images. Little information currently exists as to whether these two methods provide measurements similar enough to be interchangeable.

ANIMALS

The animals included in this study are 206 client-owned dogs: 68 healthy, 105 with myxomatous mitral valve disease, 33 with other cardiac or extracardiac disease.

MATERIALS AND METHODS

Investigators measured left ventricular diastolic and systolic dimensions from archived M-mode and two-dimensional images obtained from the right parasternal short-axis view. Agreement between the pairs of measurements was examined using limits of agreement (Bland-Altman) plots.

RESULTS

Left ventricular diastolic dimensions showed no fixed or proportional bias but did show heteroscedasticity. Ninety-five percent limits of agreement for normalized differences approximated ±10%; 95% of the absolute differences for any pair of measurements were <3.9 mm regardless of bodyweight and <2.7 mm for dogs <15 kg. Left ventricular systolic dimensions showed slight proportional bias, with two-dimensional measurements being progressively larger than M-mode measurements as ventricular size increased. Ninety-five percent limits of agreement for normalized differences approximated ±20%; 95% of the absolute differences for any pair of measurements were <4.6 mm regardless of bodyweight and <3.5 mm for dogs <15 kg. Mitral valve disease did not appreciably affect these findings.

CONCLUSIONS

Left ventricular internal dimensions in dogs with and without cardiac disease measured from two-dimensional right parasternal short-axis images are interchangeable with those measured from M-mode images using the same view.

Left ventricular M-mode prediction intervals in 7651 dogs: Population-wide and selected breed-specific values

BACKGROUND

Echocardiography is a common method to measure heart size in dogs. The heart dimensions are influenced by body weight (BW) and potentially by breed.

OBJECTIVES

To establish BW-dependent prediction intervals (PIs) of the left ventricular (LV) linear dimensions in a population of dogs of many breeds in multicenter environment, and to identify breeds deviating from these intervals. DOGS: Seven thousand six hundred and fifty-one dogs.

METHODS

Retrospectively, data from heart screens conducted between 2009 and 2016 were included. Cardiac dimensional PIs were generated using allometric scaling including all nonsighthound dogs and values were compared to previously published PIs. The values measured in dogs of respective breeds, including sighthounds, were then compared to the overall nonsighthound PIs to identify deviant breeds. The interobserver-variability of the measurements was determined using the explained residual variance.

RESULTS

Prediction intervals for the nonsighthound dogs were in agreement with previously published cardiac PIs, although the upper limits of the generated PIs of our study were slightly below those currently applied (except the interventricular septum in systole and the left ventricular free wall in diastole below 10.0 kg and 15.0 kg, respectively). Values measured in the nonsighthound breed Newfoundland deviated for most dimensions. Most of the sighthound breeds analyzed had greater cardiac dimensions, with the exception of the Irish Wolfhound.

CONCLUSION AND IMPORTANCE

Findings of our study reinforces the value of BW-dependent PIs for cardiac dimensions in dogs and suggest that these PIs are valid for most nonsighthound breeds, but not the sighthound breeds.

Echocardiographic reference intervals with allometric scaling of 823 clinically healthy rhesus macaques (Macaca mulatta)

BACKGROUND

Echocardiography is commonly used for assessing cardiac structure and function in various species including non-human primates. A few previous studies reported normal echocardiographic reference intervals of clinically healthy rhesus macaques under sedation. However, these studies were under-powered, and the techniques were not standardized. In addition, body weight, age, and sex matched reference intervals should be established as echocardiographic measurements are commonly influenced by these variables. The purpose of this study was to establish reference intervals for complete echocardiographic parameters based on a large cohort of clinically healthy rhesus macaques with wide ranges of weight and age distributions using allometric scaling.

RESULTS

A total of 823 rhesus macaques (ages 6 months to 31 years old; body weights 1.4 to 22.6 kg) were enrolled. Of these rhesus macaques, 421 were males and 402 were females. They were assessed with a complete echocardiographic examination including structural and functional evaluation under sedation with ketamine hydrochloride. The reference intervals of the key echocardiographic parameters were indexed to weight, age, and sex by calculating the coefficients of the allometric eq. Y = aM^b. On correlation matrix, body weight, age, sex, and heart rate were significantly correlated with various echocardiographic parameters and some of the parameters were strongly correlated with body weight and age. Multiple regression analysis revealed that heart rate and body weight statistically significantly predicted several echocardiographic parameters. Valve regurgitation including tricuspid, aortic, pulmonic, and mitral regurgitations without other cardiac structural and functional abnormalities are common in clinically healthy rhesus macaques under ketamine sedation.

CONCLUSIONS

In this study, the reference intervals of echocardiographic parameters were established by performing complete echocardiographic examinations on a large number of clinical healthy rhesus macaques. In addition, allometric scaling was performed based on their weight, and further indexed to age and sex. These allometrically scaled reference intervals can be used to accurately evaluate echocardiographic data in rhesus macaques and diagnose structural and functional evidence of cardiac disease.

Use of cardiac sphericity index and manubrium heart scores to assess radiographic cardiac silhouettes in large-and small-breed dogs with and without cardiac disease

OBJECTIVE

To evaluate the usefulness of manubrium heart scores (MHSs) in distinguishing between dogs with and without cardiac disease.

ANIMALS

184 client-owned dogs with (n = 64) and without (120) cardiac disease.

PROCEDURES

Medical records, including thoracic radiographic images, of dogs that either had echocardiographically confirmed moderate to severe cardiac disease with cardiomegaly (case dogs) or were healthy and without evidence of cardiac disease (control dogs) were retrospectively reviewed. From right lateral thoracic radiographic images, the lengths of the cardiac short and long axes and the manubrium were measured and cardiac sphericity indices (CSIs), MHSs, and vertebral heart scores were determined. Dogs were grouped on the basis of whether they did or did not have cardiac disease (case dogs vs control dogs), breed size (large-breed dogs vs small-breed dogs), and whether cardiac disease affected the right side of the heart (right-sided cardiac disease) or the left side of heart (left-sided cardiac disease). Results were compared across groups.

RESULTS

The mean CSI was greatest in case dogs with right-sided cardiac disease, compared with other groups. In dogs of the present study, a combination of high short-, long-, and overall-MHSs was more suggestive of left-sided cardiac disease, whereas a high short-MHS without high long- and overall-MHSs was more suggestive of right-sided cardiac disease.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that MHSs could be useful, objective values to help assess dogs for potential heart disease, and we recommend that MHSs be added to the diagnostic tools used by veterinarians when screening for heart disease in dogs.

Reference intervals and echocardiographic findings in Leonberger dogs

INTRODUCTION

Leonbergers are large-breed dogs believed to be predisposed to dilated cardiomyopathy, yet the normal echocardiographic measurements of these dogs are unknown. The aim of this study was to describe echocardiographic findings and propose breed-specific reference intervals (RIs) for Leonbergers.

ANIMALS

A total of 42 clinically healthy dogs were involved in this study.

MATERIALS AND METHODS

This study was designed as a cross-sectional study of 42 Leonberger dogs undergoing complete transthoracic echocardiographic studies at a national show. Reference intervals were determined using robust method with bootstrapping. The effects of age, sex, and body weight (BW) on linear and volumetric dimensions were evaluated by regression analysis. Intra- and interobserver variability were evaluated by coefficient of variation from 10 of the studies.

RESULTS

There were significant linear correlations with BW for many of the cardiac variables evaluated. However, despite the statistical significance, most regression equations had small slopes, necessitating large changes in BW for small changes in two-dimensional echocardiographic variables. As such, this study resulted in breed-specific RIs irrespective of BW. Trace mitral insufficiency (n = 18), trace aortic insufficiency (n = 15), or both (n = 1) was identified in 81% of dogs in this population. Coefficients of variation were <9% for all two-dimensional, volumetric, and motion mode measurements.

CONCLUSIONS

This study describes echocardiographic findings and provides RIs, which may be useful in echocardiographic evaluations of Leonbergers and may aid in early identification of heart disease within the breed.

Echocardiographic study of healthy Indian Spitz dogs with normal reference ranges for the breed

Aim:

The present study was aimed to determine the normal reference values of M-mode echocardiographic measurements in healthy Indian Spitz dogs and evaluate the influence of gender and body weight on these measurements.

Materials and Methods:

M-mode echocardiography was performed in twenty-four clinically healthy conscious Indian Spitz dogs, aged 3-5 years and weighing 7-18 kg. Measurements were made from the right parasternal long axis left ventricular outflow tract view of the heart. The parameters recorded were: Left ventricular internal dimension, interventricular septal thickness and left ventricular posterior wall thickness during diastole and systole, left atrial diameter, aortic root diameter, left ventricular systolic functional parameters, and indices and mitral valve parameters.

Results:

M-mode echocardiographic measurements in healthy Indian Spitz dogs were standardized. Gender had no influence on echocardiographic measurements except mitral valve excursion amplitude and time interval between onset and end of mitral valve closure, which were significantly (p<0.05) higher in females than males. Left ventricular internal dimension at end-diastole, left ventricular internal dimension at end-systole, left ventricular posterior wall dimension at end-systole, end-diastolic volume, end-systolic volume, stroke volume, cardiac output, left ventricular ejection time, and mitral valve excursion amplitude correlated significantly (p<0.05) with body weight in Indian Spitz dogs.

Conclusion:

Data obtained in the present study can be used as breed-specific reference values for cardiac disease diagnosis as well as for future studies in Indian Spitz dogs.

Radiographic assessment of the cardiac silhouette in clinically normal large- and small-breed dogs

OBJECTIVE To determine manubrium heart scores (MHSs) from measurements of cardiac short-axis length (cSAL) and long-axis length (cLAL) relative to the corresponding manubrium length (ML) on thoracic radiographic views of dogs and assess correlation of MHSs with vertebral heart scores (VHSs). ANIMALS 120 clinically normal large-breed dogs (LBDs) and small-breed dogs (SBDs). PROCEDURES On right lateral views (RLVs) and ventrodorsal views (VDVs) for each dog, cSAL and cLAL were measured and expressed as a ratio; the cSAL:ML ratio (short-MHS), cLAL:ML ratio (long-MHS), and cSAL-and-cLAL:ML ratio (overall-MHS) were also calculated. The VHS was determined from the RLV. Correlation of VHS with MHS was assessed. RESULTS On RLVs and VDVs, mean cSAL:cLAL ratios were 0.77 (SD, 0.05) and 0.72 (SD, 0.05), respectively, in 60 LBDs and 0.81 (SD, 0.06) and 0.78 (SD, 0.06), respectively, in 60 SBDs. In LBDs, mean short-MHS, long-MHS, and overall-MHS were 2.1 (SD, 0.22), 2.7 (SD, 0.24), and 4.8 (SD, 0.5), respectively, on RLVs and 2.3 (SD, 0.26), 3.2 (SD, 0.34), and 5.4 (SD, 0.6), respectively, on VDVs. In SBDs, mean short-MHS, long-MHS, and overall-MHS were 2.4 (SD, 0.39), 2.9 (SD, 0.50), and 5.3 (SD, 0.83), respectively, on RLVs and 2.5 (SD, 0.44), 3.2 (SD, 0.51), and 5.8 (SD, 0.92), respectively, on VDVs. Mean VHSs were 10.73 (SD, 0.52) and 10.27 (SD, 0.81) in LBDs and SBDs, respectively. A significant correlation was identified between VHS and each MHS in LBDs. CONCLUSIONS AND CLINICAL RELEVANCE In the dogs evaluated, radiographic cardiac dimensions and MHSs were correlated. Validity of the MHS for cardiac dimension assessment in other healthy dogs and dogs with cardiac disease warrants investigation.

Two-dimensional left atrium-to-aorta ratios and left ventricular M-mode transthoracic echocardiographic measurements in clinically normal adult Dachshunds

OBJECTIVE

To estimate the left atrium-to-aorta ratio (LA:Ao) and establish 95% prediction intervals for left ventricular M-mode transthoracic echocardiographic measurements in clinically normal adult Dachshunds.

ANIMALS

40 healthy Dachshunds.

PROCEDURES

For each dog, 3 standard 2-D echocardiographic methods (diameter, circumference, and cross-sectional area) were used to measure the left atrium and aorta and calculate the LA:Ao from right parasternal short axis (RPSA) images obtained at the level of the aortic valve cusps. Left ventricular M-mode measurements were acquired from RPSA images obtained at the chordal level immediately below the mitral valve. Descriptive data were generated, and the 95% prediction intervals were calculated by use of an allometric scaling equation and linear regression and compared with those calculated on the basis of data obtained from dogs of multiple breeds in a previous study.

RESULTS

The mean (SD) LA:Ao was 1.40 (0.13), 2.09 (0.17), and 2.85 (0.48) for the diameter, circumference, and cross-sectional area methods, respectively. The 95% prediction intervals for the left ventricular M-mode measurements determined by an allometric scaling equation on the basis of Dachshund-specific data were narrower than those determined on the basis of data obtained from dogs of multiple breeds. For that allometric equation, scaling exponents on the basis of Dachshund-specific data ranged from 0.129 to 0.397 and did not absolutely conform to the presumed index for linear measurements (ie, body weight(0.333)).

CONCLUSIONS AND CLINICAL RELEVANCE

The LA:Aos and 95% prediction intervals calculated in this study can be used as preliminary guidelines for echocardiographic measurements of clinically normal Dachshunds.

NT-proBNP in Children With Left to Right Shunt and Dilated Cardiomyopathy

Background

B-type natriuretic peptide (BNP) levels are elevated in children with congenital heart disease involving a left-to-right shunt (LRS) and are also raised in dilated cardiomyopathy (DCM). As far as we know, there are few reports in the literature comparing the change of the NT-proBNP in LRS and DCM especially in the pediatric age group.

Objectives

The aim of the study was to compare the changes of the NT-proBNP in pediatric patients with LRS and DCM. Correlation between the levels of NT-proBNP and the echocardiographic parameters in both groups was determined.

Patients and Methods

A total of 30 children (13 males and 17 females) participated in the study. There were 11/30 (36.7%) DCM and 19/30 (63.3%) LRS. The control group consisted of 44 healthy infants and children. Manifestations of heart failure (decompensation) were recorded. The NT-pro BNP levels were measured. The following Echo parameters were assessed: systolic function (ejection fraction and fraction shortening), pulmonary to systemic flow (Qp/Qs) in LRS, pulmonary flow and pulmonary artery pressure (SPAP) and LV diastolic function (E-wave, A-wave, E/A ratio and deceleration time).

Results

Clinically 17/30 (56.7%) (11 of the LRS and 5 of the DCM) were decompensated. Significant shunt was present in 15/19 (78.9%) in LRS. Systolic dysfunction was presented in 5/30 (16.7%) cases (4 patients were DCM and one case was LRS). Two types of diastolic dysfunction, impaired relaxation in 5/22 (22.7%) patients and restrictive-like filling pattern in 5/16 (31.2 %) were observed. The NT-Pro BNP level was significantly elevated 11 and 16 times in the LRS and DCM groups respectively. Negative significant correlations were observed between the levels of NT-ProBNP and the following echo variables; EDD, LAD, E wave and E/A ratio in the LRS patients. Positive significant correlations were observed between the levels of NT-ProBNP and the following echo variables; PAP and QP/QS in the LRS. Both the PAP and QP/QS were higher in the elevated NT-Pro BNP group compared to the normal level group. The NT-Pro BNP level was elevated in all 17/30 (56.7%) decompensated patients (11 were LRS, 6 were DCM) (P = 0.002). However, the level was elevated in only 7/13 (23.3%) of the compensated patients (3 were LRS, 4 were DCM) (P = 0.002). The NT-Pro BNP level was also elevated in 18/19 cases with pulmonary hypertension (P = 0.01). Finally, we conclude that the NT-ProBNP level is elevated in both LRS and DCM in pediatric age. This elevation is more remarkable with heart failure and increased PAP in both diseased groups. The level was also elevated and correlated to Qp/Qs in the LRS patients.

Conclusions

So, we recommend the use of NT-ProBNP as a routine marker for following up patients with heart failure and pulmonary hypertension in LRS and DCM.

Echocardiography and conventional Doppler examination in clinically healthy adult Cavalier King Charles Spaniels: effect of body weight, age, and gender, and establishment of reference intervals

OBJECTIVES

The objectives of this study were (1) to assess the potential effect of body weight (BW), age, and gender on the most commonly used echocardiographic and conventional Doppler variables in a large population of healthy Cavalier King Charles Spaniels (CKCS), and (2) to establish the corresponding reference intervals (RI).

ANIMALS

134 healthy adult CKCS.

METHODS

Ultrasound examinations were performed by trained observers in awake dogs. M-mode variables included left ventricular (LV) end-diastolic and end-systolic diameters, LV free wall and interventricular septal thicknesses at end-diastole and end-systole, and LV fractional shortening (FS%). The left atrium (LA) and aortic (Ao) diameters were measured using a 2D method, and the LA/Ao was calculated. Pulsed-wave Doppler variables included peak systolic aortic and pulmonary flow velocities, mitral E and A waves, and E/A ratio. Effects of BW, age, and gender on these 15 variables were tested using a general linear model, and RIs were determined by applying the statistical procedures recommended by the Clinical and Laboratory Standards Institute.

RESULTS

A significant BW effect was observed for all variables, except LA/Ao, FS%, and mitral E/A ratio. A significant but negligible effect of gender and age was also observed for 5/15 and 4/15 of the tested variables, respectively. Only the BW effect on M-mode variables was considered as clinically relevant and the corresponding regression-based RIs were calculated.

CONCLUSIONS

Body weight should be taken into account when interpreting echocardiographic values in CKCS, except for LA/Ao, FS%, and mitral E/A ratio.

Simpson's method of discs for measurement of echocardiographic end-diastolic and end-systolic left ventricular volumes: breed-specific reference ranges in Boxer dogs

Background

Boxer dogs are predisposed to congenital and adult onset cardiac diseases. Breed‐specific reference values for M‐mode and Doppler echocardiographic measurements previously have been established. Left ventricular (LV) end‐systolic (ESV) and end‐diastolic volumes (EDV) can be measured by M‐mode or two‐dimensional methods, such as Simpson's method of discs (SMOD). Reference ranges for SMOD‐derived LV volumes are lacking.

Objectives

To determine reference intervals for EDV and ESV in Boxer dogs.

Animals

Previously collected data from 85 healthy Boxers (37 males and 48 females) were used for analysis.

Methods

Simpson's method of discs‐derived EDV and ESV were measured using offline analysis by 1 observer, in both the right parasternal and the left apical views. Measurements were compared between both views and between male and female dogs using a t‐test. Reference intervals were established using the mean + 2 × SD.

Results

Measurements obtained from both views showed good agreement, and mean EDVI and ESVI, indexed to body surface area (BSA), were calculated. Reference intervals were 49–93 mL/m² for EDVI, and 22–50 mL/m² for ESVI. EDV and ESV were significantly higher in males compared with females, when indexing to BSA, but not when indexing to body weight.

Conclusion and Clinical Importance

The upper limit for ESVI exceeds the previously suggested cut‐off of 30 mL/m² for detection of systolic dysfunction. The reference intervals generated in this study should be useful clinically in the assessment of LV size and function in Boxer dogs.

Resting and dobutamine stress test induced serum concentrations of brain natriuretic peptide in German Shepherd dogs

Studies of clinical uses of brain natriuretic peptide (BNP) represent one of the most important advances in cardiology since the introduction of echocardiography as a clinical diagnostic procedure. Defining the clinical potential of BNP in canine cardiology has not been completed yet. The aim of this study is to measure BNP concentrations in healthy German Shepherd dogs of different ages as a baseline in resting and when conventional protocol of the dobutamine stress test (DST) is applied to dogs. Concentrations of BNP were measured in blood serum by the radioimmunoassay method. The values of BNP concentrations were compared to cardiac parameters obtained by standard cardiac diagnostic procedures (radiology, electrocardiography and echocardiography). No significant differences in serum BNP concentrations existed in dogs of different ages. A statistically significant increase in BNP concentrations was registered after DST. These changes in BNP concentrations were related to ST/T electrocardiographic changes, and correlated to changes in the left ventricular internal diameter in systole (LVESD). These data suggest that BNP is not increased in aged dogs with normal cardiac systolic function and renal function, and that myocardial ischemia leads to a significant increase in BNP concentrations even in dogs with normal left ventricular function.

Echocardiographic values in clinically healthy adult dogue de Bordeaux dogs

OBJECTIVES

To assess the influence of body surface area, age and gender on echocardiographic parameters and to establish echocardiographic reference values for dogue de Bordeaux dogs.

METHODS

Thirty-nine healthy dogue de Bordeaux dogs of both sexes, older than one year, were recruited and 31 of these were included in the study. The classic linear regression model proved to be the best way to analyse the data. The reference limits of the echocardiographic measurements were calculated using the regression equations. The difference between the mean values of body surface area in both gender groups was evaluated by using one-way ANOVA.

RESULTS

A significant correlation was seen between several echocardiographic parameters and body surface area or body surface area and age, and high coefficients of determination (R2) were found. No effect of gender was detected on echocardiographic variables, except for the thickness of the left ventricular posterior wall at end diastole.

CLINICAL SIGNIFICANCE

The echocardiographic parameters related to body surface area, in the absence of correlation with other independent variables (gender and age) should be interpreted with caution because their variation could be significant for the presence of heart disease. The proposed statistical model allows estimation of echocardiographic parameters in dogue de Bordeaux dogs with different body surface areas and ages.

Immunohistochemical evidence for expression of fast-twitch type sarco(endo)plasmic reticulum Ca2+ ATPase (SERCA1) in German shepherd dogs with dilated cardiomyopathy myocardium

OBJECTIVES

Dilated cardiomyopathy (DCM) is one of the most common acquired canine heart diseases. It is particularly common in large and giant breed dogs. Although a great deal is known about the clinical progression and manifestations of the disease, the underlying cellular and molecular mechanisms remain poorly understood. One widely held belief is that calcium-handling abnormalities are critically involved in the disease process. This study investigates the changes in expression of the sarco(endo)plasmic reticulum calcium ATPase (SERCA) isoforms in DCM myocardium from German shepherd dogs.

ANIMALS, MATERIALS AND METHODS

Affected tissue samples were obtained from German shepherd dogs with DCM, euthanized for intractable congestive heart failure while normal myocardial tissue samples were obtained from German shepherd dogs, euthanized for non-cardiovascular reasons. Tissue microarrays containing normal and DCM myocardium samples were prepared, immunostained with SERCA1 and SERCA2 antibodies and analyzed.

RESULTS

We were able to demonstrate, for the first time, that while there is little change in the expression of the cardiac isoform (SERCA2), there is clear expression of the fast-twitch skeletal muscle isoform SERCA1 in the myocardium of dogs diagnosed with DCM.

CONCLUSION

We propose that SERCA1 expression is evidence of a natural adaptive response to the impaired Ca2+ handling thought to occur in German shepherd dogs with DCM and heart failure.

M-mode and two-dimensional echocardiographic reference values for three Hungarian dog breeds: Hungarian Vizsla, Mudi and Hungarian Greyhound

The aim of the study was to establish normal reference echocardiographic values for three Hungarian dog breeds, and to determine the potential dependence of intracardiac parameters on body weight, age and gender. M-mode and two-dimensional echocardiography were performed on 95 clinically healthy dogs including 45 Hungarian Vizslas, 28 Mudis and 22 Hungarian Greyhounds. Linear intracardiac measurements included interventricular septal thickness (IVS), left ventricular internal diameter (LVID), left ventricular posterior wall thickness (LVPW) both in systole and diastole, as well as left atrial internal diameter (LAD), and aortic diameter (AOD) in early diastole. Fractional shortening (FS), end-diastolic and end-systolic left ventricular volumes (EDV and ESV), as well as LAD:AOD ratio were calculated from the linear parameters. Mean, range and standard deviation of measurements were calculated for each breed. Body weight positively correlated in all three breeds with all left ventricular dimensions, such as IVS d , IVS s , LVID d , LVIDD s , LVPW d and LVPW s parameters. LA values showed positive correlations to body weight in all three breeds. AOD and LA demonstrated a positive correlation with body weight in Hungarian Vizslas and Mudis, whilst the LAD:AOD ratio was related to body weight only in Mudis. Gender did not correlate with any of the measured echocardiographic parameters in any breeds. In Mudis, a positive correlation was found between the LAD: AOD ratio and age, as well as between the LAD: AOD ratio and E point to septal separation (EPSS).