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Corda A, Corda F, Pentcheva P, Puci M, Mollica A, Gomez Ochoa P, Dabbagh T, Pinna Parpaglia ML. The echocardiographic pulmonary to left atrial ratio: A noninvasive variable for the hemodynamic classification of pulmonary hypertension in dogs. J Vet Intern Med 2024; 38:2064-2075. [PMID: 38715386 PMCID: PMC11256189 DOI: 10.1111/jvim.17097] [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: 10/03/2023] [Accepted: 04/18/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Hemodynamic classification of pulmonary hypertension (PH) has important clinical implications. However, only a few echocardiographic variables have been used to hemodynamically classify PH in dogs. OBJECTIVE To evaluate the echocardiographic pulmonary to left atrial ratio index (ePLAR) in dogs with PH. ANIMALS Forty-six dogs with intermediate to high probability of PH. METHODS Cross-sectional study. Variables were compared between dogs with precapillary PH [PrePH (n = 24)] vs postcapillary PH [PostPH (n = 22)], and with combined PH [CombPH (n = 14)] vs isolated PH [IsoPH (n = 8)] using the t-, Mann-Whitney, Pearson's Chi, or Fisher's exact test. The receiver operating characteristic curve and Youden index were used to identify the optimal ePLAR cutoff value to differentiate among the groups, intraclass correlation coefficients (ICC) were used to determine the reliability of measurements. RESULTS The mean (SD) ePLAR of the PrePH was higher than that of the PostPH group [0.36 (0.13) vs 0.26 (0.09), respectively; P = .005]. The median (interquartile range) ePLAR of the CombPH was higher than that of the IsoPH subgroup [0.29 (0.24-0.38), vs 0.20 (0.16-0.23), respectively; P = .001]. The best cutoff value of ePLAR for identifying IsoPH was <0.245 [AUC at cutoff point = 0.86; sensitivity (95% confidence interval [CI]) = 0.71 (0.47-0.95); specificity (95% CI) = 1 (0.76-1)]. The ICC analysis indicated a high degree of reliability. CONCLUSIONS AND CLINICAL IMPORTANCE ePLAR can be considered a valid noninvasive variable to hemodynamically classify PH in dogs with an intermediate to high probability of PH. Assessment of ePLAR can be useful in the therapeutic management of PH in dogs.
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Affiliation(s)
- Andrea Corda
- Veterinary Teaching Hospital, Department of Veterinary MedicineUniversity of SassariSassariItaly
| | - Francesca Corda
- Veterinary Teaching Hospital, Department of Veterinary MedicineUniversity of SassariSassariItaly
| | - Plamena Pentcheva
- Veterinary Teaching Hospital, Department of Veterinary MedicineUniversity of SassariSassariItaly
| | - Mariangela Puci
- Clinical Epidemiology and Medical Statistic Unit, Department of Medicine, Surgery and PharmacyUniversity of SassariSassariItaly
| | - Alessandra Mollica
- Veterinary Teaching Hospital, Department of Veterinary MedicineUniversity of SassariSassariItaly
| | | | - Thouraya Dabbagh
- Veterinary Teaching Hospital, Department of Veterinary MedicineUniversity of SassariSassariItaly
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Park J, Kim M, Han JI, Lee K, Yoon H. Radiographic and echocardiographic evaluation in rescued Korean raccoon dogs ( Nyctereutes procyonoides koreensis). Front Vet Sci 2024; 11:1361843. [PMID: 39005719 PMCID: PMC11239572 DOI: 10.3389/fvets.2024.1361843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 06/04/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Nyctereutes procyonoides koreensis (Korean raccoon dog), a member of the Canidae family, is anatomically similar to dogs. Previous studies have used vertebral heart scale measurements to measure the cardiac size of Korean raccoon dogs on thoracic radiographs; however, the use of additional cardiac size indices, such as vertebral left arial score, intercostal space, cardiothoracic ratio, and echocardiographic indices, has not been reported. Therefore, this study aimed to establish normal reference ranges for various thoracic radiographic and echocardiographic indices in normal Korean raccoon dogs. Methods Twenty-six Korean raccoon dogs (11 males and 15 females) were included in this study. The thoracic radiographic indices, vertebral heart scale score, and vertebral left atrial score were measured in the right lateral view. The intercostal space and cardiothoracic ratio were measured in the ventrodorsal view. The echocardiograms were evaluated in the right parasternal long and short axis view and left parasternal apical view. Results The mean values for the thoracic radiographic and echocardiographic indices were as follows: vertebral heart scale, 9.12 ± 0.74; vertebral left atrial score, 1.5 ± 0.31; intercostal spaces, 3.17 ± 0.34; cardiothoracic ratio, 0.69 ± 0.07; left atrial to aortic root ratio, 1.22 ± 0.14; main pulmonary artery to aorta ratio, 1.22 ± 0.14; left ventricular end-diastolic internal diameter normalized for body weight, 1.36 ± 0.19; end-diastolic volume index, 51.07 ± 19.6; end-systolic volume index, 16.54 ± 7.45; the peak velocity of early diastolic transmitral flow, 73.13 ± 15.46 cm/s; and the ratio between the transmitral flow velocities and the peak early diastolic velocity, 1.77 ± 0.47. Only percent increase in the left ventricular end-systolic internal diameter was negatively correlated with body weight. The remaining indices showed no correlations with body weight. Conclusion To the best of our knowledge, this is the first case report covering both thoracic radiographic and endocardiographic indices for Korean raccoon dogs. Thus, the thoracic radiographic and echocardiographic indices established in this study may be used to evaluate the cardiac condition of Korean raccoon dogs.
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Affiliation(s)
- Junu Park
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Myeongsu Kim
- Laboratory of Wildlife Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
- Jeonbuk Wildlife Center, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Jae-Ik Han
- Laboratory of Wildlife Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
- Jeonbuk Wildlife Center, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Republic of Korea
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Mederska E, Stephenson H, Maddox TW, Dukes-McEwan J. Assessment of right ventricular function in healthy Great Danes and in Great Danes with dilated cardiomyopathy. J Vet Cardiol 2024; 54:44-56. [PMID: 39013250 DOI: 10.1016/j.jvc.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Right ventricular (RV) dysfunction is a significant negative prognostic indicator in human dilated cardiomyopathy (DCM). Many RV indices are weight-dependent, and there is a lack of reference values for the right heart in giant breed dogs (over 50 kg), including Great Danes (GDs). This study aimed to compare indices of RV function in echocardiographically normal GDs, those with preclinical DCM (PC-DCM), and those with DCM and congestive heart failure (DCM-CHF). ANIMALS A total of 116 client-owned adult GDs: 74 normal, 31 with PC-DCM, and 11 with DCM-CHF. METHODS A retrospective, single-center cohort study assessed RV function using free-wall RV longitudinal strain (RVLS), strain rate, fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and pulsed-wave tissue Doppler imaging-derived systolic myocardial velocity of the lateral tricuspid annulus (TDI S'). Relationships between DCM status and RV function indices were analyzed. RESULTS RV function, measured by TAPSE (P=0.001), FAC (P<0.001), and TDI S' (P<0.001), decreased in dogs with PC-DCM and DCM-CHF compared to healthy dogs, with FAC being lower in DCM-CHF compared to PC-DCM (P=0.048). RVLS impairment was more significant in the DCM-CHF group than in the PC-DCM group (P=0.048). RVLS had the highest area under the curve (0.899) for differentiating between normal and DCM-CHF dogs. CONCLUSION As DCM progresses, echocardiographic variables of RV function, including TAPSE, FAC, TDI S', RVLS, and strain rate, worsen, indicating impaired RV systolic function in GDs affected by DCM.
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Affiliation(s)
- E Mederska
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK.
| | - H Stephenson
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK; HS Cardiology Ltd, Dalton House, 9 Dalton Square, Lancaster LA1 1WD, UK
| | - T W Maddox
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
| | - J Dukes-McEwan
- Small Animal Teaching Hospital, Department of Small Animal Clinical Sciences, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK
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Lekane M, Burnotte P, Gommeren K, Mc Entee K, Merveille AC. Left ventricular eccentricity index to assess precapillary pulmonary hypertension in dogs. J Vet Cardiol 2023; 51:220-231. [PMID: 38246109 DOI: 10.1016/j.jvc.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Interventricular septal flattening, frequently present in pulmonary hypertension (PH) can be quantified by the left ventricular eccentricity index (EI) measured at end-diastole (EId), end-systole (EIs) and at maximal septal flattening (EIm). In humans, EI correlates with invasive pulmonary arterial pressure. The aim of this study was to evaluate if EI correlates with parameters of right heart remodeling (RHR) and if EI is a quantitative marker of PH in dogs. MATERIALS AND METHODS Left ventricular eccentricity indices were retrospectively measured in four groups (no, mild, moderate and severe PH) with interpretable tricuspid and/or pulmonary regurgitation. RESULTS Ninety-seven dogs were included, with no (n = 29), mild (n = 13), moderate (n = 25) and severe (n = 30) PH. The intra- and inter-observer variability for EI measurements ranged from 2 % to 11 %. All EI were significantly elevated in severe compared to no, mild and moderate PH (P < 0.0005). In the moderate group, EIs and EIm were higher compared to the no PH group (P < 0.01). Tricuspid and pulmonary regurgitation pressure gradients and RHR parameters correlated with EId, EIs and EIm in all groups. Optimal cut-off values discriminating moderate and severe PH from no and mild PH were 1.24 (Sensitivity (Se) 60 %; Specificity (Sp) 90 %) for EId, 1.34 (Se 67 %; Sp 95 %) for EIs and 1.37 (Se 76 %; Sp 83 %) for EIm. CONCLUSIONS Left ventricular eccentricity indices are reproducible echocardiographic variables increasing with severity of PH. Dogs with moderate and severe PH can be discriminated from dogs with no or mild PH using EIs and EIm.
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Affiliation(s)
- M Lekane
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium.
| | - P Burnotte
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium
| | - K Gommeren
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium
| | - K Mc Entee
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, ULB, Route de Lennik, 808, 1070 Bruxelles, Belgium
| | - A-C Merveille
- Department of Small Animal Veterinary Clinical Sciences, University of Liège, Quartier Vallée 2, Avenue de Cureghem 1, 4000 Liège, Belgium
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Keating S, Eberhard J, Friederich J, Wess G. Systolic function in dogs with pulmonic stenosis of different severities and the effect of balloon valvuloplasty. J Vet Cardiol 2023; 46:40-54. [PMID: 37058905 DOI: 10.1016/j.jvc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/07/2023]
Abstract
INTRODUCTION/OBJECTIVES Pulmonic stenosis (PS) is one of the most common congenital heart diseases in dogs leading to right ventricular (RV) pressure overload, myocardial remodeling, and potential RV dysfunction. Our objectives were to investigate the extent of RV systolic dysfunction in canine PS and to examine the immediate influence of balloon valvuloplasty (BV) on systolic function. ANIMALS, MATERIALS AND METHODS This prospective study evaluated 72 dogs with PS and 86 healthy dogs. Echocardiographic parameters of systolic function included normalized tricuspid annular plane systolic excursion (N-TAPSE), normalized systolic myocardial tissue Doppler velocity of the lateral tricuspid annulus (N-RVFW-S'), fractional area change, and speckle-tracking longitudinal endocardial RV strain. Forty-four dogs underwent BV and were re-examined after surgery. RESULTS Systolic function at the basal segment of the RV was significantly lower in the PS group when compared to healthy dogs (mean N-TAPSE 4.29 ± standard deviation 1.18 mm/kg0.285 vs. 5.60 ± 1.29 mm/kg0.285; median N-RVFW-S' 5.28 [lower-upper 25% quantile 4.35-6.43 cm/s/kg0.186] vs. 7.82 [6.73-8.79 cm/s/kg0.186]; all P<0.001). Global longitudinal RV endocardial strain showed no significant difference between the two groups (-28.50 ± 6.23% vs. 28.61 ± 4.64%; P=0.886), but segmental strain analyses revealed basal hypo- and potential compensatory hyperkinesis of the apical RVFW. Furthermore, BV affected most parameters of systolic function, but not the segmental strain values and N-TAPSE. CONCLUSIONS Right ventricular basal longitudinal systolic function is decreased in dogs with PS in comparison to a healthy cohort. Regional and global function does not necessarily coincide.
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Brložnik M, Nemec Svete A, Erjavec V, Domanjko Petrič A. Echocardiographic parameters in French Bulldogs, Pugs and Boston Terriers with brachycephalic obstructive airways syndrome. BMC Vet Res 2023; 19:49. [PMID: 36793024 PMCID: PMC9930355 DOI: 10.1186/s12917-023-03600-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND In this prospective study, we hypothesized that dogs with signs of brachycephalic obstructive airway syndrome (BOAS) would show differences in left and right heart echocardiographic parameters compared with brachycephalic dogs without signs of BOAS and non-brachycephalic dogs. RESULTS We included 57 brachycephalic (30 French Bulldogs 15 Pugs, and 12 Boston Terriers) and 10 non-brachycephalic control dogs. Brachycephalic dogs had significantly higher ratios of the left atrium to aorta and mitral early wave velocity to early diastolic septal annular velocity; smaller left ventricular (LV) diastolic internal diameter index; and lower tricuspid annular plane systolic excursion index, late diastolic annular velocity of the LV free wall, peak systolic septal annular velocity, late diastolic septal annular velocitiy, and right ventricular global strain than non-brachycephalic dogs. French Bulldogs with signs of BOAS had a smaller diameter of the left atrium index and right ventricular systolic area index; higher caudal vena cava at inspiration index; and lower caudal vena cava collapsibility index, late diastolic annular velocity of the LV free wall, and peak systolic annular velocity of the interventricular septum than non-brachycephalic dogs. CONCLUSIONS The differences in echocardiographic parameters between brachycephalic and non-brachycephalic dogs, brachycephalic dogs with signs of BOAS and non-brachycephalic dogs, and brachycephalic dogs with and without signs of BOAS indicate higher right heart diastolic pressures affecting right heart function in brachycephalic dogs and those with signs of BOAS. Most changes in cardiac morphology and function can be attributed to anatomic changes in brachycephalic dogs alone and not to the symptomatic stage.
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Affiliation(s)
- M. Brložnik
- grid.8954.00000 0001 0721 6013University of Ljubljana, Veterinary Faculty, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - A. Nemec Svete
- grid.8954.00000 0001 0721 6013University of Ljubljana, Veterinary Faculty, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - V. Erjavec
- grid.8954.00000 0001 0721 6013University of Ljubljana, Veterinary Faculty, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - A. Domanjko Petrič
- grid.8954.00000 0001 0721 6013University of Ljubljana, Veterinary Faculty, Small Animal Clinic, Gerbičeva 60, 1000 Ljubljana, Slovenia
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Chen J, Huayu M, Su S, Wang S, Yang Z, Nan X, Lu D, Li Z. Vanillic Acid Alleviates Right Ventricular Function in Rats With MCT-Induced Pulmonary Arterial Hypertension. Nat Prod Commun 2023. [DOI: 10.1177/1934578x221148896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This study examined the molecular processes behind the effects of vanillic acid (VA) on right ventricular (RV) hypertrophy and function in rats with monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). There were 40 male Sprague‒Dawley (SD) rats that were separated into 4 groups: Control, PAH, MCT + VA (50 mg/kg/d), and MCT + VA (100 mg/kg/d). Male SD rats were injected with MCT once under the skin to create the PAH model (40 mg/kg). RV morphological properties were evaluated using Masson and hematoxylin and eosin (H&E) staining. Echocardiography was used to evaluate RV functioning and right ventricle–pulmonary artery (RV-PA) coupling. In addition, Rho-associated protein kinase (ROCK) pathway-related factors were evaluated using Western blotting. Enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory markers as well as atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) in the blood of PAH rats. As a result, VA effectively reduced the development of RV cardiomyocyte hypertrophy and fibrosis in PAH rats; levels of ANP, BNP, and inflammatory markers in the blood of PAH rats were also significantly decreased by VA intervention. Additionally, VA enhanced RV functioning and RV-PA coupling in PAH rats. In response to VA, the expression of proteins related to the ROCK pathway (ROCK1, ROCK2, NFATc3, P-STAT3, and Bax) was downregulated, whereas Bcl-2 expression was elevated. This study found that VA could attenuate RV remodeling and improve RV-PA coupling in PAH rats. RV remodeling and dysfunction may be linked to the dysregulation of the ROCK pathway, and the protective action of VA on RV function may be due to a block in the ROCK signaling pathway or its downstream signaling molecules.
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Affiliation(s)
- Ju Chen
- Research Center for High Altitude Medicine, Key Laboratory of High Altitude Medicine (Ministry of Education), Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, China
- School of Ecological and Environmental Engineering, Qinghai University, Xining, China
| | - Meiduo Huayu
- Research Center for High Altitude Medicine, Key Laboratory of High Altitude Medicine (Ministry of Education), Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, China
| | - Shanshan Su
- Technical center of Xining Customs, Key Laboratory of Food Safety Research in Qinghai Province, Xining, China
| | - Shan Wang
- Research Center for High Altitude Medicine, Key Laboratory of High Altitude Medicine (Ministry of Education), Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, China
| | | | - Xingmei Nan
- Research Center for High Altitude Medicine, Key Laboratory of High Altitude Medicine (Ministry of Education), Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, China
- School of Ecological and Environmental Engineering, Qinghai University, Xining, China
| | - Dianxiang Lu
- Research Center for High Altitude Medicine, Key Laboratory of High Altitude Medicine (Ministry of Education), Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, China
- Medical College, Qinghai University, Xining, China
| | - Zhanqiang Li
- Research Center for High Altitude Medicine, Key Laboratory of High Altitude Medicine (Ministry of Education), Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai-Utah Joint Research Key Lab for High Altitude Medicine), Qinghai University, Xining, China
- Medical College, Qinghai University, Xining, China
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Feldhütter EK, Domenech O, Vezzosi T, Tognetti R, Eberhard J, Friederich J, Wess G. Right ventricular size and function evaluated by various echocardiographic indices in dogs with pulmonary hypertension. Vet Med (Auckl) 2022; 36:1882-1891. [PMID: 36168939 DOI: 10.1111/jvim.16496] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 07/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Three-dimensional (3D) echocardiography and 2-dimensional (2D) strain measurements of the right ventricle (RV) are important indices in humans with pulmonary hypertension (PH) and need further evaluation in dogs with PH. OBJECTIVES To evaluate various RV size and function indices in dogs with PH and to examine differences between pre- and postcapillary PH. ANIMALS A total of 311 client-owned dogs: 100 dogs with PH, 31 with postcapillary and 69 with precapillary PH, and 211 healthy control dogs. METHODS Retro- and prospective, multicenter study. Size and function of the RV was determined using several indices, derived using dedicated RV software, including 3D RV end-diastolic volume (EDVn), end-systolic volume (ESVn), ejection fraction, 2D global and free wall RV longitudinal strain (RVLS), end-diastolic area, end-systolic area, fractional area change, tricuspid annular plane systolic excursion, and tissue Doppler imaging-derived systolic myocardial velocity of the lateral tricuspid annulus (S'n). RESULTS The EDVn (1.8 vs 2.5 mL/kg0.942 , P < .01) and ESVn (0.8 vs 1.2 mL/kg0.962 , P < .001) were significantly larger in the PH group compared to healthy controls. Free wall RVLS was decreased in dogs with severe PH compared to controls (-24% vs -29.6%, P < .001). Dogs with precapillary PH had worse RV systolic function than dogs with postcapillary PH. CONCLUSION Three-dimensional echocardiography of the RV is a promising tool to detect RV changes in dogs with PH. Also, 2D strain measurements are able to detect decreased RV function and offer several advantages compared to conventional indices.
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Affiliation(s)
| | | | - Tommaso Vezzosi
- Anicura Istituto Veterinario Novara, Novara, Italy.,Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Rosalba Tognetti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Jenny Eberhard
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
| | - Jana Friederich
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
| | - Gerhard Wess
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
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Wiegel PS, Nolte I, Mach R, Freise F, Bach JP. Reference ranges for standard-echocardiography in pugs and impact of clinical severity of Brachycephalic Obstructive Airway Syndrome (BOAS) on echocardiographic parameters. BMC Vet Res 2022; 18:282. [PMID: 35854376 PMCID: PMC9297600 DOI: 10.1186/s12917-022-03348-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Echocardiographic measurements may be influenced by breed-specific characteristics. Therefore, this study aims to establish reference values for standard echocardiographic measurements in pugs by investigating the influence of age, sex, heart rate, body weight and Brachycephalic Obstructive Airway Syndrome (BOAS). Sixty-two privately owned pugs underwent physical examination, blood sample collection, non-invasive blood pressure measurements and echocardiography. Influences of independent variables on echocardiographic measurements were examined using a multiple linear regression analysis model. For the entire study population, 95% prediction intervals were generated. Further, reference ranges for subcategories of clinical severities of BOAS were provided. Selected echocardiographic measurements of pugs were compared to reference values of previous studies generated from various breeds. RESULTS In the study, a total of fifty-one privately owned pugs aged between two and 10 years were included for establishing reference ranges. Mainly body weight, but also age, sex and heart rate had influence on several echocardiographic parameters. The clinical grading of BOAS was conducted in 42 pugs. Except for pulmonic peak velocity (Pvel), which declined with increasing severity of BOAS, clinical symptoms of upper airway disease did not have significant impact on echocardiographic measurement results. Significant deviations, however, of left ventricular (LV) internal dimension (LVID), interventricular septum (IVS), LV posterior wall (LVPW), and tricuspid annular plane systolic motion excursion (TAPSE) compared to interbreed reference values were observed. CONCLUSIONS Breed-specific reference ranges for echocardiographic values with special regard to BOAS are provided to enable a more accurate assessment of cardiac health in pugs.
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Affiliation(s)
- Pia Saskia Wiegel
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Ingo Nolte
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Rebekka Mach
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Fritjof Freise
- Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Bünteweg 2, 30559, Hannover, Germany
| | - Jan-Peter Bach
- Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
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Donati PA, Tarragona L, Sandez Cordero I, Alzate D, Otero PE. Relationship between tricuspid annular plane systolic excursion, fluid responsiveness and volume status in hospitalised dogs with circulatory abnormalities. N Z Vet J 2022; 70:326-331. [PMID: 35719118 DOI: 10.1080/00480169.2022.2091676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS To evaluate the echocardiographic variable tricuspid annular plane systolic excursion normalised to body weight (TAPSEnorm) as a predictor of fluid responsiveness in hospitalised dogs with haemodynamic and tissue perfusion alterations and to investigate the association of left ventricular internal diameter in diastole normalised to body weight (LVIDdN) and aortic velocity time integral (VTIAo) with TAPSEnorm. METHODS A single-centre, prospective study was carried out in a cohort of spontaneously breathing dogs, hospitalised for any reason, with severe haemodynamic and tissue perfusion alterations. The echocardiographic variables TAPSEnorm, LVIDdN, and VTIAO were measured. A bolus of 30 mL/kg of lactated Ringer's solution was administered and then VTIAo was subsequently remeasured. Patients were classified as fluid responsive if VTIAo increased by ≥15% after fluid expansion, or non-responsive if VTIAo increased by <15% after fluid expansion. The area under the receiver operating characteristic (AUROC) curve was generated to evaluate the ability of TAPSE to predict fluid responsiveness. Simple regression models were used to assess the linear relationship between TAPSEnorm and LVIDdN or VTIAO. RESULTS TAPSEnorm was lower in fluid responsive dog (mean 0.57 (95% CI=0.50-0.64) cm/kg) compared to non-responders (mean 0.76 (95% CI=0.62-0.90) cm/kg). The AUROC for TAPSEnorm was 0.827 (95% CI=0.65-1.00). The optimal cut-off point was 0.76 with sensitivity of 80 (95% CI=28.4-99.5)% and specificity of 86.7 (95% CI=69.3-99.2)%, positive predictive value of 50 (95% CI=15.7-84.3)% and negative predictive value of 96.3 (95% CI=81-99.9)%. A monotonic linear relationship was observed between TAPSEnorm and LVIDdN (p<0.001) and between TAPSEnorm and VTIAo (p=0.001). CONCLUSIONS AND CLINICAL RELEVANCE TAPSEnorm could be useful in determining those dogs that are likely to respond to a fluid bolus from those that are likely to be non-responsive. Additionally, a positive linear association between the LVIDdN and the TAPSEnorm suggests that TAPSEnorm decreases at lower preload values. The present study results suggest that TAPSEnorm could be a valuable tool for evaluating blood volume status and fluid responsiveness in hospitalised dogs.
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Affiliation(s)
- P A Donati
- UCIcoop, Buenos Aires, Argentina.,Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - L Tarragona
- Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - D Alzate
- Hospital Veterinario Caninos y Felinos, Medellín, Colombia
| | - P E Otero
- Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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11
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Effectiveness of therapy with low-dosage masitinib on pulmonary hypertension in dogs: a pilot study. ACTA VET BRNO 2022. [DOI: 10.2754/avb202291040363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this pilot study was to assess the efficacy of long-term masitinib therapy at low doses on echocardiographic, cardiovascular, haematological, and blood biochemical indicators, as well as clinical symptoms in dogs with pulmonary hypertension (PH) caused by advanced chronic degenerative mitral valve disease or heartworm disease. Seven client-owned dogs with severe PH were recruited prospectively and given low-dose masitinib orally, 3 mg/kg body weight (approximately one-fourth of the recommended antineoplastic dosage), q24h, for 123–928 days. Examinations were performed prior to masitinib administration, as well as 1, 2, 3, 6, and 12 months later. At 1–12 months, low-dose masitinib significantly reduced systolic pulmonary arterial pressure (P < 0.05 or 0.01) and dramatically improved clinical symptoms. Low-dose masitinib treatment improved right ventricular function indicators such as right atrium/aorta ratio, maximum tricuspid regurgitation velocity, right ventricular Tei index, and tricuspid annular plane systolic excursion, without worsening left ventricular function indicators. These findings suggest that low-dose masitinib may be effective as an adjunctive therapeutic for chronic heart failure in dogs with PH and may increase the survival of PH dogs.
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12
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Feldhütter EK, Domenech O, Vezzosi T, Tognetti R, Sauter N, Bauer A, Eberhard J, Friederich J, Wess G. Echocardiographic reference intervals for right ventricular indices, including 3-dimensional volume and 2-dimensional strain measurements in healthy dogs. J Vet Intern Med 2021; 36:8-19. [PMID: 34874066 PMCID: PMC8783368 DOI: 10.1111/jvim.16331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is currently a lack of reference intervals (RIs) for the novel measures like 3-dimensional (3D) echocardiography or speckle-tracking strain for assessment of right ventricular (RV) structure and function. OBJECTIVES To generate RIs and to determine the influence of age, heart rate, and body weight (BW) on various RV function indices using a dedicated RV software for 3D RV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), global and free wall RV longitudinal strain (RVLS), end-diastolic area (RVEDA), end-systolic area (RVESA), fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and tissue Doppler imaging (TVI)-derived systolic myocardial velocity of the lateral tricuspid annulus (S'). ANIMALS Healthy adult client-owned dogs (n = 211) of various breeds and ages. METHODS Prospective study. Reference intervals were estimated as statistical prediction intervals using allometric scaling for BW-dependent variables. Right-sided (upper limit) or left-sided (lower limit) 95% RIs were calculated for every variable. Inter- and intraobserver variability was determined. RESULTS Most variables showed clinically acceptable repeatability with coefficient of variation less than 10. Upper or respectively lower RI after allometric scaling to normalize for different BWs were: EDVn ≤ 2.5 mL/kg0.942 , ESVn ≤ 1.2 mL/kg0.962 , TAPSEn ≥ 4.5 mm0.285 , RVEDAn ≤ 1.4 cm2 /kg0.665 , RVESAn ≤ 0.8 cm2 /kg0.695 , and TVI S'n ≥ 5.6 cm/s/kg0.186 . The calculated limits for indices without allometric normalization were: EF > 42.1%, FAC > 30.0%, free wall RVLS < -20.8%, and global RVLS < -18.3%. CONCLUSIONS Echocardiographic RIs for RV structure and function are provided.
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Affiliation(s)
| | | | - Tommaso Vezzosi
- Anicura Istituto Veterinario Novara, Novara, Italy.,Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Rosalba Tognetti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Nadja Sauter
- Statistical Consulting Unit StaBLab, LMU University, Munich, Germany
| | - Alexander Bauer
- Statistical Consulting Unit StaBLab, LMU University, Munich, Germany
| | - Jenny Eberhard
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
| | - Jana Friederich
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
| | - Gerhard Wess
- Clinic of Small Animal Medicine, LMU University, Munich, Germany
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13
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Yuchi Y, Suzuki R, Teshima T, Matsumoto H, Koyama H. Investigation of the influence of manual ventilation-controlled respiration on right ventricular pressure-volume loops and echocardiographic variables in healthy anesthetized dogs. Am J Vet Res 2021; 82:865-871. [PMID: 34669489 DOI: 10.2460/ajvr.82.11.865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the influence of manual ventilation-controlled respiration on right ventricular (RV) pressure-volume loop-derived and echocardiographic variables in dogs. ANIMALS 8 healthy, anesthetized Beagles. PROCEDURES In a prospective experimental study, pressure-volume catheters were percutaneously inserted into the right ventricle of each dog, and manual ventilation was performed; RV pressure-volume loop (hemodynamic) data and conventional echocardiographic variables were assessed. Two-dimensional speckle tracking echocardiography-derived RV strain (RVS) and RV systolic strain rate (RVSR) were obtained with RV free wall-only analysis (free wall) and RV global analysis (RVGA; interventricular septum). Variables were compared between end-inspiratory and end-expiratory phases of respiration by statistical methods. Multiple regression analysis was used to assess associations between selected hemodynamic and echocardiographic variables. RESULTS The RV pressure significantly increased, and RV volume, stroke volume, tricuspid annular plane systolic excursion, RV fractional area change, peak myocardial systolic velocity of the lateral tricuspid annulus, and RV free wall only-assessed RVS and RVSR significantly decreased in the inspiratory phase, compared with the expiratory phase. There were no significant differences in end-systolic elastance or RVGA-assessed RVS or RVSR between respiratory phases. The RVGA-assessed RVSR was significantly associated with stroke volume and end-systolic elastance. CONCLUSIONS AND CLINICAL RELEVANCE Specific RV echocardiographic variables were significantly affected by respiration. In contrast, RVS and RVSR determined with RVGA were not affected by respiration and were associated with hemodynamic indicators of RV contractility.
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Affiliation(s)
- Yunosuke Yuchi
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Ryohei Suzuki
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Takahiro Teshima
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Hirotaka Matsumoto
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
| | - Hidekazu Koyama
- From the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo, 180-8602, Japan
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14
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Vatne L, Dickson D, Tidholm A, Caivano D, Rishniw M. The effects of activity, body weight, sex and age on echocardiographic values in English setter dogs. J Vet Cardiol 2021; 37:26-41. [PMID: 34517274 DOI: 10.1016/j.jvc.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Breed-specific reference intervals improve echocardiographic interpretation and thereby reduce misdiagnoses, especially in athletic breeds. OBJECTIVES The objectives of the study were to examine transthoracic echocardiographic values in healthy adult English setter dogs and determine the effects of activity, body weight, sex and age on these values. ANIMALS, MATERIALS AND METHODS One hundred and one adult English setter dogs, recruited from local veterinary clinics and from the Norwegian English setter club, underwent routine transthoracic echocardiography. The population was stratified into two groups based on the reported level of activity. The effects of activity level, body weight, sex and age on echocardiographic variables were examined. Results were compared with published data from other breeds and from a pre-existing species-wide allometric model. RESULTS Of the 100 dogs between 19 months and 10 years of age included in the study, 72 were reported as very active and 28 as less active. Echocardiographic intervals were calculated for body size-independent echocardiographic variables. The upper limits of the intervals for left-atrial-to-aortic ratios and normalised left ventricular volumes exceeded those of various, previously published studies of other breeds. Normalised left ventricular dimensions exceeded published allometric 95th percentile upper reference values in 13% of dogs in diastole and 32% of dogs in systole. More active dogs had larger cardiac dimensions than less active dogs; however, the activity level did not predict echocardiographic variables when included in a multiple regression model. CONCLUSIONS The study provides breed specific transthoracic echocardiographic values for English setter dogs, thereby contributing to improve diagnostic assessment of cardiac health in this breed.
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Affiliation(s)
- L Vatne
- AniCura Oslo Animal Hospital, Hoffsveien 70C, 0377 Oslo, Norway.
| | | | - A Tidholm
- AniCura Albano Animal Hospital, Rinkebyvagan 21B, 182 36 Danderyd, Sweden
| | - D Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - M Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
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15
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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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16
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Baron Toaldo M, Glaus T, Campagna I, Novo Matos J, Dennler M. Echocardiographic assessment of right ventricular systolic function in healthy Beagle dogs compared to high field cardiac magnetic resonance imaging. Vet J 2021; 271:105653. [PMID: 33840484 DOI: 10.1016/j.tvjl.2021.105653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Abstract
Ten healthy Beagle dogs were used to compare selected echocardiographic parameters of right ventricular (RV) systolic function with high field cardiac magnetic resonance imaging (MRI). All dogs underwent complete transthoracic echocardiography before and during anesthesia, as well as cardiac MRI with determination of morphology-based ejection fraction, and phase contrast angiography-derived stroke volume. A correlation analysis was carried out between echocardiographic and MRI parameters. The values of fractional area change, tricuspid annular plane systolic excursion, tissue Doppler imaging derived peak velocity of the isovolumic contraction wave and systolic wave of the lateral tricuspid valve annulus showed lower values under general anesthesia. Of all echocardiographic parameters of RV systolic function, only fractional area change (r = 0.671, P = 0.034) and tissue Doppler imaging derived peak velocity of the systolic wave of the lateral tricuspid valve annulus (r = 0.768; P = 0.01), showed a significant correlation with MRI derived stroke volume. None of the echocardiographic parameters correlated with MRI derived ejection fraction. When evaluating the RV echocardiographically, fractional area change and peak velocity of the systolic wave of the lateral tricuspid valve annulus appear to be the most reliable predictors of RV systolic function when compared to MRI under anesthesia.
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Affiliation(s)
- M Baron Toaldo
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - T Glaus
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - I Campagna
- Department of Clinical Diagnostics and Services, Section of Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - J Novo Matos
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - M Dennler
- Department of Clinical Diagnostics and Services, Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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17
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Yuchi Y, Suzuki R, Teshima T, Matsumoto H, Koyama H. Utility of tricuspid annular plane systolic excursion normalized by right ventricular size indices in dogs with postcapillary pulmonary hypertension. J Vet Intern Med 2020; 35:107-119. [PMID: 33277735 PMCID: PMC7848373 DOI: 10.1111/jvim.15984] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background Tricuspid annular plane systolic excursion (TAPSE) is a common right ventricular (RV) function indicator. However, TAPSE was not decreased in dogs with myxomatous mitral valve disease (MMVD) and postcapillary pulmonary hypertension (PH) because of its load, angle, and body weight dependency, and TAPSE was considered a preload‐dependent index. Objectives To evaluate the utility of TAPSE normalized by RV size in dogs with postcapillary PH. Animals Twenty healthy dogs and 71 MMVD dogs with or without PH. Methods In this prospective observational study, end‐diastolic RV internal dimension (RVIDd), end‐diastolic and end‐systolic RV area, and end‐diastolic RV wall thickness were measured as RV size indices. The TAPSE was measured using B‐mode and M‐mode methods. Normalized TAPSE was calculated by dividing TAPSE by each RV size index. The RV strain was obtained as the detailed RV function using 2‐dimensional speckle tracking echocardiography. All indices were compared among the PH severity groups and in the presence of right‐sided congestive heart failure (R‐CHF). Results Although nonnormalized TAPSE was higher with PH severity progression, each normalized TAPSE showed a significant decrease in the severe PH group (P < .05). The TAPSEB‐mode/RVIDd ratio had high area under the curve to predict R‐CHF and had moderate correlation with RV strain (P < .05). The TAPSEB‐mode/RVIDd and left atrial‐to‐aortic diameter ratios were independent predictors for R‐CHF. Conclusions and Clinical Importance Normalized TAPSE could reflect RV systolic dysfunction in dogs with severe PH, which could not be detected by nonnormalized TAPSE. The TAPSEB‐mode/RVIDd ratio might predict R‐CHF with high sensitivity and reproducibility.
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Affiliation(s)
- Yunosuke Yuchi
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ryohei Suzuki
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Takahiro Teshima
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hirotaka Matsumoto
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hidekazu Koyama
- Faculty of Veterinary Science, Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
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18
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Saetang K, Surachetpong SD. Short-term effects of sildenafil in the treatment of dogs with pulmonary hypertension secondary to degenerative mitral valve disease. Vet World 2020; 13:2260-2268. [PMID: 33281365 PMCID: PMC7704324 DOI: 10.14202/vetworld.2020.2260-2268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/25/2020] [Indexed: 11/21/2022] Open
Abstract
Background and Aim: Pulmonary hypertension (PH) is a common complication of degenerative mitral valve disease (DMVD). Sildenafil, a phosphodiesterase-5 inhibitor, has effects in reducing pulmonary arterial pressure by selectively dilating pulmonary vessels. The study aimed to evaluate the effects of sildenafil in combination with conventional therapy in dogs with PH caused by DMVD. Materials and Methods: Fourteen dogs diagnosed with PH secondary to DMVD Stage C on conventional therapy were randomly assigned to placebo (n=7) and sildenafil (n=7) groups. On day 0, the recruited dogs underwent physical examinations, clinical score assessments, electrocardiography, systolic blood pressure measurements, blood collection, thoracic radiography, and echocardiography for baseline. The dogs then received a combination of conventional therapy with sildenafil or placebo every 8 h for 1 week. On day 7, all dogs underwent the baseline evaluations again. Results: The sildenafil group experienced a significant decrease in estimated systolic pulmonary artery pressure (sPAP) (p=0.043) from day 0 to day 7. Moreover, the total clinical scores were decreased in dogs treated with sildenafil relative to those who received the placebo (p=0.007); however, the lung scores were not different between before and after treatment with sildenafil. Conclusion: Sildenafil had a synergistic effect with conventional therapy in reducing the estimated sPAP and clinical scores in dogs with PH secondary to DMVD.
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Affiliation(s)
- Karun Saetang
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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19
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Savadelis MD, Coleman AE, Rapoport GS, Sharma A, Sakamoto K, Keys DA, Ohmes CM, Hostetler JA, Dzimianski MT, Moorhead AR. Clinical assessment of heartworm-infected Beagles treated with a combination of imidacloprid/moxidectin and doxycycline, or untreated. J Vet Intern Med 2020; 34:1734-1745. [PMID: 32691900 PMCID: PMC7517868 DOI: 10.1111/jvim.15853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 11/26/2022] Open
Abstract
Background Administration of moxidectin topically and doxycycline PO has been utilized experimentally as an alternative treatment for heartworm disease. However, clinical effects of this protocol remain poorly characterized. Objective To evaluate the clinical and postmortem findings associated with administration of doxycycline and monthly 10% imidacloprid + 2.5% moxidectin (IMD + MOX, Advantage Multi/Advocate) to Dirofilaria immitis‐experimentally infected as compared to nontreated control dogs. Animals Sixteen purpose‐bred, female, Beagle dogs. Methods Prospective, blinded, experimental study. Animals with surgically transplanted adult heartworms were randomized into 2 study groups of equal size: a nontreated control group (n = 8) and an IMD + MOX and doxycycline‐treated group (n = 8). Randomization was performed using a complete block design according to circulating microfilarial concentrations, measured before treatment. Serum biochemical profiles, CBCs, thoracic radiographs and echocardiograms were performed prior to and 3 weeks after transplantation, and monthly for 10 months. Postmortem gross and histopathologic evaluations were performed. Results Compared to control animals, mean ± SD serum alanine aminotransferase (181 ± 203 U/L vs 33 ± 7 U/L; P < .0001) and alkaline phosphatase (246 ± 258 U/L vs 58 ± 19 U/L; P < .0001) activities were significantly higher in the treated group on day 28. Radiographic and echocardiographic evidence of heartworm disease was observed in both groups; however, no significant differences in these variables were noted between groups. Mean ± SD pulmonary arterial thrombus score was significantly higher in the treated vs nontreated group (3.9 ± 0.4 and 1.5 ± 2.1, respectively; P = .01). Conclusions and Clinical Importance The treatment protocol was well‐tolerated with no clinically relevant adverse effects for any variable evaluated during the observational period.
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Affiliation(s)
- Molly D Savadelis
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Amanda E Coleman
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Gregg S Rapoport
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Ajay Sharma
- Department of Veterinary Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Kaori Sakamoto
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | | | | | | | - Michael T Dzimianski
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Andrew R Moorhead
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
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Aoki T, Doiguchi M. Effects of Right Atrioventricular Expanded Polytetrafluoroethylene Path Graft Reconstruction on Arrhythmogenicity and Ventricular Function in Dogs. J Am Anim Hosp Assoc 2020; 55:231-237. [PMID: 31433222 DOI: 10.5326/jaaha-ms-6943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Right atrioventricular pericardial autografts, including the coronary groove, may cause myocardial ischemia. Our aim was to explore the effects of this procedure using an expanded polytetrafluoroethylene (ePTFE) patch on arrhythmogenicity and right ventricular function. Four healthy beagles and one client-owned golden retriever with recurrent cardiac tamponade as a result of hemangiosarcoma were included. The four healthy dogs underwent right atrioventricular ePTFE patch graft reconstruction after complete resection of the right auricle. Right ventricular function and arrhythmia were evaluated using tricuspid annular plane systolic excursion and tissue Doppler imaging on echocardiography and Holter electrocardiography, respectively, before and after surgery. The golden retriever underwent right atrioventricular ePTFE patch graft reconstruction followed by resection of the cardiac mass. None of the echocardiographic values, not involving systolic function, changed after surgery in the four healthy dogs. Transient arrhythmias tended to increase 1 day after surgery. The dog with recurrent cardiac tamponade exhibited more severe arrhythmia and required transient antiarrhythmic treatment for 3 days and survived the cardiac tamponade for 434 days after surgery. We showed that an ePTFE patch can serve as a suitable alternative material for right atrioventricular patch graft reconstruction, although transient arrhythmias may occur following surgery.
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Affiliation(s)
- Takuma Aoki
- From the Laboratory of Surgery 1, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Tokyo, Japan
| | - Makoto Doiguchi
- From the Laboratory of Surgery 1, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Tokyo, Japan
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Visser LC, Wood JE, Johnson LR. Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension. J Vet Intern Med 2020; 34:1379-1388. [PMID: 32501601 PMCID: PMC7379050 DOI: 10.1111/jvim.15826] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The clinical relevance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension (PH) is unknown. OBJECTIVE To determine if echocardiographic measurements of right heart size and right ventricular (RV) function are associated with survival times in dogs with PH. ANIMALS Eighty-two client-owned dogs. METHODS Retrospective study where data from medical records and baseline echocardiographic examinations were collected and measured in a standardized manner. Owners or primary veterinarians were contacted for outcome data. RESULTS Enlargement of the right atrium (88%), RV (69%), and pulmonary artery (72%) was common. One-third of the cases had reduced RV function quantified by two-dimensional echocardiography-derived tricuspid annular plane systolic excursion (TAPSE). Decreased TAPSE was significantly (P = .008) more common in dogs with PH not secondary to left heart disease (LHD; 43%) compared to dogs with PH secondary to LHD (14%) but median survival times (182, 95% confidence interval [CI] = 39-309 versus 298, 95% CI = 85-314 days, respectively) were not significantly different (P = .78). Right atrial area (hazard ratio [HR] = 2.72, 95% CI = 1.58-4.70), TAPSE < 3.23 mm/kg0.284 (HR = 2.19, 95% CI = 1.28-3.74), and right heart failure (HR = 2.05, 95% CI = 1.18-3.57) were independently associated with shorter survival time (P ≤ .04). CONCLUSIONS AND CLINICAL IMPORTANCE Right atrial area, RV function (TAPSE < 3.23 mm/kg0.284 ), and right heart failure offer clinically relevant prognostic information in dogs with PH. Results support the quantitative assessment of right heart size and function in dogs with PH.
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Affiliation(s)
- Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - James E Wood
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Lynelle R Johnson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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Pariaut R, Jung SW, Vila J, Newhard DK. Resolution of caval syndrome during initial hemodynamic stabilization in dogs with heartworm disease. J Vet Emerg Crit Care (San Antonio) 2020; 30:295-301. [PMID: 32077239 DOI: 10.1111/vec.12948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 07/27/2018] [Accepted: 09/10/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To report on the spontaneous resolution of caval syndrome in 5 dogs selected for their response to medical stabilization prior to scheduled heartworm extraction. SERIES SUMMARY Five dogs with heartworm caval syndrome were treated with sildenafil, fluid, and supplemental oxygen therapy. Moreover, 4 of 5 dogs were also administered pimobendan to achieve hemodynamic stabilization in preparation for percutaneous heartworm extraction. Spontaneous heartworm migration back into the pulmonary arteries was detected from 2 h to 5 days after treatment initiation. UNIQUE INFORMATION PROVIDED Unanticipated spontaneous resolution of caval syndrome was documented in a low number of dogs after initiation of a patient stabilization protocol aiming at improving right ventricular hemodynamics and reducing pulmonary artery pressure prior to scheduled heartworm extraction. At this time, it is unknown if intervention to improve the hemodynamic status of the animal prior to heartworm extraction improves procedure outcome, and which factors contributed to the migration of the heartworms back into the pulmonary arteries in these selected cases. Therefore, this approach cannot be recommended in place of current recommendations for treatment of caval syndrome.
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Affiliation(s)
- Romain Pariaut
- Department of Clinical Sciences, Cornell University, Ithaca, New York
| | - Seung Woo Jung
- Department of Clinical Sciences, Auburn University, Auburn, Alaska
| | | | - Daniel K Newhard
- Department of Clinical Sciences, Auburn University, Auburn, Alaska
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Reinero C, Visser LC, Kellihan HB, Masseau I, Rozanski E, Clercx C, Williams K, Abbott J, Borgarelli M, Scansen BA. ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. J Vet Intern Med 2020; 34:549-573. [PMID: 32065428 PMCID: PMC7097566 DOI: 10.1111/jvim.15725] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/30/2020] [Indexed: 01/01/2023] Open
Abstract
Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.
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Affiliation(s)
- Carol Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Heidi B Kellihan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin
| | - Isabelle Masseau
- Department of Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, Medford, Massachusetts
| | - Cécile Clercx
- Department of Clinical Sciences of Companion Animals and Equine, University of Liège, Liège, Belgium
| | - Kurt Williams
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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Treseder JR, LeBlanc NL, Scollan KF. Inotropic and chronotropic effects of sotalol in healthy dogs. J Vet Cardiol 2019; 25:14-24. [PMID: 31442634 DOI: 10.1016/j.jvc.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 07/09/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Sotalol is an anti-arrhythmic drug commonly used for the treatment of pathologic tachyarrhythmias in dogs. The β-adrenergic blockade associated with sotalol administration may result in reduced myocardial contractility, which is clinically relevant for treating dogs with arrhythmias and concurrent myocardial dysfunction. The inotropic properties of sotalol are not well characterized in dogs. ANIMALS, MATERIALS, AND METHODS Ten healthy, adult, large breed dogs were prospectively enrolled. All dogs underwent physical examination, blood pressure measurement, electrocardiography, 24-h Holter monitoring, and echocardiography including three-dimensional left ventricular volume measurements. Dogs were subsequently administered sotalol (1-2 mg/kg) orally twice daily for 12-16 days, and the same diagnostic tests were performed. Paired statistical analysis was used to compare parameters at baseline and after treatment with sotalol. RESULTS Standard echocardiographic parameters of systolic function were reduced on sotalol compared to baseline, including ejection fraction via Simpson's method of disks which was 5.8% (95% confidence interval [CI]: 2.77-8.83%, p = 0.002) lower post-treatment. Maximum heart rate on Holter monitor was 17 bpm (95% CI: 9-37 bpm, p = 0.002) lower post-treatment than at baseline. CONCLUSIONS Sotalol has a mild negative inotropic effect in healthy dogs based on standard echocardiographic measurements. There is also a negative chronotropic effect at higher heart rates based on 24-h Holter monitoring.
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Affiliation(s)
- J R Treseder
- Oregon State University, Carlson College of Veterinary Medicine, Department of Clinical Sciences, 105 Magruder Hall, 700 SW 30th Street, Corvallis, Oregon, 97331, USA
| | - N L LeBlanc
- Oregon State University, Carlson College of Veterinary Medicine, Department of Clinical Sciences, 105 Magruder Hall, 700 SW 30th Street, Corvallis, Oregon, 97331, USA.
| | - K F Scollan
- Oregon State University, Carlson College of Veterinary Medicine, Department of Clinical Sciences, 105 Magruder Hall, 700 SW 30th Street, Corvallis, Oregon, 97331, USA
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Vezzosi T, Schober KE. Doppler-derived echocardiographic evidence of pulmonary hypertension in cats with left-sided congestive heart failure. J Vet Cardiol 2019; 23:58-68. [PMID: 31174730 DOI: 10.1016/j.jvc.2019.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 01/21/2019] [Accepted: 01/28/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Pulmonary hypertension (PH) caused by left-sided congestive heart failure (L-CHF) is common in dogs and contributes to clinical signs and outcome. The aim of this study was to evaluate the prevalence of Doppler echocardiography-derived PH in a population of cats with L-CHF. ANIMALS The study involved 131 cats with L-CHF and 56 control cats. METHODS The study design is retrospective, observational study. Tricuspid regurgitation velocity, right atrial dimension, right ventricular (RV) dimension and function, RV wall thickness, pulmonary artery (PA) dimension, Doppler-derived systolic time intervals of PA flow, and presence of septal flattening were evaluated. Pulmonary hypertension was considered if tricuspid regurgitation velocity was >2.7 m/s. RESULTS Tricuspid regurgitation was present in 57/131 (44%) of cats with L-CHF and 24/56 (43%) in control cats based on color flow Doppler. Doppler-derived of PH was identified in 22/131 cats with L-CHF (17%). In 15/22 cats, PH was associated with cardiomyopathy, in 5/22 cases with congenital heart disease, and in 2/22 cases with other causes. Cats with Doppler-derived PH more often had chronic L-CHF, as opposed to acute L-CHF (p<0.05). All cats with Doppler-derived PH had subjectively-assessed right-sided heart enlargement, with larger right atrial and RV diameters (p<0.001), increased RV wall thickness (p<0.05), and higher prevalence of septal flattening (<0.001) and PA enlargement (p<0.05). CONCLUSIONS Pulmonary hypertension identified by Doppler echocardiography is not a common finding in cats with L-CHF. Right-sided heart enlargement, more frequently observed, may raise the suspicion of PH in cats with L-CHF.
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Affiliation(s)
- T Vezzosi
- Department of Veterinary Sciences, University of Pisa, via Livornese, 56122, San Piero a Grado, Pisa, Italy.
| | - K E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, OH, 43210, USA
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Total anomalous pulmonary venous connection in a mature dog. J Vet Cardiol 2019; 21:10-17. [PMID: 30797440 DOI: 10.1016/j.jvc.2018.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 10/12/2018] [Accepted: 11/06/2018] [Indexed: 11/21/2022]
Abstract
A 2-year 10-month, male neutered, crossbreed dog presented for evaluation of cyanosis and exercise intolerance. Doppler echocardiography revealed severe dilation of the right atrium and right ventricle with moderate pulmonary hypertension. Right-to-left shunting across a large ostium secundum atrial septal defect was confirmed by contrast echocardiography. Thoracic radiography revealed a vascular pattern together with cardiomegaly. Computed tomography angiography identified an anomalous pulmonary venous connection in which all pulmonary veins, apart from the right middle vein, coalesced into a single, large aneurysmal vein that then drained into the right atrium via the cranial vena cava. The distal opening of the right middle pulmonary vein could not be determined. A presumptive diagnosis of partial anomalous pulmonary venous connection was made. The dog was medically managed with sildenafil (1.5 mg/kg by mouth [PO] every 8 h) and remained clinically stable for 2 months before euthanasia due to worsening exercise intolerance. On postmortem examination, all pulmonary veins, including the right middle vein, were shown to communicate with a single, large central vein. This large vein then connected with the right atrium via the cranial vena cava, consistent with a total anomalous pulmonary venous connection. This case report describes a rare congenital abnormality which has not been previously reported in a mature dog.
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Sudunagunta S, Green D, Christley R, Dukes-McEwan J. The prevalence of pulmonary hypertension in Cavalier King Charles spaniels compared with other breeds with myxomatous mitral valve disease. J Vet Cardiol 2019; 23:21-31. [PMID: 31174726 DOI: 10.1016/j.jvc.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 01/01/2019] [Accepted: 01/04/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Pulmonary hypertension (PH) is a common consequence of myxomatous mitral valve disease (MMVD). Cavalier King Charles spaniels (CKCS) are frequently affected with MMVD and appear to have different disease progression compared to other dogs. This study aimed to determine if CKCS are more likely to develop PH as a result of MMVD than dogs of other breeds. A secondary aim was to explore whether breed or PH impacted survival. ANIMALS A total of 187 dogs diagnosed with MMVD, 94 CKCS and 93 non-CKCS, were included in this study. METHODS This is a retrospective review of dogs with MMVD. Data were analyzed for presence of PH, congestive heart failure (CHF) and echocardiographic variables including the ratio between mitral E wave velocity (E vel) and isovolumic relaxation time (E/IVRT) and were compared between CKCS/non-CKCS and dogs with/without PH. Survival analysis was also performed. RESULTS American College of Veterinary Internal Medicine (ACVIM) stage (p < 0.001), CKCS (p = 0.005), left atrium-to-aortic ratio (LA/Ao) (p < 0.001), E vel (p < 0.001) and log10(E/IVRT) (p < 0.001) were significant at the univariate level for PH development. At the multivariate level, only ACVIM stage remained significant (p = 0.044), suggesting that worsening MMVD was the predominant determinant of PH development in this study. Pulmonary hypertension was associated with greater likelihood of CHF (p < 0.001) and death (both cardiac [p < 0.001] and all-cause mortality [p = 0.011]). Cavalier King Charles spaniels were more likely to experience cardiac death than non-CKCS (p = 0.004). CONCLUSIONS In this study, development of PH was associated with worse MMVD, according to ACVIM stage.
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Affiliation(s)
- S Sudunagunta
- Cardiology Service, Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK.
| | - D Green
- Waikanae Beach, Wellington, 5036, New Zealand
| | - R Christley
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, CH64 7TE, UK
| | - J Dukes-McEwan
- Cardiology Service, Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
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Right ventricular function and dyssynchrony measured by echocardiography in dogs with precapillary pulmonary hypertension. J Vet Cardiol 2019; 23:1-14. [PMID: 31174719 DOI: 10.1016/j.jvc.2018.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 11/27/2018] [Accepted: 12/21/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Assessment of the right ventricular (RV) function by echocardiography is important in dogs with pulmonary hypertension (PH). Few reports are available on RV function and dyssynchrony in dogs, especially in the context of precapillary PH. ANIMALS The study included 79 client-owned dogs: 25 dogs with precapillary PH and 54 control dogs. METHODS Dogs with precapillary PH were prospectively enrolled between December 2013 and February 2017. The echocardiographic indices of RV function, including RV strain and the dyssynchrony index by speckle-tracking echocardiography, were measured. Multivariate analysis was used to determine independent predictors of the RV dyssynchrony index. RESULTS Dogs with precapillary PH showed RV dilation, hypertrophy and right atrial dilation. Impaired echocardiographic indices of RV function, including RV strain, were observed. In addition, RV dyssynchrony occurred in dogs with precapillary PH. Multivariate analysis revealed that tricuspid regurgitation velocity and RV dilation were independent predictors of the RV dyssynchrony index. CONCLUSIONS Echocardiographic RV function indices are impaired in dogs with precapillary PH. In addition, RV dilation and elevated systolic pulmonary arterial pressure estimated by echocardiography are associated with RV dyssynchrony.
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Morita T, Nakamura K, Osuga T, Yokoyama N, Morishita K, Sasaki N, Ohta H, Takiguchi M. Effect of acute volume overload on echocardiographic indices of right ventricular function and dyssynchrony assessed by use of speckle tracking echocardiography in healthy dogs. Am J Vet Res 2019; 80:51-60. [DOI: 10.2460/ajvr.80.1.51] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Santos E, Aptekmann K, Santos P, Reis A, Kuster M, Andrade Junior P. Echocardiographic parameters in dogs treated with acepromazine and fentanyl. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-10002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Considering that the use of tranquillizers could optimize the performance of the echocardiogram, this study aimed to evaluate the effect of protocols with acepromazine and fentanyl on the echocardiographic parameters of healthy dogs, besides their effect in systolic blood pressure (SBP), respiratory rate (RR), heart rate (HR), time spent for examination and sedation scale. Ten adult dogs were submitted to different tranquilizing protocols 20 minutes before the echocardiographic examination, totalling five treatments for each pair, performed at seven-day intervals between evaluations. The treatments were CT (control treatment), IAT (intramuscular acepromazine), OAT (oral acepromazine), FT (fentanyl) and AFT (acepromazine associated with fentanyl). In addition to the echocardiographic evaluation, SBP, degree of reassurance, duration of the exam, HR and RR in the different protocols were evaluated. There was a significant decrease of SBP in OAT. There was a significant reduction in left ventricular diameter during systole and diastole and mitral annular movement in IAT, OAT and AFT, compared with CT. There was a decrease in tricuspid annular plane systolic excursion and increase in mitral E/mitral A ratio in IAT and OAT when compared with CT. All the tranquillizer protocols studied were found to significantly reduce HR, that facilitated the echocardiographic examination.
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Affiliation(s)
- E.A. Santos
- Universidade Federal do Espírito Santo, Brazil
| | | | | | - A.C. Reis
- Universidade Federal do Espírito Santo, Brazil
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Chetboul V, Damoiseaux C, Lefebvre HP, Concordet D, Desquilbet L, Gouni V, Poissonnier C, Pouchelon JL, Tissier R. Quantitative assessment of systolic and diastolic right ventricular function by echocardiography and speckle-tracking imaging: a prospective study in 104 dogs. J Vet Sci 2018; 19:683-692. [PMID: 30041288 PMCID: PMC6167344 DOI: 10.4142/jvs.2018.19.5.683] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/16/2018] [Accepted: 06/25/2018] [Indexed: 11/20/2022] Open
Abstract
Our aim was (1) to determine the within-day and between-day variability of several indices of systolic and diastolic right ventricular (RV) function by using conventional echocardiography and speckle-tracking echocardiography (STE) (Study 1), (2) to quantify these variables in a large healthy canine population (n = 104) with Doppler-derived estimated systolic pulmonary arterial pressure (SPAP) and left ventricular (LV) function, and (3) to establish the corresponding reference intervals (Study 2). For both studies, RV variables included tricuspid annular plane systolic excursion (TAPSE), right fractional area change (RFAC), STE longitudinal systolic strain (StS) of the RV free wall (RVFW) and of the entire RV (i.e., global RV StS), STE longitudinal systolic RVFW strain rate (SRS), and the diastolic early:late strain rate ratio. All but one within- and between-day coefficients of variation (13/14) were < 15%, the lowest being observed for TAPSE (3.6–9.8%), global RV StS (3.8–9.9%), and RVFW StS (3.7–7.3%). SPAP was weakly and negatively correlated with the TAPSE:body weight ratio (rs = −0.26, p = 0.01) and RVFW SRS (rs = −0.23, p < 0.05). Reference intervals (lower and upper limits with 90% confidence intervals) were provided for all variables. STE provides a non-invasive evaluation of RV function that may be used for clinical investigations in canine cardiology.
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Affiliation(s)
- Valérie Chetboul
- Alfort Cardiology Unit (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France.,Inserm U955, Team 03, Créteil, 94010 Cedex, France
| | - Cécile Damoiseaux
- Alfort Cardiology Unit (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France
| | - Hervé P Lefebvre
- Research Clinic Unit, National Veterinary School of Toulouse, Toulouse University, Toulouse, F-31076 Cedex 03, France
| | - Didier Concordet
- TOXALIM, National Veterinary School of Toulouse, INRA, Toulouse University, Toulouse, F-31076 Cedex 03, France
| | - Loic Desquilbet
- Clinical Epidemiology and Biostatistics Unit, National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France
| | - Vassiliki Gouni
- Alfort Cardiology Unit (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France.,Inserm U955, Team 03, Créteil, 94010 Cedex, France
| | - Camille Poissonnier
- Alfort Cardiology Unit (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France
| | - Jean-Louis Pouchelon
- Alfort Cardiology Unit (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France.,Inserm U955, Team 03, Créteil, 94010 Cedex, France
| | - Renaud Tissier
- Inserm U955, Team 03, Créteil, 94010 Cedex, France.,Pharmacology-Toxicology Unit, National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort, 94704 Cedex, France
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Cunningham S, Aona B, Antoon K, Rush J, Barton B. Echocardiographic assessment of right ventricular systolic function in Boxers with arrhythmogenic right ventricular cardiomyopathy. J Vet Cardiol 2018; 20:343-353. [DOI: 10.1016/j.jvc.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 07/10/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
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33
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Caivano D, Rishniw M, Birettoni F, Patata V, Giorgi M, Dei K, Porciello F. Right ventricular outflow tract fractional shortening: an echocardiographic index of right ventricular systolic function in dogs with pulmonary hypertension. J Vet Cardiol 2018; 20:354-363. [DOI: 10.1016/j.jvc.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Vezzosi T, Domenech O, Costa G, Marchesotti F, Venco L, Zini E, Del Palacio MJF, Tognetti R. Echocardiographic evaluation of the right ventricular dimension and systolic function in dogs with pulmonary hypertension. J Vet Intern Med 2018; 32:1541-1548. [PMID: 30216561 PMCID: PMC6189358 DOI: 10.1111/jvim.15253] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/09/2018] [Accepted: 05/31/2018] [Indexed: 12/12/2022] Open
Abstract
Background Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH). Hypothesis/Objectives To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right‐sided congestive heart failure (R‐CHF). Animals 89 dogs with PH and 74 healthy dogs. Methods Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end‐diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively). Results RVEDA index was higher in dogs with moderate PH (10.8 cm2/m2; range, 6.2‐14.4 cm2/m2) and severe PH (12.4 cm2/m2; range, 7.7‐21.4 cm2/m2) than in those with mild PH (8.4 cm2/m2; range, 4.8‐11.6 cm2/m2) and control dogs (8.5 cm2/m2; range, 2.8‐11.6 cm2/m2; P < .001). RVEDA index was significantly higher in dogs with R‐CHF (13.7 cm2/m2; range, 11.0‐21.4 cm2/m2) than in dogs without R‐CHF (9.4 cm2/m2; range, 4.8‐17.1 cm2/m2; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R‐CHF. Conclusions and Clinical Importance The RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R‐CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.
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Affiliation(s)
- Tommaso Vezzosi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Giulia Costa
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Luigi Venco
- Veterinary Hospital Città di Pavia, Pavia, Italy
| | - Eric Zini
- Istituto Veterinario di Novara, Novara, Italy.,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | | | - Rosalba Tognetti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
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Santos P, Santos E, Reis A, Santos A, Kuster M, Trivilin L, Aptekmann K. Effect of exercise on cardiovascular parameters in search and rescue-trained dogs. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-10027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Physical activity alters the cardiovascular system of dogs, depending on the exercise characteristics and the animal’s physical conditioning. Little is known about the cardiovascular changes in rescue-trained dogs. This study evaluated the cardiovascular responses to a search and rescue exercise session to differentiate these alterations from cases of exhaustion or some possible pathology. Nine healthy rescue-trained dogs that trained for at least one year were used. Seven German Shepherds and two Belgian Shepherd Malinois were evaluated twice, immediately before exercise (M0) and immediately after a 20-minute training (M1). Electrocardiographic, echocardiographic, and systemic blood pressure (SBP) measurements were performed at each evaluation. Heart rate was evaluated in three moments, M0, M1 and five minutes after the end of the physical activity (M2). The results indicated that training increased oxygen demand and significantly increased cardiac output, left ventricular volume in diastole and aortic artery diameter, and the contraction force with the increased mitral annular motion without impairing systolic and diastolic cardiac functions. Heart rate values immediately and five minutes after exercise were similar to baseline values. Training did not alter SBP and the electrocardiographic parameters. The present study indicated good cardiac performance to the physical effort of rescue-trained dogs and reduced the chances of poor performance and the occurrence of sudden death caused by exercise in response to the pattern of activity performed.
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Affiliation(s)
| | - E.A. Santos
- Universidade Federal do Espírito Santo, Brazil
| | - A.C. Reis
- Universidade Federal do Espírito Santo, Brazil
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Evaluation of tricuspid annular plane systolic excursion measured by two-dimensional echocardiography in healthy dogs: repeatability, reference intervals, and comparison with M-mode assessment. J Vet Cardiol 2018; 20:165-174. [DOI: 10.1016/j.jvc.2018.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 11/20/2022]
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Caivano D, Dickson D, Pariaut R, Stillman M, Rishniw M. Tricuspid annular plane systolic excursion-to-aortic ratio provides a bodyweight-independent measure of right ventricular systolic function in dogs. J Vet Cardiol 2018; 20:79-91. [DOI: 10.1016/j.jvc.2018.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/19/2018] [Accepted: 01/30/2018] [Indexed: 12/24/2022]
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Baron Toaldo M, Poser H, Menciotti G, Battaia S, Contiero B, Cipone M, Diana A, Mazzotta E, Guglielmini C. Utility of Tissue Doppler Imaging in the Echocardiographic Evaluation of Left and Right Ventricular Function in Dogs with Myxomatous Mitral Valve Disease with or without Pulmonary Hypertension. J Vet Intern Med 2018; 30:697-705. [PMID: 27177623 PMCID: PMC4913565 DOI: 10.1111/jvim.13940] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 02/02/2016] [Accepted: 03/07/2016] [Indexed: 11/29/2022] Open
Abstract
Background In human medicine, right ventricular (RV) functional parameters represent a tool for risk stratification in patients with congestive heart failure caused by left heart disease. Little is known about RV alterations in dogs with left‐sided cardiac disorders. Objectives To assess RV and left ventricular (LV) function in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH). Animals One‐hundred and fourteen dogs: 28 healthy controls and 86 dogs with MMVD at different stages. Methods Prospective observational study. Animals were classified as healthy or having MMVD at different stages of severity and according to presence or absence of PH. Twenty‐eight morphological, echo‐Doppler, and tissue Doppler imaging (TDI) variables were measured and comparison among groups and correlations between LV and RV parameters were studied. Results No differences were found among groups regarding RV echo‐Doppler and TDI variables. Sixteen significant correlations were found between RV TDI and left heart echocardiographic variables. Dogs with PH had significantly higher transmitral E wave peak velocity and higher E/eʹ ratio of septal (sMV) and lateral (pMV) mitral annulus. These 2 variables were found to predict presence of PH with a sensitivity of 84 and 72%, and a specificity of 71 and 80% at cut‐off values of 10 and 9.33 for sMV E/eʹ and pMV E/eʹ, respectively. Conclusions and clinical importance No association between variables of RV function and different MMVD stage and severity of PH could be detected. Some relationships were found between echocardiographic variables of right and left ventricular function.
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Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - H Poser
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - G Menciotti
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - S Battaia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - E Mazzotta
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
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Chapel EH, Scansen BA, Schober KE, Bonagura JD. Echocardiographic Estimates of Right Ventricular Systolic Function in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med 2017; 32:64-71. [PMID: 29224256 PMCID: PMC5787149 DOI: 10.1111/jvim.14884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/01/2017] [Accepted: 10/19/2017] [Indexed: 01/01/2023] Open
Abstract
Background Right ventricular (RV) dysfunction independently predicts outcomes in human myxomatous mitral valve disease (MMVD). There is limited information regarding RV systolic function in dogs with MMVD. Hypothesis Right ventricular systolic function differs among stages of disease, decreasing in decompensated MMVD. Animals Thirty‐sixclient‐owned dogs with MMVD not receiving oral cardiovascular medications. Methods Prospective clinical study. Dogs were categorized according to disease severity as ACVIM Stage B1, B2, or C. Seven echocardiographic indices of RV systolic function were measured. Groups were compared by 1‐way ANOVA and Tukey's HSD test. Frequencies of cases with cardiac remodeling falling outside previously established reference intervals were compared using Fisher's exact test. Intra‐ and interobserver measurement variability was calculated for each RV function index. Results The indices TAPSE (P = 0.029), RV StL (P = 0.012), and RV StRL (P = 0.041) were significantly different between groups. A greater proportion of B2 dogs (7 of 12) had TAPSE values above reference intervals compared with B1 (2 of 12) or C (2 of 12) dogs (P = 0.027). Measurement variability of TAPSE, RV S', and RV StG was clinically acceptable. Conclusions and Clinical Importance Right ventricular systolic function differs between stages of MMVD, increasing in stage B2, and declining in stage C. The prognostic importance of RV function indices, particularly TAPSE, might be worth evaluating in dogs with MMVD.
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Affiliation(s)
- E H Chapel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - B A Scansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - K E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - J D Bonagura
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
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Reis A, Aptekmann K, Egert L, Andrade-Júnior P. Parâmetros ecocardiográficos em cães saudáveis tratados com acepromazina, meperidina e sua associação. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-8979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se avaliar os efeitos da tranquilização com meperidina, acepromazina e de sua associação sobre os parâmetros ecocardiográficos em cães. Foram utilizados 12 cães adultos, da raça Rottweiler, submetidos ao exame ecocardiográfico sem utilização de sedação (controle - TC) e a três protocolos de tratamento, utilizando-se meperidina (TM), acepromazina (TA) e a associação dos medicamentos (TMA). As variáveis foram analisadas pelo teste de Tukey (P<0,05). Observou-se que as médias obtidas na onda A do fluxo mitral em TA e TMA diminuíram significativamente com relação ao TM, que não diferiu do TC. Houve uma diminuição significativa no valor de movimento anular mitral (MAM) e excursão sistólica do plano anular tricúspide (ESPAT) no TA. Não houve diferença significativa para os valores de fração de encurtamento (FE) entre TA e os demais tratamentos. Entretanto, observou-se que 57,3% dos cães apresentaram valores de FE abaixo da normalidade. As alterações encontradas podem ser decorrentes dos efeitos hipotensores da acepromazina utilizada de forma isolada. Conclui-se que a meperidina ou sua associação com acepromazina não alteram os parâmetros ecocardiográficos em cães saudáveis e que a acepromazina, utilizada isoladamente, causa alteração nos parâmetros de função sistólica dos cães, não sendo recomendada para a contenção química dos cães submetidos ao ecocardiograma, o que poderia levar à má interpretação do exame.
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Affiliation(s)
- A.C. Reis
- Universidade Federal do Espírito Santo, Brazil
| | | | - L. Egert
- Universidade Federal do Espírito Santo, Brazil
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Abbott JA, Gentile-Solomon JM. Measurement Variation and Repeatability of Echocardiographic Variables Used to Estimate Pulmonary Artery Pressure in Dogs. J Vet Intern Med 2017; 31:1622-1628. [PMID: 29031025 PMCID: PMC5697183 DOI: 10.1111/jvim.14846] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/09/2017] [Accepted: 08/28/2017] [Indexed: 11/30/2022] Open
Abstract
Background Pulmonary hypertension (PH) is an important clinical entity in dogs. Pulmonary hypertension is generally identified based on echocardiographic findings, but measurement variation of the variables most often used in this context has not been reported. Objective To define measurement variation of echocardiographic variables that are used to estimate pulmonary artery pressure. Animals Four dogs with subclinical tricuspid valve regurgitation were selected from a hospital population. Methods Prospective descriptive study ‐ dogs were subject to repeated echocardiographic examination by 2 operators. Each dog was echocardiographically examined 12 times, once by each operator during mornings and afternoons of 3 nonconsecutive days. Measurement variation was defined by coefficients of variation and by mean square errors (MSE) from ANOVA models. Repeatability coefficients (RC) were calculated from MSE. Results Of 50 within‐day, between‐day, and interoperator coefficients of variation (CVs), 37 were less than 10% and 46 were less than 15%. The range of peak velocity of tricuspid valve regurgitation (VTR) VTR was 1.87–3.34 m/s. Analysis of variance revealed a significant effect (P < 0.05) of operator for 7 of 10 measurements. Within‐operator/between‐day/within‐subject and between‐operator/between‐day/within‐subject RCs of VTR were, respectively, 0.3 and 0.6 m/s. Conclusions and Clinical Importance With regard to repeatability, VTR is superior to other methods used for echocardiographic estimation of systolic pulmonary artery pressure. When TR is absent, the acceleration time of pulmonary ejection and the acceleration‐to‐ejection time ratio are alternative measures. A change in VTR exceeding 0.3 m/s might be outside the range of expected within‐operator variation.
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Affiliation(s)
- J A Abbott
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA
| | - J M Gentile-Solomon
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA
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Sutherland-Smith J, Hankin EJ, Cunningham SM, Sato AF, Barton BA. Comparison of a computed tomographic pulmonary trunk to aorta diameter ratio with echocardiographic indices of pulmonary hypertension in dogs. Vet Radiol Ultrasound 2017; 59:18-26. [DOI: 10.1111/vru.12540] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/24/2017] [Accepted: 06/21/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- James Sutherland-Smith
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA 01536
| | - Elyshia J. Hankin
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA 01536
| | - Suzanne M. Cunningham
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA 01536
| | - Amy F. Sato
- Department of Clinical Sciences; Tufts Cummings School of Veterinary Medicine; North Grafton MA 01536
| | - Bruce A. Barton
- Department of Quantitative Health Sciences; University of Massachusetts Medical School; Worcester MA 01655
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The repeatability and characteristics of right ventricular longitudinal strain imaging by speckle-tracking echocardiography in healthy dogs. J Vet Cardiol 2017; 19:351-362. [DOI: 10.1016/j.jvc.2017.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 11/19/2022]
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Poser H, Berlanda M, Monacolli M, Contiero B, Coltro A, Guglielmini C. Tricuspid annular plane systolic excursion in dogs with myxomatous mitral valve disease with and without pulmonary hypertension. J Vet Cardiol 2017; 19:228-239. [PMID: 28579307 DOI: 10.1016/j.jvc.2017.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 03/02/2017] [Accepted: 03/07/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate tricuspid annular plane systolic excursion (TAPSE) in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH) and to study the correlations with clinical and echocardiographic parameters. ANIMALS The study population included 99 dogs with MMVD and tricuspid regurgitation. METHODS This is a prospective clinical study. All dogs received a transthoracic echocardiographic evaluation, including 2D, M-mode, echo-Doppler, and tissue Doppler measurements. The TAPSE was measured from the left apical four-chamber view and normalized for the effect of body weight (nTAPSE). The dogs were grouped according to the severity of MMVD (American College of Veterinary Internal Medicine guidelines) and presence/absence and severity of PH. Significant differences between TAPSE or nTAPSE and echocardiographic parameters were analyzed among the MMVD and PH severity groups. Correlations between TAPSE or nTAPSE and echocardiographic parameters were calculated. RESULTS Tricuspid annular plane systolic excursion or nTAPSE were not significantly different among dogs of the MMVD or PH severity groups. Significant correlations were obtained between TAPSE and body weight, left ventricular and atrial dimensions, early diastolic septal and early diastolic and systolic tricuspid annulus velocity (p<0.001); nTAPSE was significantly correlated with normalized end-diastolic left ventricular dimension and fractional shortening (p<0.001). CONCLUSIONS The results show that neither TAPSE nor nTAPSE are reduced in dogs with MMVD with or without PH. It remains unclear if the right ventricle function is not reduced or if a reduced right ventricle function is masked by the contraction of the left ventricle through ventricular interdependence.
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Affiliation(s)
- H Poser
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy.
| | - M Berlanda
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - M Monacolli
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - B Contiero
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - A Coltro
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - C Guglielmini
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
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Spalla I, Payne JR, Borgeat K, Pope A, Fuentes VL, Connolly DJ. Mitral Annular Plane Systolic Excursion and Tricuspid Annular Plane Systolic Excursion in Cats with Hypertrophic Cardiomyopathy. J Vet Intern Med 2017; 31:691-699. [PMID: 28370313 PMCID: PMC5435071 DOI: 10.1111/jvim.14697] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 01/03/2017] [Accepted: 02/23/2017] [Indexed: 11/29/2022] Open
Abstract
Background Left ventricular (LV) systolic dysfunction is associated with increased risk of death in cats with hypertrophic cardiomyopathy (HCM). Mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE, respectively) are measures of longitudinal systolic function and are reduced in human patients with HCM. Hypotheses Cats with HCM have lower MAPSE and TAPSE compared to control cats; lower MAPSE and TAPSE are associated with the presence of congestive heart failure (CHF) and reduced survival time. Animals 64 cats with HCM and 27 healthy cats. Forty‐five cats with HCM were not showing clinical signs, and 19 had CHF. Methods Retrospective study. Anatomic M‐mode from the left apical 4‐chamber view was used to record MAPSE from the free wall (MAPSE FW) and septum (MAPSE IVS) and TAPSE. Results Compared to controls, cats with HCM had lower MAPSE IVS (controls 5.2 [4.6–5.6] mm, asymptomatic HCM 4.7 [4.1–5.2] mm, HCM with CHF 2.6 [2.5–3.2] mm, P < .001), MAPSE FW (controls 5.9 [5.3–6.2] mm, asymptomatic HCM 4.7 [4.1–5.1] mm, HCM with CHF 2.8 [2.4–3.2] mm) and TAPSE (controls 8.6 [7.4–10.2] mm, asymptomatic HCM 7.2 [6.3–8.2] mm, HCM with CHF 4.6 [4.1–5.4] mm), with the lowest in the CHF group. Univariate survival analysis showed a shorter survival in cats displaying lower MAPSE IVS, MAPSE FW, and TAPSE. Conclusions and Clinical Importance MAPSE and TAPSE were lower in cats with HCM than in control cats and were lowest in CHF, suggesting that systolic longitudinal dysfunction is present in cats with HCM. MAPSE and TAPSE have potential prognostic significance.
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Affiliation(s)
- I Spalla
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| | - J R Payne
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK.,Highcroft Veterinary Referrals, Whitchurch, Bristol, UK
| | - K Borgeat
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK.,Highcroft Veterinary Referrals, Whitchurch, Bristol, UK
| | - A Pope
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| | - V Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
| | - D J Connolly
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK
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Serrano-Parreño B, Carretón E, Caro-Vadillo A, Falcón-Cordón Y, Falcón-Cordón S, Montoya-Alonso JA. Evaluation of pulmonary hypertension and clinical status in dogs with heartworm by Right Pulmonary Artery Distensibility Index and other echocardiographic parameters. Parasit Vectors 2017; 10:106. [PMID: 28241783 PMCID: PMC5330087 DOI: 10.1186/s13071-017-2047-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/18/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) is a frequent and severe phenomenon in heartworm disease caused by Dirofilaria immitis, mainly caused by intimal proliferation of the arteries and pulmonary thromboembolisms. Transthoracic echocardiography is the method of choice for diagnosing PH in dogs although the diagnosis is often based on indirect and subjective parameters. The Right Pulmonary Artery Distensibility Index (RPAD Index) is a method that has been recently validated to estimate the presence and severity of PH in heartworm-infected dogs. This study compared some echocardiographic parameters commonly used to estimate PH in 93 dogs infected by D. immitis and evaluated the impact of the parasite burden, microfilaremia, sex or origin of the dog (client-owned/shelter). RESULTS None of the studied echocardiographic variables seemed useful in the estimation of the evaluated clinical aspects, except for the PA/Ao ratio for parasite burden. The RPAD Index was determined in 88 of the dogs; of these, 70.4% had PH (mild: 37.5%, moderate: 19.3%, severe: 13.6%). This Index showed non-significant differences according to microfilaremia, sex, origin or parasite burden. Symptomatic dogs showed PH more often and displayed more severe PH, in addition the presence of symptoms was greater among dogs with high burden; on the other hand 64.4% of asymptomatic dogs had some degree of PH according to the RPAD Index. Apart from the PA/Ao ratio, the other evaluated echocardiographic variables were not useful in evaluating of the hypertensive status of the heartworm-infected dog compared to the RPAD Index. CONCLUSIONS The estimation of most common indirect parameters is not useful in predicting PH in heartworm-infected dogs. The results confirm the RPAD Index as an objective and supportive test in the monitoring and evaluation of PH in the heartworm-infected dog, and show a potential diagnostic value for the detection of PH in asymptomatic animals.
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Affiliation(s)
- B Serrano-Parreño
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - E Carretón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - A Caro-Vadillo
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Y Falcón-Cordón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - S Falcón-Cordón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - J A Montoya-Alonso
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Gentile-Solomon J, Abbott J. Conventional echocardiographic assessment of the canine right heart: reference intervals and repeatability. J Vet Cardiol 2016; 18:234-247. [DOI: 10.1016/j.jvc.2016.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/26/2016] [Accepted: 05/24/2016] [Indexed: 11/24/2022]
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Morita T, Nakamura K, Osuga T, Lim SY, Yokoyama N, Morishita K, Ohta H, Takiguchi M. Repeatability and reproducibility of right ventricular Tei index valves derived from three echocardiographic methods for evaluation of cardiac function in dogs. Am J Vet Res 2016; 77:715-20. [DOI: 10.2460/ajvr.77.7.715] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Novo Matos J, Malbon A, Dennler M, Glaus T. Intrapulmonary arteriovenous anastomoses in dogs with severe Angiostrongylus vasorum infection: clinical, radiographic, and echocardiographic evaluation. J Vet Cardiol 2016; 18:110-24. [DOI: 10.1016/j.jvc.2015.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 10/08/2015] [Accepted: 10/14/2015] [Indexed: 11/25/2022]
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