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Fries R. Hypertrophic Cardiomyopathy-Advances in Imaging and Diagnostic Strategies. Vet Clin North Am Small Anim Pract 2023; 53:1325-1342. [PMID: 37423845 DOI: 10.1016/j.cvsm.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Hypertrophic cardiomyopathy (HCM) is the most important and prevalent cardiac disease in cats. Due to the highly variable nature of HCM, a multimodal approach including physical examination, genetic evaluation, cardiac biomarkers, and imaging are all essential elements to appropriate and timely diagnosis. These foundational elements are advancing rapidly in veterinary medicine. Newer biomarkers such as galectin-3 are currently being researched and advances in tissue speckle-tracking and contrast-enhanced echocardiography are readily available. Advanced imaging techniques, such as cardiac MRI, are providing previously unavailable information about myocardial fibrosis and paving the way for enhanced diagnostic capabilities and risk-stratification in cats with HCM.
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Affiliation(s)
- Ryan Fries
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 West Hazelwood Drive, Urbana, IL 61802, USA.
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Novo Matos J, Payne JR. Predicting Development of Hypertrophic Cardiomyopathy and Disease Outcomes in Cats. Vet Clin North Am Small Anim Pract 2023; 53:1277-1292. [PMID: 37500329 DOI: 10.1016/j.cvsm.2023.05.012] [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: 07/29/2023]
Abstract
Echocardiography is the gold standard imaging modality to diagnose hypertrophic cardiomyopathy (HCM) in cats. Echocardiographic features can predict both cats at an increased risk of developing HCM and cats with HCM at an increased risk of developing cardiovascular events or experiencing cardiac death. Left atrial dysfunction seems to be an important feature of HCM, as it is an early phenotypic abnormality and is also associated with worse outcome.
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Affiliation(s)
- Jose Novo Matos
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
| | - Jessie Rose Payne
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford BS40 5DU, UK
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Stack JP, Fries RC, Kruckman L, Kadotani S, Wallace G. Galectin-3 as a novel biomarker in cats with hypertrophic cardiomyopathy. J Vet Cardiol 2023; 48:54-62. [PMID: 37480722 DOI: 10.1016/j.jvc.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 07/24/2023]
Abstract
INTRODUCTION/OBJECTIVES Galectin-3 (Gal-3) is a circulating biomarker of fibrosis. In humans, increased Gal-3 is predictive of myocardial fibrosis and adverse cardiac events. The aim of this study was to evaluate the potential for Gal-3 as a cardiac biomarker in cats with hypertrophic cardiomyopathy (HCM). MATERIALS AND METHODS Eighty cats were enrolled (25 healthy cats with normal hearts, 35 with HCM American College of Veterinary Internal Medicine (ACVIM) stage B, and 21 with HCM ACVIM stage C). Each cat received a full echocardiogram, health panel, and total thyroxin level. Galectin-3 levels were measured for each enrolled patient. Troponin I and N-terminal pro-brain natriuretic peptide (NT-proBNP) were obtained for the majority of cats. Additionally, 17 ACVIM stage B cats underwent cardiac-gated magnetic resonance (CMR) imaging to assess myocardial extracellular volume (ECV), a noninvasive measure of myocardial fibrosis. RESULTS Galectin-3 levels are increased in cats with HCM ACVIM stage B and C compared to healthy cats; however, no significant differences were detected between ACVIM stage B and ACVIM stage C cats. In HCM-affected cats, Galectin-3 showed statistically significant correlations with left atrial dimensions, left atrial:aorta ratio, and CMR-derived ECV. Quantitative NT-proBNP showed excellent discrimination between all groups and troponin I was able to discriminate between ACVIM stage C and normal cats, but not between other groups. CONCLUSIONS Circulating Gal-3 levels are increased in cats with HCM and is positively correlated with left atrial dimensions and ECV in affected cats. Further studies evaluating the relationship between Gal-3, myocardial fibrosis, and clinical outcomes are warranted.
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Affiliation(s)
- J P Stack
- VCA Loomis Basin Veterinary Clinic, Loomis, CA, USA
| | - R C Fries
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign College of Veterinary Medicine, Urbana, IL, USA.
| | - L Kruckman
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign College of Veterinary Medicine, Urbana, IL, USA
| | - S Kadotani
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign College of Veterinary Medicine, Urbana, IL, USA
| | - G Wallace
- Pacific Northwest Pet ER and Specialty Center, Vancouver, WA, USA
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El Sharkawy S, Dukes-McEwan J, Abdelrahman H, Stephenson H. Long-term outcome and troponin I concentrations in Great Danes screened for dilated cardiomyopathy: an observational retrospective epidemiological study. J Vet Cardiol 2023; 47:1-13. [PMID: 37099865 DOI: 10.1016/j.jvc.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION Dilated cardiomyopathy (DCM) is common in Great Danes (GDs) but screening for this condition can be challenging. We hypothesised that cardiac troponin-I (cTnI) concentration is elevated in GDs with DCM and/or ventricular arrhythmias (VAs), and is associated with reduced survival time in GDs. ANIMALS One hundred and twenty-four client-owned GDs assigned echocardiographically as normal (n = 53), equivocal (n = 37), preclinical DCM (n = 21), or clinical DCM (n = 13). MATERIALS AND METHODS A retrospective epidemiological study. Echocardiographic diagnosis, VAs, and contemporaneous cTnI concentrations were recorded. Diagnostic accuracy and cTnI cut-offs were determined with receiver operating characteristic analyses. Effects of the cTnI concentration and disease status on survival and cause of death were explored. RESULTS Median cTnI was greater in clinical DCM (0.6 ng/mL [25th-75th percentiles: 0.41-1.71 ng/mL]) and GDs with VAs (0.5 ng/mL [0.27-0.80 ng/mL], P<0.001). Elevated cTnI detected these dogs with good accuracy (area under the curve: 0.78-0.85; cut-offs 0.199-0.34 ng/mL). Thirty-eight GDs (30.6%) suffered a cardiac death (CD); GDs suffering CD (0.25 ng/mL [0.21-0.53 ng/mL]) and specifically sudden cardiac death (SCD) (0.51 ng/mL [0.23-0.72 ng/mL]) had higher cTnI than GDs dying of other causes (0.20 ng/mL [0.14-0.35 ng/mL]; P<0.001). Elevated cTnI (>0.199 ng/mL) was associated with shorter long-term survival (1.25 years) and increased risk of SCD. Great Danes with VAs had shorter survival times (0.97 years). CONCLUSIONS A cardiac troponin-I concentration is a useful adjunctive screening tool. Elevated cTnI is a negative prognostic indicator.
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Pelander L, Bach MBT, Ljungvall I, Willesen JL, Koch J, Dreimanis K, Telling A, Damsgard RM, Ohlsson Å, Häggström J, Langhorn R. Evaluation of cardiac troponin I as a predictor of death in critically ill cats. J Vet Intern Med 2023; 37:403-411. [PMID: 36708236 PMCID: PMC10061183 DOI: 10.1111/jvim.16635] [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: 02/12/2022] [Accepted: 01/05/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Abnormally high serum cardiac troponin I (cTnI) concentration, reflecting leakage from or necrosis of cardiomyocytes, is a negative prognosticator for death in dogs. OBJECTIVES To investigate in critically ill cats whether serum cTnI concentration is abnormally high, identify conditions associated with abnormally high cTnI concentrations, and evaluate cTnI as an independent prognosticator for death and a potential coprognosticator to the acute patient physiologic and laboratory evaluation (APPLE) score in cats. ANIMALS One hundred nineteen cats admitted to intensive care units (ICU) and 13 healthy cats at 2 university teaching hospitals. METHODS Prospective study. Clinical examinations were performed, APPLE scores calculated, and serum cTnI and serum amyloid A (SAA) measured within 24 hours after admission. Outcome was defined as death/euthanasia or survival to discharge, 28 and 90 days after ICU-admission. Prognostic capacity of cTnI, APPLE scores and models combining cTnI and scores were evaluated by receiver-operator-characteristic analyses. RESULTS Median (IQR) serum cTnI concentration was higher in ill (0.63 [0.18-2.65] ng/mL) compared to healthy (0.015 [0.005-0.041] ng/mL) cats (P < .001) and higher in subgroups with structural cardiac disease (2.05 [0.54-16.59] ng/mL; P < .001) or SAA >5 mg/L (0.84 [0.23-2.81] ng/mL; P = .009) than in cats without these characteristics (0.45 [0.12-1.70] and 0.35 [0.015-0.96] ng/mL). The in-hospital case fatality rate was 29%. Neither serum cTnI concentration for all critically ill cats (area-under-the-curve 0.567 [95% CI 0.454-0.680], n = 119) or subgroups (0.625 [0.387-0.863], n = 27; 0.506 [0.360-0.652], n = 86), nor APPLE scores (fast 0.568 [0.453-0.682], full 0.585 [0.470-0.699], n = 100), were significant prognosticators for death. CONCLUSIONS AND CLINICAL IMPORTANCE Abnormally high serum cTnI concentration was common in critically ill cats. Unlike in dogs, cTnI did not confer prognostic information regarding death.
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Affiliation(s)
- Lena Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Maiken B T Bach
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jakob L Willesen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Jörgen Koch
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Kristoffer Dreimanis
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Amalie Telling
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Rikke M Damsgard
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Åsa Ohlsson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Rebecca Langhorn
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
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Hanås S, Larsson A, Rydén J, Lilliehöök I, Häggström J, Tidholm A, Höglund K, Ljungvall I, Holst BS. Cardiac troponin I in healthy Norwegian Forest Cat, Birman and domestic shorthair cats, and in cats with hypertrophic cardiomyopathy. J Feline Med Surg 2022; 24:e370-e379. [PMID: 36073987 PMCID: PMC9511503 DOI: 10.1177/1098612x221117115] [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] [Indexed: 11/21/2022]
Abstract
Objectives The aims of this study were to assess the potential associations between the serum cardiac troponin I (cTnI) concentration in healthy cats and feline characteristics, systolic blood pressure, heart rate (HR), echocardiographic measurements and storage time; and to compare cTnI concentrations in healthy cats with concentrations in cats with hypertrophic cardiomyopathy (HCM), with or without left atrial enlargement (LAE) and in cats with HCM, to assess potential associations between cTnI concentration and echocardiographic variables. Methods Cardiac TnI was analysed using an Abbott ARCHITECT ci16200 analyser in serum from prospectively included healthy Norwegian Forest Cat (NF; n = 33), Birman (n = 33) and domestic shorthair (DSH; n = 30) cats, and from 39 cats with HCM, with or without LAE. Results In healthy cats, higher cTnI concentrations were found in Birman cats than in NF cats (P = 0.014) and in neutered male cats than in intact females (P = 0.032). Cardiac TnI was positively associated with HR (P <0.0001). In cats with HCM, cTnI concentration was positively associated with left ventricular wall thickness and with left atrial-to-aortic root ratio (all P ⩽0.010). Cats with HCM had higher cTnI concentrations than healthy cats, and cTnI concentrations were higher in cats with HCM and LAE than in those with HCM without LAE (all P = 0.0003). Conclusions and relevance Breed and sex may affect serum cTnI concentrations in healthy cats. The cTnI concentration increased with increasing severity of HCM.
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Affiliation(s)
- Sofia Hanås
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Evidensia Specialist Animal Hospital Strömsholm, Strömsholm, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Jesper Rydén
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Inger Lilliehöök
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anna Tidholm
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Anicura Albano Animal Hospital, Stockholm, Sweden
| | - Katja Höglund
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Bodil S Holst
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Fries RC, Kadotani S, Stack JP, Kruckman L, Wallace G. Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Cats With Hypertrophic Cardiomyopathy. Front Vet Sci 2022; 9:813524. [PMID: 35359679 PMCID: PMC8964083 DOI: 10.3389/fvets.2022.813524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo assess the prognostic value of neutrophil-to-lymphocyte ratio (NLR) for cardiac death in cats with hypertrophic cardiomyopathy.Study DesignProspective observation study.AnimalsNinety-six client-owned cats.MethodsComplete blood count samples were collected from 38 healthy and 58 cats with hypertrophic cardiomyopathy (HCM), and the NLR ratios were analyzed. All cats had echocardiographic measurements performed on the same day as blood collection. Spearman rank correlation was used to assess the relationship between echocardiographic measurements and NLR. Long-term outcome data were obtained, and time to cardiac death and variables associated with cardiac death were analyzed using Kaplan–Meier survival curves and Cox proportional hazards models, respectively.ResultsThe NLR was significantly higher in cats with confirmed congestive heart failure. When evaluating HCM patients, cats in the third NLR tertile had a significantly higher risk of cardiac death with a hazard ratio of 10.26 (95% CI: 1.84–57.14; p = 0.0001) when compared with that of patients in the first tertile. NLR was significantly associated with echocardiographic measures of left atrial size, left auricular function, the presence of left atrial spontaneous echo contrast (SEC), and thrombus formation.Conclusions and Clinical RelevanceIncreased NLR is a negative prognostic indicator in cats with HCM.
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Affiliation(s)
- Ryan C. Fries
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- *Correspondence: Ryan C. Fries
| | - Saki Kadotani
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jonathan P. Stack
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- VCA Loomis Basin Veterinary Clinic, Loomis, CA, United States
| | - Leah Kruckman
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Gabrielle Wallace
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Pacific Northwest Pet ER and Specialty Center, Vancouver, WA, United States
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Eason BD, Fine-Ferreira DM, Leeder D, Stauthammer C, Lamb K, Tobias A. Natural history of subaortic stenosis in 166 dogs (1999-2011). J Vet Cardiol 2021; 37:71-80. [PMID: 34634578 DOI: 10.1016/j.jvc.2021.08.005] [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: 10/14/2020] [Revised: 07/29/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Subaortic stenosis (SAS) is one of the most common congenital cardiac diseases in dogs. The objective of this study was to provide survival times on a large population of dogs with SAS and to propose a redefined pressure gradient (PG) scale to include a mild, moderate, severe and very severe disease group. ANIMALS, MATERIALS AND METHODS Dogs were divided into four groups based on the Doppler-derived PG across the stenosis. Disease severity was defined as follows: mild = PG < 50 mmHg; moderate = PG range 50-80 mmHg; severe = PG range 80-130 mmHg; and very severe = PG > 130 mmHg. Over the study period (1999-2011), 166 client-owned dogs were diagnosed with SAS of which 129 had follow-up information available. RESULTS Unadjusted median survival time for severity groups were as follows: mild 10.6 years; moderate 9.9 years; severe 7.3 years; and very severe 3.0 years. Univariable analysis examining the effect of the PG, age at diagnosis and sex found only the PG and age at diagnosis had a significant effect on survival. Adjusted survival curves showed that the survival time in the very severe group was decreased compared with all other groups. CONCLUSION Based on the results of this study, a revised SAS classification system with four PG groups is appropriate. Dogs with a PG > 130 mmHg were identified as those with the lowest median survival time.
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Affiliation(s)
- B D Eason
- University of Missouri, College of Veterinary Medicine, 900 E Campus Dr, Columbia, MO, 65211, USA.
| | - D M Fine-Ferreira
- University of Missouri, College of Veterinary Medicine, 900 E Campus Dr, Columbia, MO, 65211, USA
| | - D Leeder
- University of Minnesota, College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN, 55108, USA
| | - C Stauthammer
- University of Minnesota, College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN, 55108, USA
| | - K Lamb
- Lamb Statistical Consulting LLC, 404 Thompson Ave W, Saint Paul, MN, 55118, USA
| | - A Tobias
- University of Minnesota, College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN, 55108, USA
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Updates on Laboratory Evaluation of Feline Cardiac Diseases. Vet Sci 2021; 8:vetsci8030041. [PMID: 33802401 PMCID: PMC8000286 DOI: 10.3390/vetsci8030041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Laboratory tests can be altered in cardiovascular diseases and the investigation of specific tests or biomarkers may provide additional information about myocardial damage. Traditional laboratory tests, such as cell blood count, serum biochemistry, and coagulation, can be useful in investigating patients, but are not specific. However, markers like Troponin and Natriuretic Peptides may possibly furnish further data on myocardium damage and can be used in both studying and monitoring cats with cardiac disease. Moreover, the evaluation of the thyroid profile is very important as hyperthyroid cats concomitant cardiovascular diseases are very common and they can also be a direct consequence of endocrinopathy. The purpose of this manuscript is to provide the widest possible overview of what is present in the literature about the feline clinical pathology of heart diseases through a rational division of the main alterations of traditional tests and biomarkers.
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Ironside VA, Tricklebank PR, Boswood A. Risk indictors in cats with preclinical hypertrophic cardiomyopathy: a prospective cohort study. J Feline Med Surg 2021; 23:149-159. [PMID: 32696726 PMCID: PMC10741343 DOI: 10.1177/1098612x20938651] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aimed to identify indicators of the risk of progression of preclinical hypertrophic cardiomyopathy (HCM). METHODS This was a prospective cohort study following a population of cats with preclinical HCM. Cats serially underwent physical examination, blood pressure measurement, blood sampling and echocardiography. Development of congestive heart failure (CHF), arterial thromboembolism (ATE) or sudden death (SD) were considered cardiac-related events. Associations between factors recorded at baseline, and on revisit examinations, and the development of a cardiac-related event were explored using receiver operator characteristic (ROC) analysis. RESULTS Forty-seven cats were recruited to the study and were followed for a median period of 1135 days. Fifteen cats (31.9%) experienced at least one cardiac-related event; six CHF, five ATE and five SD. One cat experienced a cardiac-related event per 10.3 years of patient follow-up. Cats with increased left atrial (LA) size and higher concentrations of N-terminal pro B-type natriuretic peptide (NTproBNP) at baseline were more likely to experience an event. Cats with a greater rate of enlargement of LA size between examinations were also more likely to experience an event. CONCLUSIONS AND RELEVANCE Factors easily measured, either once or serially, in cats with preclinical HCM can help to identify those at greater risk of going on to develop clinical signs.
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Affiliation(s)
| | | | - Adrian Boswood
- The Royal Veterinary College, Hatfield,
Hertfordshire, UK
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11
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van Hoek I, Hodgkiss-Geere H, Bode EF, Hamilton-Elliott J, Mõtsküla P, Palermo V, Pereira YM, Culshaw GJ, Laxalde J, Dukes-McEwan J. Association of diet with left ventricular wall thickness, troponin I and IGF-1 in cats with subclinical hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:2197-2210. [PMID: 33118674 PMCID: PMC7694815 DOI: 10.1111/jvim.15925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cats with subclinical hypertrophic cardiomyopathy (sHCM) have elevated serum insulin and serum amyloid A concentrations correlating with the degree of cardiac hypertrophy. Diet might affect these and other cardiac variables. OBJECTIVE Evaluate the effect of a complete, balanced diet with restricted starch and supplemented with eicosapentaenoic acid + docosahexaenoic acid (EPA + DHA) on echocardiographic variables and cardiac biomarkers in cats with sHCM. ANIMALS Forty-four client-owned cats with sHCM. METHODS A prospective, randomized, double-blind, multicenter study enrolled cats with end-diastole interventricular septum thickness (IVSd) or left ventricular wall thickness (LVWd) ≥6 mm, or both. Nonsedated, fasted cats were examined at baseline and after 6 and 12 months of Test (restricted starch and EPA + DHA supplements) (n = 23) or Control (unrestricted starch without EPA + DHA supplementation) (n = 21) diet. Assessments included auscultation, body weight, body condition score, echocardiography and blood analysis. Linear and generalized mixed models analyzed diet, time and diet * time interactions (5% significance level). RESULTS No differences between diet groups were significant for any variable at any timepoint. There were significant decreases in the Test but not Control group in maximum IVSd (P = .03), maximum LVWd (P = .02) and insulin-like growth factor-1 levels (P = .04) after 12 months, and in ultrasensitive cardiac troponin I (cTnI) (P = .001) after 6 months; effect sizes (95% confidence interval) were 0.53 (0.09; 0.99), 0.63 (0.18; 1.09), 0.61 (0.16; 1.07), and 0.37 (-0.06; 0.8), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Cats with sHCM fed Test diet had significant decreases in echocardiographic variables of sHCM and in cTnI and IGF-1.
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Affiliation(s)
| | - Hannah Hodgkiss-Geere
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| | - Elizabeth F Bode
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| | - Julie Hamilton-Elliott
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
| | - Paul Mõtsküla
- Estonian University of Life Sciences, Tartu, Estonia
| | | | | | | | | | - Joanna Dukes-McEwan
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, United Kingdom
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12
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Ferasin L, Ferasin H, Borgeat K. Twenty-four-hour ambulatory (Holter) electrocardiographic findings in 13 cats with non-hypertrophic cardiomyopathy. Vet J 2020; 264:105537. [PMID: 33012440 DOI: 10.1016/j.tvjl.2020.105537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
Detection and characterisation of cardiac arrhythmias in cats with hypertrophic cardiomyopathy (HCM) has already been documented in various studies. However, similar studies have not been reported for other forms of feline cardiomyopathy. The clinical records of 13 client-owned cats diagnosed with restrictive cardiomyopathy (RCM), arrhythmogenic right ventricular cardiomyopathy (ARVC) and non-specific cardiomyopathy (NSCM) that underwent Holter recording at the time of diagnosis were reviewed retrospectively. Eight cats had signs of congestive heart failure at presentation, one cat had a history of recurrent syncope and the remaining four cats were asymptomatic. The average heart rate was 138 ± 22 (range 97-181) beats per minute (bpm) with the lowest value (97 bpm) recorded in a cat with third degree atrioventricular block (3-AVB) and the highest value (181 bpm) observed in a cat with atrial fibrillation (AF). The median number of ventricular ectopic beats (VEB) over 24 h was 2031 (338-8305), mostly represented by single isolated VPCs (803, 123-2221). Cardiac pauses were observed in three cats, with the longest pause lasting more than 6 s. A survival analysis was not performed due to the small number of cats and limited follow-up information. Holter recording revealed cardiac arrhythmias in all 13 cats, while 8/13 cats (61.5%) had an unremarkable resting electrocardiogram (ECG). The average daily heart rate in these cats did not appear affected by the presence of heart failure, although periods of sinus arrhythmia were absent in all individuals.
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Affiliation(s)
- L Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd, Alton, Hampshire, United Kingdom.
| | - H Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd, Alton, Hampshire, United Kingdom
| | - K Borgeat
- Langford Vets, University of Bristol, Somerset, United Kingdom
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Seo J, Payne JR, Novo Matos J, Fong WW, Connolly DJ, Luis Fuentes V. Biomarker changes with systolic anterior motion of the mitral valve in cats with hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:1718-1727. [PMID: 32822105 PMCID: PMC7517492 DOI: 10.1111/jvim.15807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) are biomarkers commonly evaluated in cats with suspected heart disease. Many cats with hypertrophic cardiomyopathy (HCM) have systolic anterior motion of the mitral valve (SAM), but its influence on circulating NT-proBNP or cTnI concentrations is currently unknown. HYPOTHESIS/OBJECTIVES Cats with HCM and SAM (HCMSAM+ ) have higher NT-proBNP and cTnI concentrations than do cats with HCM but without SAM (HCMSAM- ). ANIMALS One hundred forty cats with HCM: 70 with SAM and 70 without SAM. METHODS Retrospective case-to-case study. Cats were recruited if diagnosed with HCM by echocardiography and results were available for NT-proBNP or cTnI concentrations or both. Cats with SAM were matched to those without SAM for clinical presentation, left atrial (LA) size and left ventricular (LV) fractional shortening. RESULTS A total of 119 NT-proBNP and 123 cTnI results were available. The HCMSAM+ cats had higher median concentrations than did HCMSAM- cats for NT-proBNP (729 pmoL/L; interquartile range [IQR], 275-1467 versus 65 pmoL/L; IQR, 25-271; P < .001) and cTnI (0.27 ng/mL; IQR, 0.10-0.81 versus 0.07 ng/mL; IQR, 0.01-0.43; P = .002). In general linear models for both NT-proBNP and cTnI, the independent explanatory variables were SAM, congestive heart failure, maximal LV wall thickness, and LA size. CONCLUSIONS AND CLINICAL IMPORTANCE For cats with HCM and equivalent LA size and LV systolic function, those with SAM had higher NT-proBNP and cTnI concentrations than did those without SAM. Presence of SAM should be considered when interpreting biomarker concentrations in cats with HCM.
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Affiliation(s)
- Joonbum Seo
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Jessie Rosie Payne
- Langford Vets Small Animal Referral Hospital, University of Bristol, Bristol, United Kingdom
| | - Jose Novo Matos
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom.,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Wesley Wynne Fong
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - David J Connolly
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Virginia Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
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14
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Coleman AE, DeFrancesco TC, Griffiths EH, Lascelles BDX, Kleisch DJ, Atkins CE, Keene BW. Atenolol in cats with subclinical hypertrophic cardiomyopathy: a double-blind, placebo-controlled, randomized clinical trial of effect on quality of life, activity, and cardiac biomarkers. J Vet Cardiol 2020; 30:77-91. [PMID: 32707333 DOI: 10.1016/j.jvc.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare quality of life (QOL) and activity measures between healthy control cats and cats with subclinical hypertrophic cardiomyopathy (HCM), and to evaluate the effect of oral atenolol therapy on QOL, activity, and circulating biomarkers in cats with subclinical HCM. ANIMALS Thirty-two client-owned cats with subclinical HCM and 27 healthy control cats. METHODS Owner responses to a QOL questionnaire, circulating cardiac biomarker concentrations, and accelerometer-based activity measures were compared prospectively in cats with and without HCM, and in cats with HCM before and after treatment with oral atenolol (6.25 mg/cat q 12 h) for 6 months. RESULTS Owner-assessed activity of daily living score was lower in cats with HCM than in cats in controls (p=0.0420). No differences were identified between control cats and cats with HCM for any activity variable. Compared with placebo, treatment with atenolol was associated with a lower baseline-adjusted mean ± SD heart rate (157 ± 30 vs. 195 ± 20 bpm; p=0.0001) and rate-pressure product (22,446 ± 6,237 vs. 26,615 ± 4,623 mmHg/min; p=0.0146). A treatment effect of atenolol on QOL or activity was not demonstrated. CONCLUSIONS This study failed to identify an effect of subclinical HCM on owner-assessed QOL or activity or a treatment effect of atenolol on these variables at the dosage evaluated. These findings do not support a treatment benefit of atenolol for the goal of symptom reduction in cats with subclinical HCM.
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Affiliation(s)
- A E Coleman
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - T C DeFrancesco
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA.
| | - E H Griffiths
- Department of Statistics, College of Agriculture and Life Sciences, North Carolina State University, 2311 Stinson Drive, Raleigh, NC, 27695, USA
| | - B D X Lascelles
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - D J Kleisch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - C E Atkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
| | - B W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27606, USA
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15
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Assessment of left ventricular systolic function in hypertrophic cardiomyopathy patients with myocardial injury: a study based on layer-specific speckle tracking echocardiaography. Int J Cardiovasc Imaging 2020; 36:2129-2137. [PMID: 32602022 DOI: 10.1007/s10554-020-01921-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Abstract
We conducted this study to investigate left ventricle (LV) systolic function in endocardial, mid-myocardial, and epicardial layers by two-dimensional (2D) speckle tracking echocardiography (STE) in hypertrophic cardiomyopathy (HCM) patients with myocardial injury indexed by elevated serum cardiac troponin I (cTnI). Twenty-nine HCM patients with myocardial injury, thirty-five HCM patients without myocardial injury, and ninty-one healthy controls were enrolled in this study. Serum cTnI > 0.026 ng/mL was defined as myocardial injury. LV longitudinal and circumferential strain (LS and CS) were assessed in endocardial, mid-myocardial and epicardial layers. Layer-specific LS and CS differed significantly (all P < 0.001) among all three groups in all three layers, in a descending order from healthy controls to HCM patients without myocardial injury to HCM patients with myocardial injury. Layer-specific LS and CS were decreased the most in HCM patients with myocardial injury indexed by elevated seum cTnI (all P < 0.05). In HCM patients with myocardial injury, layer-specific LS and CS were significantly lower in the segments with greater hypertrophy (segmental thickness ≥ 15 mm) (all P < 0.001) except for endocardial CS (P > 0.05). Layer-specific evaluation of LV strain may improve understanding of impaired LV systolic function in HCM patients with myocardial injury, thus preventing further damage.
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16
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Hezzell M. Monitoring congestive heart failure. IN PRACTICE 2020. [DOI: 10.1136/inp.m1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Ferasin L, Kilkenny E, Ferasin H. Evaluation of N-terminal prohormone of brain natriuretic peptide and cardiac troponin-I levels in cats with systolic anterior motion of the mitral valve in the absence of left ventricular hypertrophy. J Vet Cardiol 2020; 30:23-31. [PMID: 32645686 DOI: 10.1016/j.jvc.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To identify the prevalence of systolic anterior motion of the mitral valve (SAM) in apparently healthy cats in the absence of left ventricular hypertrophy (LVH) and examine the relationship between specific cardiac biomarker concentrations and echocardiographic parameters in these individuals. ANIMALS eighty client-owned cats. MATERIALS AND METHODS retrospective study; inclusion criteria were the presence of SAM on conscious echocardiography and concurrent measurement of plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and serum cardiac troponin-I (cTnI). Cats were excluded if they had LVH, left atrial enlargement or systemic disease. The percentages of cats with NT-proBNP and cTnI concentrations above the normal reference range were calculated. The correlation between each biomarker concentration and left ventricular myocardial wall thickness, left atrial size and maximum left ventricular outflow tract velocity was evaluated. RESULTS Thirty-four of 80 patients with SAM showed no evidence of cardiac remodelling (LVH or left atrial enlargement). Of these patients, 30 of 34 had elevated NT-proBNP, and cTnI was elevated in 13 of 27 (48.1%) cats where this biomarker was measured in association with the NT-proBNP assay. A positive correlation was observed between concentration of plasma NT-proBNP and maximum left ventricular outflow tract velocity (rs = 0.67, p<0.0001). No significant correlations were found between the concentration of biomarkers and the remaining echocardiographic parameters. CONCLUSIONS SAM is frequently observed in cats even in the absence of cardiac remodelling, and these individuals often demonstrate elevated plasma NT-proBNP and serum cTnI concentrations. Plasma NT-proBNP elevation is correlated with the severity of the left ventricular outflow obstruction caused by SAM.
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Affiliation(s)
- L Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd., Alton, Hampshire, United Kingdom.
| | - E Kilkenny
- Lumbry Park Veterinary Specialists, Alton, Hampshire, United Kingdom
| | - H Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd., Alton, Hampshire, United Kingdom
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18
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Lester S. New Tests in Feline Veterinary Medicine: When to Use Them and When to Stick with Tried-and-True Tests. Vet Clin North Am Small Anim Pract 2020; 50:883-898. [PMID: 32360014 DOI: 10.1016/j.cvsm.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The focus of this article is on how interpretations of laboratory data can utilize both population and individual reference intervals, while making the most of routine testing procedures coupled with some of the newer laboratory tests, which can complement the existing tests in diagnosing disease.
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Affiliation(s)
- Sally Lester
- True North Veterinary Diagnostics, Langley, British Columbia, Canada; Pilchuck Veterinary Hospital, Snohomish, WA, USA.
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19
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Luis Fuentes V, Abbott J, Chetboul V, Côté E, Fox PR, Häggström J, Kittleson MD, Schober K, Stern JA. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med 2020; 34:1062-1077. [PMID: 32243654 PMCID: PMC7255676 DOI: 10.1111/jvim.15745] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022] Open
Abstract
Cardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are well‐tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death. Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk of life‐threatening complications and those at higher risk. Based on the available literature, we offer recommendations for the approach to diagnosis and staging of cardiomyopathies, as well as for management at each stage.
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Affiliation(s)
- Virginia Luis Fuentes
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Valérie Chetboul
- Alfort Cardiology Unit (UCA), Université Paris-Est, École Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Maisons-Alfort cedex, France
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Mark D Kittleson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Karsten Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
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20
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Loughran KA, Rush JE, Rozanski EA, Oyama MA, Larouche-Lebel É, Kraus MS. The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats. J Vet Intern Med 2019; 33:1892-1901. [PMID: 31317580 PMCID: PMC6766524 DOI: 10.1111/jvim.15549] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 06/19/2019] [Indexed: 12/13/2022] Open
Abstract
Background Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients. Hypothesis Focused cardiac ultrasound by a nonspecialist practitioner (NSP) will increase the detection of occult heart disease in asymptomatic cats compared with physical examination and ECG. Animals Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed. Methods Multicenter prospective cohort study. Twenty‐two NSPs were trained to perform FCU. Cats without clinical signs of heart disease were recruited, and NSPs performed the following in sequential order: physical examination, ECG, FCU, and point‐of‐care N‐terminal pro‐B‐type natriuretic peptide assay (POC‐BNP). After each step, NSPs indicated yes, no, or equivocal as to whether they believed heart disease was present. The level of agreement between the NSP diagnosis and a blinded cardiologist's diagnosis after echocardiogram was evaluated using Cohen's kappa test. Results Cardiologist diagnoses included 148 normal cats, 102 with heart disease, and 39 equivocal ones. Agreement between NSP and cardiologist was slight after physical examination (kappa 0.253 [95% CI, 0.172‐0.340]), did not increase after ECG (0.256 [0.161‐0.345]; P = .96), increased after FCU (0.468 [0.376‐0.558]; P = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; P = .67). In cats with mild, moderate, and marked occult heart disease, the proportion of cats having a NSP diagnosis of heart disease after FCU was 45.6%, 93.1%, and 100%, respectively. Conclusions and Clinical Importance Focused cardiac ultrasound performed by NSPs increased the detection of occult heart disease, especially in cats with moderate to marked disease. Focused cardiac ultrasound appears to be a feasible and useful tool to assist NSPs in the detection of heart disease in cats.
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Affiliation(s)
- Kerry A Loughran
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts.,Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts
| | - Mark A Oyama
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Éva Larouche-Lebel
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marc S Kraus
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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21
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Irvine KL, McLeish SA, Sarvani E, Papasouliotis K. Analytical quality assessment and method comparison of two immunoassays for the measurement of serum cardiac Troponin I in dogs and cats. Vet Clin Pathol 2019; 48 Suppl 1:70-77. [PMID: 31310344 DOI: 10.1111/vcp.12761] [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: 09/28/2018] [Revised: 01/26/2019] [Accepted: 02/22/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cardiac troponin I (cTnI) is a sensitive and specific biomarker for myocardial injury. Validation of point-of-care (POC) analyzers for cTnI measurement is valuable to the critical care setting, in which rapid results can facilitate prompt diagnoses. An immunoassay for detecting cTnI is available for the POC AIA-360 analyzer (Tosoh Bioscience), but this has not been validated using canine and feline serum. OBJECTIVES The objectives were (a) to determine precision, accuracy, and linearity of cTnI measurement using the AIA-360 immunoassay in pooled canine and feline samples, and (b) to compare results for individual canine and feline samples with those obtained using a reference chemiluminescence method (Immulite 1000, Siemens). METHODS Intra- and inter-assay repeatability was determined using pooled canine and feline samples, and the coefficient of variation (CV) was calculated for each. Pooled samples were also serially diluted to assess linearity. A modified spike and recovery analysis was performed by mixing pooled samples with different concentrations. Bland-Altman and Deming regression analyses were used to determine bias for individual samples, and the total observed error (TEobs ) was calculated. RESULTS Coefficient of variation values were well within the required maximum of 20%. Linearity was demonstrated over the range of samples tested, and the recovery study showed minimal proportional inaccuracies. Although the correlation between the analyzers was excellent, there was a large mean bias due to relative proportional bias. Total observed error consequently exceeded the total allowable error (TEA ). CONCLUSION Although, in most respects, the analyzer demonstrated adequate performance, pronounced bias contributed to the large TEobs , indicating a requirement for analyzer-specific reference intervals.
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Affiliation(s)
- Katherine L Irvine
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Susan A McLeish
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Elpida Sarvani
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Kostas Papasouliotis
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Bristol, UK
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22
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Bartoszuk U, Keene BW, Baron Toaldo M, Pereira N, Summerfield N, Novo Matos J, Glaus TM. Holter monitoring demonstrates that ventricular arrhythmias are common in cats with decompensated and compensated hypertrophic cardiomyopathy. Vet J 2018; 243:21-25. [PMID: 30606435 DOI: 10.1016/j.tvjl.2018.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/25/2022]
Abstract
Arrhythmias can complicate cardiac disease in cats and are a potential cause of sudden death. The aim of this study was to evaluate the presence and nature of cardiac arrhythmias, and the potential correlation between plasma serum troponin I (cTnI) concentrations and the presence or severity of arrhythmias in cats with decompensated (dHCM) and compensated hypertrophic cardiomyopathy (cHCM). Forty one client-owned cats were studied: 16 with cHCM, 15 with dHCM and 10 healthy control cats. Physical examination, echocardiography, cTnI and 24-h Holter recordings were obtained in all cats and thoracic radiographs in cats with dHCM. Cats in both HCM groups were followed for 1 year after their initial Holter examination. The median (range) number of ventricular premature complexes (VPCs) over 24h was 867 (1-35,160) in cats with dHCM, 431 (0-18,919) in cats with cHCM and 2 (0-13) in healthy control cats. The median number of episodes of ventricular tachycardia (VTach) was 0 (0-1497) in dHCM and 0.5 (0-91) in cats with cHCM. The number of VPCs, VTach episodes and heart rate was not different between the HCM groups. Plasma serum troponin I was highest in the cats with dHCM, but there was no correlation between cTnI concentration and the number of arrhythmias. Thirteen of 31 cats with HCM died, but an association with the presence and complexity of ventricular arrhythmias was not observed. Compared to healthy cats, ventricular arrhythmias were common in cats with cHCM and dHCM, but neither presence nor complexity of arrhythmias could be linked to prognosis.
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Affiliation(s)
- U Bartoszuk
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland
| | - B W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr. Raleigh, NC 27607, USA
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano Emilia, Italy
| | - N Pereira
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Vet Zentrum, Riedäckerstrasse 7, 8422 Pfungen, Switzerland
| | - N Summerfield
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Virtual Veterinary Specialists, P.O. Box 1301, RH10 0NT, UK
| | - J Novo Matos
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland.
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23
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Cullimore AM, Lester GD, Secombe CJ, Campbell K. Hypertrophic cardiomyopathy in a Clydesdale gelding. Aust Vet J 2018; 96:212-215. [DOI: 10.1111/avj.12701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 10/04/2017] [Accepted: 11/22/2017] [Indexed: 01/23/2023]
Affiliation(s)
- AM Cullimore
- College of Veterinary Medicine, School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - GD Lester
- College of Veterinary Medicine, School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - CJ Secombe
- College of Veterinary Medicine, School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - K Campbell
- College of Veterinary Medicine, School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
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24
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Hori Y, Iguchi M, Heishima Y, Yamashita Y, Nakamura K, Hirakawa A, Kitade A, Ibaragi T, Katagi M, Sawada T, Yuki M, Kanno N, Inaba H, Isayama N, Onodera H, Iwasa N, Kino M, Narukawa M, Uchida S. Diagnostic utility of cardiac troponin I in cats with hypertrophic cardiomyopathy. J Vet Intern Med 2018; 32:922-929. [PMID: 29660794 PMCID: PMC5980312 DOI: 10.1111/jvim.15131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 01/09/2018] [Accepted: 03/08/2018] [Indexed: 12/26/2022] Open
Abstract
Background Cardiac troponin I (cTnI) is useful for assessing hypertrophic cardiomyopathy (HCM) in cats. Objective To measure plasma cTnI concentrations in healthy cats and evaluate the clinical utility of cTnI in determining the severity of HCM. Animals Clinically healthy cats (n = 88) and cats with HCM (n = 93). Methods Multicenter prospective study. Cats with HCM, including hypertrophic obstructive cardiomyopathy at various stages, were diagnosed using echocardiography. Plasma cTnI concentrations were analyzed by a commercial laboratory. Receiver‐operating characteristic curve analysis was used to evaluate the accuracy of plasma cTnI concentrations to detect HCM. Results The median cTnI concentration was 0.027 ng/mL (interquartile range, 0.012‐0.048 ng/mL) in healthy cats. Concentrations were significantly higher in diseased cats than in healthy controls, and concentrations were significantly higher in cats with heart failure than in asymptomatic cats. A plasma cTnI concentration of 0.163 ng/mL had a sensitivity of 62.0% and specificity of 100% when used to distinguish normal cats from asymptomatic HCM cats without left atrial dilatation. A cutoff of 0.234 ng/mL had high sensitivity (95.0%) and specificity (77.8%) for assessing heart failure. The areas under the receiver‐operating characteristic curves were 0.85 and 0.93, respectively. Conclusions and Clinical Importance Increased cTnI concentrations reflect the severity of HCM. If other causes of cardiac injury are ruled out, plasma cTnI concentration may be useful for predicting the severity of HCM in cats.
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Affiliation(s)
- Yasutomo Hori
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midori-machi, Bunkyodai, Ebetsu, Hokkaido, Japan
| | - Masayuki Iguchi
- Iguchi Animal Hospital, 6-2-34 Kamijima, Naka ward, Hamamatsu, Shizuoka, Japan
| | - Yasuhiro Heishima
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midori-machi, Bunkyodai, Ebetsu, Hokkaido, Japan.,Heisei Animal Hospital, 2-1-1 Futago-cho, Kasugai, Aichi, Japan
| | - Yohei Yamashita
- Ebisu Animal Hospital, 3-3-43 Nishitaga, Taihaku ward, Sendai, Miyagi, Japan
| | - Kensuke Nakamura
- Organization for Promotion of Tenure Track, University of Miyazaki, 1-1 Gakuenkibanadai-nishi, Miyazaki, Japan
| | - Atsushi Hirakawa
- Pet Clinic Hallelujah, 2544-1 Nakabaru, Kasuya-machi, Kasuya County, Fukuoka, Japan
| | - Akihito Kitade
- Kitade Animal Hospital, 2 Tajiri, Ichishi-cho, Tsu, Mie, Japan
| | - Toshiki Ibaragi
- Miyoshi Inter Animal Hospital, 27-103 Neura Fukuya-cho, Miyoshi, Aichi, Japan
| | - Michio Katagi
- Katagi Animal Hospital, 565-5 Matoba, Kawagoe, Saitama, Japan
| | - Tamotsu Sawada
- Kitanomori Animal Hospital, 17-1-35 11-Jyou, Shin-kotoni, Kita ward, Sapporo, Hokkaido, Japan
| | - Masashi Yuki
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Nagoya, Aichi, Japan
| | - Nobuyuki Kanno
- Department of Veterinary Medicine, Veterinary Internal Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa, Japan
| | - Haruki Inaba
- Inaba Veterinary Hospital, 533-2 Shimojo, Fujinomiya, Shizuoka, Japan
| | - Noriko Isayama
- Uenonomori Animal Clinic, 1-5-11 Yanaka Taito ward, Tokyo, Japan
| | - Hideyuki Onodera
- Onodera Animal Hospital, 1-10-4 Chuou, Rifu-cho, Miyagi County, Miyagi, Japan
| | - Naoki Iwasa
- Hashima Animal Hospital, 2-17 Asahira, Fukujyu-cho, Hashima, Gifu, Japan
| | - Mikio Kino
- Lita Pet Clinic, 1-170 Matsumoto-cho, Inuyama, Aichi, Japan
| | - Mikihiro Narukawa
- Mie Animal Medical Center, 1596 Nishihino-cho, Yokkaichi, Mie, Japan
| | - Syuhei Uchida
- Uchida Animal Hospital, 48 Shinmeishita, Shimo-machi, Nishio, Aichi, Japan
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Bogan JE. Measuring Cardiac Troponin I in Snake Cardiac Muscle: A Pilot Study. ACTA ACUST UNITED AC 2017. [DOI: 10.5818/16-12-101.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- James E. Bogan
- Central Florida Zoo & Botanical Gardens, 3755 NW Hwy 17-92, Sanford, FL 32771, USA
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27
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Roderick KV, Abelson AL, Nielsen L, Price LL, Quinn R. Evaluation of red blood cell distribution width as a prognostic indicator in cats with acquired heart disease, with and without congestive heart failure. J Feline Med Surg 2017; 19:648-656. [PMID: 27225272 PMCID: PMC11128818 DOI: 10.1177/1098612x16649988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Congestive heart failure secondary to cardiomyopathy is a common manifestation of cardiac disease in cats, carrying a variable prognosis. The objective of this retrospective study was to evaluate the relationship between red blood cell distribution width (RDW) and survival time in feline patients with acquired heart disease with and without congestive heart failure (CHF). Methods Three hundred and forty-nine client-owned cats with echocardiograms and complete blood count, including RDW measurement, performed between March 2006 and December 2011, were included in the study. Patient characteristics, including signalment, hematocrit, RDW, echocardiographic parameters and survival, were recorded. Comparisons between RDW in cats with asymptomatic acquired heart disease and those with CHF were made. Survival was documented and compared at 30 days and 6 months. Results CHF was present in 80 cats and absent in 269 cats. Cats with CHF had an increase in mortality compared with cats without CHF at 30 days and 6 months ( P = 0.007 and P = 0.04, respectively). RDW was not significantly associated with survival in cats with or without CHF at 30 days or 6 months. A significant difference was found between median RDW values in cats with CHF vs cats without CHF (16.3% vs 15.8%; P = 0.02). The median RDW value was significantly higher in cats with unclassified cardiomyopathy compared with cats with other types of cardiomyopathy (16.3% vs 15.8%; P = 0.03). Conclusions and relevance Single RDW values did not predict mortality in cats with acquired heart disease but may be useful in determining if cats have decompensated heart disease and CHF. Human studies indicate that incremental increases in serial RDW measurements are associated with decreased survival; serial RDW measurements in cats may be an area of future study.
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Affiliation(s)
- Kursten V Roderick
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, USA
- Angell Animal Medical Center, MA, USA
| | - Amanda L Abelson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, USA
| | | | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, MA, USA
- Tufts Clinical and Translational Science Institute, Tufts University, MA, USA
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28
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Follow-up of troponin I concentration in dogs with atrioventricular block and dual-chamber pacing in a case-matched study. J Vet Cardiol 2017; 19:247-255. [PMID: 28478942 DOI: 10.1016/j.jvc.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 11/25/2016] [Accepted: 01/18/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Increased cardiac troponin I (cTnI) concentration has been reported in dogs with atrioventricular (AV) block before and shortly following pacemaker implantation. The role of AV dyssynchrony, age, or concurrent cardiac disease on cTnI concentration remains unknown. OBJECTIVES To investigate change in cTnI concentration following dual-chamber pacemaker implantation on short- and long-term follow-up and to compare cTnI values to a case-matched control group. ANIMALS Thirty-eight client-owned dogs with permanent AV block and 38 matched control dogs. METHODS Retrospective review of medical records. Pacemaker group consisted of dogs with AV block and dual-chamber pacing. Control group matched the study population in age and cardiac disease. cTnI was compared between pacemaker and control group on short- and long-term follow-up. Different lead types and influence of arrhythmia on cTnI were tested. RESULTS cTnI was high at presentation (median 0.66 ng/ml; range 0.03-18.6) and showed a significant reduction over time after pacemaker implantation (p < 0.0001). Median cTnI values were significantly different between pacemaker and control group on short-term (p = 0.0004; 0.11 ng/ml, range 0.03-1.36 versus 0.06 ng/ml, range 0.03-0.46), but not on long-term follow-up (p = 0.0547; 0.14 ng/ml, range 0.03-0.73 versus 0.07 ng/ml, range 0.03-0.46). Lead type and severity of arrhythmia did not show a significant correlation to cTnI concentration. CONCLUSIONS On long-term follow-up, cTnI remained mildly elevated in some of the pacemaker dogs but was not significantly different to the matched control group.
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Bijsmans ES, Jepson RE, Wheeler C, Syme HM, Elliott J. Plasma N-Terminal Probrain Natriuretic Peptide, Vascular Endothelial Growth Factor, and Cardiac Troponin I as Novel Biomarkers of Hypertensive Disease and Target Organ Damage in Cats. J Vet Intern Med 2017; 31:650-660. [PMID: 28387019 PMCID: PMC5435049 DOI: 10.1111/jvim.14655] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/06/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
Background In the absence of ocular target organ damage (ocular‐TOD), diagnosis of hypertension is challenging in cats. Biomarkers would provide additional support for the diagnosis of hypertension. Hypothesis Vascular endothelial growth factor (VEGF), N‐terminal probrain natriuretic peptide (NT‐proBNP), cardiac troponin I (cTnI), and urine protein‐to‐creatinine ratio (UPC) are predictors of systemic hypertension, will be increased in cats with hypertension with or without ocular‐TOD, and will decrease with antihypertensive treatment. Methods Plasma VEGF, NT‐proBNP, and cTnI concentrations and UPC were determined in healthy geriatric cats, normotensive cats with chronic kidney disease (CKD), hypertensive cats with evidence of hypertensive retinopathy (HT‐ocular‐TOD), and hypertensive cats without hypertensive ocular‐TOD (HT‐noTOD). Comparisons among groups were performed. Multivariable binary logistic regression models were built to identify independent biomarkers of hypertension and ocular‐TOD. Receiver operator characteristic (ROC) curves were drawn to assess clinical use. Results Cats with HT‐ocular‐TOD had significantly higher VEGF than all other groups (P < .05) and significantly higher NT‐proBNP than healthy cats (P < .001). Healthy cats had significantly lower cTnI than all other groups (P < .05). No differences were found among groups for UPC (P = .08). Cardiac troponin I and VEGF were independent predictors of hypertension (P < .05), but none of the biomarkers were independent predictors of ocular‐TOD. N‐terminal probrain natriuretic peptide concentrations decreased with antihypertensive treatment (P < .001). The ROC curves indicated that none of the biomarkers met the criteria to function as diagnostic tests for the diagnosis of hypertension or associated ocular‐TOD. Conclusions and Clinical Significance Despite statistical significance and changes with ocular‐TOD, antihypertensive treatment, or both, VEGF, NT‐proBNP, and cTnI did not function as useful diagnostic tests for hypertension. Persistently increased systolic blood pressure (SBP) measurements in combination with fundoscopy remains the preferred method for diagnosis of feline hypertension.
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Affiliation(s)
- E S Bijsmans
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - C Wheeler
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - H M Syme
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
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Pierce KV, Rush JE, Freeman LM, Cunningham SM, Yang VK. Association between Survival Time and Changes in NT-proBNP in Cats Treated for Congestive Heart Failure. J Vet Intern Med 2017; 31:678-684. [PMID: 28370373 PMCID: PMC5435051 DOI: 10.1111/jvim.14690] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 12/15/2016] [Accepted: 02/14/2017] [Indexed: 12/03/2022] Open
Abstract
Background Reductions in N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations after treatment have been associated with improved survival in people with congestive heart failure (CHF), but have not been reported in cats with CHF. Objectives To evaluate changes in NT‐proBNP concentrations in cats with CHF after treatment and determine whether serial NT‐proBNP measurements provide prognostic information. Animals Thirty‐one client‐owned cats. Methods Prospective, observational study in cats with new onset CHF secondary to cardiomyopathy. Concentrations of NT‐proBNP were measured within 4 hours of admission to the hospital, on the day of discharge, and at re‐evaluation 7–10 days later. Results Median NT‐proBNP concentrations decreased significantly from admission (1,713 pmol/L [range, 160–3,784 pmol/L]) to discharge (902 pmol/L [range, 147–3,223 pmol/L]); P = .005) and from admission to re‐evaluation (1,124 pmol/L [range, 111–2,727 pmol/L]; P = .024). Median survival time was 109 days (range, 1–709 days), with 5 cats still alive at the time of analysis. Cats with a larger percent decrease in NT‐proBNP from admission to discharge had a longer survival time (P = .048). Cats with evidence of active CHF at the time of re‐evaluation (P = .010) and cats whose owners had difficulty administering medications (P = .045) had shorter survival times. Conclusions and clinical importance Cats with a larger percent decrease in NT‐proBNP during hospitalization and no evidence of CHF at the time of re‐evaluation had longer survival times. Additional studies are needed to determine whether NT‐proBNP can help guide treatment in cats with CHF.
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Affiliation(s)
- K V Pierce
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - J E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - L M Freeman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - S M Cunningham
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - V K Yang
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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Simpson S, Rutland P, Rutland CS. Genomic Insights into Cardiomyopathies: A Comparative Cross-Species Review. Vet Sci 2017; 4:E19. [PMID: 29056678 PMCID: PMC5606618 DOI: 10.3390/vetsci4010019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 12/19/2022] Open
Abstract
In the global human population, the leading cause of non-communicable death is cardiovascular disease. It is predicted that by 2030, deaths attributable to cardiovascular disease will have risen to over 20 million per year. This review compares the cardiomyopathies in both human and non-human animals and identifies the genetic associations for each disorder in each species/taxonomic group. Despite differences between species, advances in human medicine can be gained by utilising animal models of cardiac disease; likewise, gains can be made in animal medicine from human genomic insights. Advances could include undertaking regular clinical checks in individuals susceptible to cardiomyopathy, genetic testing prior to breeding, and careful administration of breeding programmes (in non-human animals), further development of treatment regimes, and drugs and diagnostic techniques.
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Affiliation(s)
- Siobhan Simpson
- Faculty of Medicine and Health Sciences, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
| | - Paul Rutland
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK.
| | - Catrin Sian Rutland
- Faculty of Medicine and Health Sciences, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK.
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Häggström J, Luis Fuentes V, Wess G. Screening for hypertrophic cardiomyopathy in cats. J Vet Cardiol 2016; 17 Suppl 1:S134-49. [PMID: 26776573 DOI: 10.1016/j.jvc.2015.07.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/27/2015] [Accepted: 07/01/2015] [Indexed: 11/17/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats, and it can lead to increased morbidity and mortality. Cats are often screened for HCM because of the presence of a heart murmur, but screening for breeding purposes has also become common. These cats are usually purebred cats of breeding age, and generally do not present with severe disease or with any clinical signs. This type of screening is particularly challenging because mild disease may be difficult to differentiate from a normal phenotype, and the margin for error is small, with potentially major consequences for the breeder. This article reviews HCM screening methods, with particular emphasis on echocardiography.
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Affiliation(s)
- Jens Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, Uppsala, Sweden.
| | - Virginia Luis Fuentes
- The Royal Veterinary College, Department of Clinical Science and Services, Hawkshead Lane, Hatfield AL9 7TA, United Kingdom
| | - Gerhard Wess
- Clinic of Small Animal Medicine, LMU University, Veterinaerstr. 13, 80539 Munich, Germany
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33
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Payne JR, Borgeat K, Brodbelt DC, Connolly DJ, Luis Fuentes V. Risk factors associated with sudden death vs. congestive heart failure or arterial thromboembolism in cats with hypertrophic cardiomyopathy. J Vet Cardiol 2016; 17 Suppl 1:S318-28. [PMID: 26776589 DOI: 10.1016/j.jvc.2015.09.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 09/17/2015] [Accepted: 09/27/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To evaluate risk factors associated with different types of cardiac death in cats with hypertrophic cardiomyopathy (HCM). ANIMALS Two hundred fifty-five cats with HCM referred to a veterinary teaching hospital. METHODS This is a retrospective study. Cats with HCM were identified that had either died within 2 years of diagnosis or were known to be alive 2 years after initial examination. Signalment, physical exam, electrocardiographic and echocardiographic data were analyzed separately for association with death due to congestive heart failure (CHF) vs. aortic thromboembolism (ATE) vs. sudden death. RESULTS Within 2 years of follow-up, 23/255 (9.0%) cats had died with ATE, 44/255 (17.3%) cats had died with CHF and 12/255 (4.7%) cats had experienced a sudden death, with 141/255 (55.3%) cats still alive at the end of 2 years. Presence of CHF at presentation and reduced left ventricular fractional shortening (FS%) were independently associated with a CHF death within 2 years of diagnosis. Presence of ATE and reduced left atrial fractional shortening (LA-FS%) were independently associated with dying with ATE within 2 years. No multivariable models were generated for risks of dying a sudden death owing to the low event rate, but syncope at presentation and arrhythmias on auscultation were associated with sudden death on univariable analysis. CONCLUSIONS Asymptomatic cats have a reduced risk of all three types of death. Reduced FS% and a history of CHF independently predict CHF death, and reduced LA-FS% and history of ATE independently predict ATE death. Sudden death is less commonly reported but is associated with syncope.
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Affiliation(s)
- J R Payne
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - K Borgeat
- Highcroft Veterinary Referrals, 615 Wells Road, Whitchurch, Bristol, BS14 9BE, United Kingdom
| | - D C Brodbelt
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - D J Connolly
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
| | - V Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom.
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Borgeat K, Connolly DJ, Luis Fuentes V. Cardiac biomarkers in cats. J Vet Cardiol 2016; 17 Suppl 1:S74-86. [PMID: 26776596 DOI: 10.1016/j.jvc.2015.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 07/16/2015] [Accepted: 08/06/2015] [Indexed: 12/15/2022]
Abstract
Cardiac biomarkers have been used in cats as part of the clinical assessment of heart disease for over a decade. They are widely available to practitioners through commercial reference laboratories. The evidence base for the use of cardiac biomarkers (primarily N-terminal pro-B type natriuretic peptide and cardiac troponin I) in cats is comprehensively reviewed in this article, focusing on each of six specific areas: distinguishing cardiac from non-cardiac causes of respiratory distress; measurement of cardiac biomarkers in urine and pleural fluid; identification of occult cardiomyopathy; effects of systemic disease on circulating concentrations of cardiac biomarkers; point-of-care biomarker testing, and the possible prognostic utility of cardiac biomarker measurement.
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Affiliation(s)
- K Borgeat
- Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom; Highcroft Veterinary Referrals, Bristol, United Kingdom.
| | - D J Connolly
- Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - V Luis Fuentes
- Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
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35
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Langhorn R, Willesen JL, Tarnow I, Kjelgaard-Hansen M, Koch J. Cardiac troponin I in three cat breeds with hypertrophic cardiomyopathy. Vet Rec 2016; 178:532. [PMID: 27076529 DOI: 10.1136/vr.103549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/03/2022]
Affiliation(s)
- R Langhorn
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C DK-1870, Denmark
| | - J L Willesen
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C DK-1870, Denmark
| | - I Tarnow
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C DK-1870, Denmark
| | - M Kjelgaard-Hansen
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C DK-1870, Denmark
| | - J Koch
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Dyrlaegevej 16, Frederiksberg C DK-1870, Denmark
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36
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Dickson D, Caivano D, Patteson M, Rishniw M. The times they are a-changin': Two-dimensional aortic valve measurements differ throughout diastole. J Vet Cardiol 2016; 18:15-25. [PMID: 26810488 DOI: 10.1016/j.jvc.2015.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 11/03/2015] [Accepted: 11/10/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Diastolic aortic valve measurements are used to obtain weight-independent cardiac ratiometric indices. However, whether clinically important variations in valve measurements occur during diastole remains undetermined. ANIMALS One hundred sixty-three dogs and 40 cats; a mixture of healthy animals and patients with heart disease. MATERIALS AND METHODS Aortic valve diameter and area were measured at three time-points: early diastole {AoMAX}, during the P-wave {AoP} and at end-diastole {AoMIN}. Measurement beat-to-beat variability was determined. Difference plots were generated for each measurement pair. Aortic measurements were compared by repeated measures analysis of variance. RESULTS In dogs, normalised aortic diameters showed a fixed bias of approximately 14% for AoMAX-AoMIN, 6% for AoMAX-AoP and 8% for AoP-AoMIN. In cats, the aortic diameter and area biases were all less than 2.5% and less than 7% respectively. AoMAX was the largest measurement in 78% patients and AoMIN was the smallest measurement in 73% patients. In dogs, AoMAX > AoP > AoMIN (p < 0.0001). Median within-patient measurement variability was 5% for linear dimensions and 8% for area measurements in dogs and 4.5% for linear and 10.4% for area in cats. DISCUSSION Aortic measurements in dogs differ significantly throughout diastole, with Ao(A)MAX > Ao(A)P > Ao(A)MIN. These differences could clinically impact cardiac ratiometric indices. The difference in cats is less than the within-patient measurement variability and unlikely to be of clinical significance. CONCLUSIONS Operators should adopt a single diastolic time-point for measurement of the aorta to ensure consistency in measuring and reporting in echocardiography.
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Affiliation(s)
- D Dickson
- HeartVets, The Animal Hospital, Dursley, Gloucestershire, GL11 6AJ, UK.
| | - D Caivano
- Department of Clinical Sciences, School of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - M Patteson
- HeartVets, The Animal Hospital, Dursley, Gloucestershire, GL11 6AJ, UK
| | - M Rishniw
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA
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37
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Luis Fuentes V. Heart disease: time to take cats seriously. J Vet Cardiol 2016; 17 Suppl 1:S2-5. [PMID: 26776578 DOI: 10.1016/j.jvc.2015.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/24/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
Affiliation(s)
- V Luis Fuentes
- The Royal Veterinary College, Department of Clinical Science and Services, North Mymms, Hatfield, AL9 7TA, United Kingdom.
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38
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Langhorn R, Willesen JL. Cardiac Troponins in Dogs and Cats. J Vet Intern Med 2015; 30:36-50. [PMID: 26681537 PMCID: PMC4913658 DOI: 10.1111/jvim.13801] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 09/04/2015] [Accepted: 11/03/2015] [Indexed: 11/26/2022] Open
Abstract
Cardiac troponins are sensitive and specific markers of myocardial injury. The troponin concentration can be thought of as a quantitative measure of the degree of injury sustained by the heart, however, it provides no information on the cause of injury or the mechanism of troponin release. Conventionally, the cardiac troponins have been used for diagnosis of acute myocardial infarction in humans and have become the gold standard biomarkers for this indication. They have become increasingly recognized as an objective measure of cardiomyocyte status in both cardiac and noncardiac disease, supplying additional information to that provided by echocardiography and ECG. Injury to cardiomyocytes can occur through a variety of mechanisms with subsequent release of troponins. Independent of the underlying disease or the mechanism of troponin release, the presence of myocardial injury is associated with an increased risk of death. As increasingly sensitive assays are introduced, the frequent occurrence of myocardial injury is becoming apparent, and our understanding of its causes and importance is constantly evolving. Presently troponins are valuable for detecting a subgroup of patients with higher risk of death. Future research is needed to clarify whether troponins can serve as monitoring tools guiding treatment, whether administering more aggressive treatment to patients with evidence of myocardial injury is beneficial, and whether normalizing of troponin concentrations in patients presenting with evidence of myocardial injury is associated with reduced risk of death.
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Affiliation(s)
- R Langhorn
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - J L Willesen
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark
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Ferasin L, DeFrancesco T. Management of acute heart failure in cats. J Vet Cardiol 2015; 17 Suppl 1:S173-89. [DOI: 10.1016/j.jvc.2015.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 09/13/2015] [Accepted: 09/17/2015] [Indexed: 10/22/2022]
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40
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Evaluation of red blood cell distribution width in cats with hypertrophic cardiomyopathy. J Vet Cardiol 2015; 17 Suppl 1:S233-43. [DOI: 10.1016/j.jvc.2015.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 06/24/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
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