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Brown K, Williams Louie E, Pinn-Woodcock T, Pearson E, Pearson GB, Marr J, Hackett ES, Rath Brown L, Mitchell KJ. Cardiac Disease Related to Primary Hyperthyroidism in a 20-Year-Old Mule. Animals (Basel) 2024; 14:1660. [PMID: 38891707 PMCID: PMC11171152 DOI: 10.3390/ani14111660] [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: 04/02/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Primary hyperthyroidism is a rarely diagnosed endocrinopathy in equids and there have been no previous reports of structural and functional cardiac changes associated with hyperthyroidism in these species. This case report investigates a 20-year-old mule gelding that presented for a three-month history of thin body condition despite polyphagia, with a heart murmur and elevated free and total thyroid hormone concentrations. On presentation, physical exam revealed a body condition score of two out of nine, persistent tachycardia, pansystolic heart murmur and firm bilateral ventral proximal cervical masses. Bloodwork confirmed markedly elevated free T4, total T4 and T3 concentrations. Echocardiogram demonstrated left ventricular concentric hypertrophy with increased ventricular and atrial systolic function. Bilateral thyroidectomy was performed under standing sedation without complications. Histopathology demonstrated adenocarcinoma of the left thyroid gland and multiple adenomas with osseous metaplasia within the right thyroid. The mule was supplemented with levothyroxine sodium two weeks post-op after a thyroid panel demonstrated undetectable concentrations. Polyphagia resolved following surgery and the mule began gaining weight. Echocardiographic changes improved but did not resolve at two years post-operative. Continued bi-annual follow up and monitoring of thyroid levels was recommended. This case represents the first documentation of hemodynamically relevant cardiac remodeling in an equid associated with primary hyperthyroidism.
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Affiliation(s)
- Kaitlin Brown
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
| | - Elizabeth Williams Louie
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
| | - Toby Pinn-Woodcock
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
| | - Erin Pearson
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
| | - Garett B. Pearson
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
| | - Jacqueline Marr
- New Hampshire Veterinary Diagnostic Laboratory, University of New Hampshire, Durham, NH 03824, USA;
| | - Eileen S. Hackett
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
| | | | - Katharyn J. Mitchell
- Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA; (K.B.); (E.W.L.); (T.P.-W.); (E.P.); (G.B.P.); (E.S.H.)
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Piotrowski IL, Junge HK, Schwarzwald CC. Evaluation of the Audicor Acoustic Cardiography Device as a Diagnostic Tool in Horses with Mitral or Aortic Valve Insufficiency. Animals (Basel) 2024; 14:331. [PMID: 38275790 PMCID: PMC10812805 DOI: 10.3390/ani14020331] [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: 12/10/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Mitral and aortic valve insufficiencies have been commonly reported in horses. The objective of this study was to establish the use of acoustic cardiography (Audicor®) in horses with aortic (AI) or mitral valve insufficiency (MI). A total of 17 healthy horses, 18 horses with AI, and 28 horses with MI were prospectively included. None of the horses was in heart failure. Echocardiography and Audicor® analyses were conducted. Electromechanical activating time (EMAT), rate-corrected EMATc, left ventricular systolic time (LVST), rate-corrected LVSTc, and intensity and persistence of the third and fourth heart sound (S3, S4) were reported by Audicor®. Graphical analysis of the three-dimensional (3D) phonocardiogram served to visually detect murmurs. Audicor® snapshot variables were compared between groups using one-way ANOVA followed by Tukey's multiple-comparisons test. The association between Audicor® snapshot variables and the corresponding echocardiographic variables was investigated by linear regression and Bland-Altman analyses. Heart murmurs were not displayed on Audicor® phonocardiograms. No significant differences were found between Audicor® variables obtained in clinically healthy horses and horses with valvular insufficiency. The Audicor® device is unable to detect heart murmurs in horses. Audicor® variables representing cardiac function are not markedly altered, and their association with corresponding echocardiographic variables is poor in horses with valvular insufficiency that are not in heart failure.
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Affiliation(s)
- Isabelle L. Piotrowski
- Clinic for Equine Internal Medicine, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (H.K.J.); (C.C.S.)
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Dufourni A, Buschmann E, Vernemmen I, Van Steenkiste G, van Loon G, Decloedt A. Effect of physiological and pharmacological stress on heart rate, blood pressure, and echocardiographic measurements in healthy Warmblood horses. J Vet Intern Med 2024; 38:398-410. [PMID: 38174810 PMCID: PMC10800213 DOI: 10.1111/jvim.16967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Echocardiographic measurements are important prognostic indicators but might be influenced by heart rate and blood pressure. This is particularly important when comparing repeated examinations. HYPOTHESIS To determine the effect of physiological stress at mildly increased heart rates and pharmacological challenge using IV administration of N-butylscopolammonium bromide and metamizol sodium on heart rate, blood pressure, and echocardiographic measurements. ANIMALS Twenty healthy Warmblood horses. METHODS Randomized crossover study. Horses were examined echocardiographically by 2-dimensional, M-mode, pulsed wave (PW) Doppler, and PW tissue Doppler imaging with simultaneous ECG recording and noninvasive blood pressure measurements during rest, physiological stress, and pharmacological challenge. Cardiac dimensions and functions were measured by a blinded observer. Data were analyzed using repeated-measures analysis of variance. RESULTS Mean heart rate and arterial blood pressure were significantly higher during physiological stress (46 ± 2 bpm, 93 ± 16 mm Hg) and pharmacological challenge (62 ± 13 bpm, 107 ± 17 mm Hg) compared with rest (34 ± 3 bpm, 86 ± 12 mm Hg; P < .05). Compared with rest, physiological stress resulted in increased left atrial fractional area change (34.3 ± 7.5 vs 27.3 ± 5.1%; P = .01) and left ventricular late diastolic radial wall motion velocity (13 ± 3 vs 10 ± 2 cm/s; P = .01) but had no significant effect on most other echocardiographic variables. Compared with rest, pharmacological challenge led to significantly decreased left atrial and diastolic ventricular dimensions (left ventricular internal diameter: 10.3 ± 0.9 vs 10.7 ± 0.8 cm; P = .01), increased aortic and pulmonary diameters, and ventricular wall thickness. CONCLUSIONS AND CLINICAL IMPORTANCE Physiological stress at mildly increased heart rates significantly enhanced atrial pump function. Larger heart rate and blood pressure increases during pharmacological challenge resulted in altered cardiac dimensions. This should be taken into account when evaluating echocardiographic measurements at increased heart rates.
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Affiliation(s)
- Alexander Dufourni
- Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Eva Buschmann
- Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Ingrid Vernemmen
- Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Glenn Van Steenkiste
- Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Gunther van Loon
- Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Annelies Decloedt
- Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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Ferraro A, Hartnack S, Schwarzwald CC. Diagnostic value of two-dimensional echocardiographic measurements of the pulmonary artery diameter and the pulmonary artery distensibility index to detect pulmonary hypertension in horses. J Vet Cardiol 2023; 49:52-66. [PMID: 37832424 DOI: 10.1016/j.jvc.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION/OBJECTIVES Echocardiographic diagnosis of pulmonary hypertension (PH) in horses is usually based on Doppler interrogation of tricuspid (TR) or pulmonic regurgitation (PR). This study aimed at investigating two-dimensional echocardiographic (2DE) variables, including pulmonary artery diameter (PAD) and pulmonary artery distensibility index (PADI), to diagnose PH. ANIMALS, MATERIALS AND METHODS 41 healthy horses; 82 horses with TR or PR and normal intracardiac pressure gradients; and 35 horses with TR or PR velocities indicating PH. The 2DE variables were compared between groups, cut-offs for the diagnosis of PH were determined, and conditional inference trees served to identify the variable best predicting PH in the absence of TR or PR. RESULTS Horses with PH had larger end-diastolic cross-sectional (short-axis) PAD (PADed-sx) (5.8 ± 1.0 cm; mean ± SD) and smaller PADI[/PADps] (15.4 ± 7.7%) than healthy horses (5.0 ± 0.6 cm, P<0.0001; 20.5 ± 4.4%, P<0.001) and horses with TR or PR but no PH (5.3 ± 0.6 cm, P=0.003; 18.8 ± 4.2%, P=0.005). PADed-sx predicted PH with sensitivity (Se) = 36% and specificity (Sp) = 94% (cut-off 6.0 cm, AUC = 0.668, P=0.002), while PADI[/PADps] predicted PH with Se = 43% and Sp = 92% (cut-off 13.7%, AUC = 0.662, P=0.004). In the absence of TR, PADed-sx and the end-diastolic long-axis aortic diameter-to-PADed-sx ratio (AoDed-lx/PADed-sx) were most suitable to diagnose PH. CONCLUSION Pulmonary artery crosssectional (short-axis) diameter at end-diastole measured in a right-parasternal long axis view of the left ventricular outflow tract and Pulmonary artery distensibility index were moderately specific but not very sensitive to diagnosing PH. Nonetheless, they may be used as complementary indices suggesting PH in the absence of TR or PR.
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Affiliation(s)
- A Ferraro
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - S Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - C C Schwarzwald
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.
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Carstensen H, Nissen SD, Saljic A, Hesselkilde EM, van Hunnik A, Hohl M, Sattler SM, Fløgstad C, Hopster-Iversen C, Verheule S, Böhm M, Schotten U, Jespersen T, Buhl R. Long-Term Training Increases Atrial Fibrillation Sustainability in Standardbred Racehorses. J Cardiovasc Transl Res 2023; 16:1205-1219. [PMID: 37014465 PMCID: PMC10615936 DOI: 10.1007/s12265-023-10378-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/14/2023] [Indexed: 04/05/2023]
Abstract
Atrial fibrillation (AF) is more prevalent in athletes, and currently, the mechanisms are not fully understood. Atrial fibrillation inducibility and stability was investigated in trained and untrained Standardbred racehorses. The horses underwent echocardiography for evaluation of atrial size. High-density mapping during AF was performed, and the presence of structural remodeling, as well as the expression of inflammatory and pro-inflammatory markers in the atria, was studied. Atrial fibrillation sustained significantly longer after tachypacing in the trained horses, whereas no difference in AF inducibility was found. The untrained horses displayed a significant difference in the AF complexity when comparing right and left atria, whereas such difference was not observed in the trained animals. No evidence of increased structural remodeling or inflammation could be identified. Left atrial dimensions were not significantly increased. The increased AF sustainability in trained horses was not related to fibrosis or inflammation as seen in other animal exercise models.
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Affiliation(s)
- Helena Carstensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630, Taastrup, Denmark
| | - Sarah Dalgas Nissen
- Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
| | - Arnela Saljic
- Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Eva Melis Hesselkilde
- Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Arne van Hunnik
- Department of Physiology, Maastricht University, Maastricht, Netherlands
| | - Mathias Hohl
- Department of Internal Medicine III, University Hospital, Saarland University, Homburg, Saar, Germany
| | - Stefan Michael Sattler
- Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Cecilie Fløgstad
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630, Taastrup, Denmark
| | - Charlotte Hopster-Iversen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630, Taastrup, Denmark
| | - Sander Verheule
- Department of Physiology, Maastricht University, Maastricht, Netherlands
| | - Michael Böhm
- Department of Internal Medicine III, University Hospital, Saarland University, Homburg, Saar, Germany
| | - Ulrich Schotten
- Department of Physiology, Maastricht University, Maastricht, Netherlands
| | - Thomas Jespersen
- Laboratory of Cardiac Physiology, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Rikke Buhl
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630, Taastrup, Denmark
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Kis J, Rózsa L, Husvéth F, Mezőszentgyörgyi D, Kovács S, Bakos Z, Zsolnai A, Anton I. Association of myostatin gene polymorphism with echocardiographic and muscular ultrasonographic measurements in Hungarian thoroughbreds horses. Res Vet Sci 2023; 160:45-49. [PMID: 37267767 DOI: 10.1016/j.rvsc.2023.05.009] [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: 04/26/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023]
Abstract
The g.66493737C/T polymorphism of the myostatin gene (MSTN) majorly influences muscle fiber composition and best race distance of Thoroughbreds. Thus, a better understanding of this process may lead to superior genetic exploitation for maximizing Thoroughbred athletic potential. Our objective is to investigate whether myostatin genotypes are associated with muscular development and cardiac variables of Thoroughbreds. Echocardiography and muscular ultrasonography were performed on three groups having C/C, C/T, and T/T genotypes, respectively. Each group consisted of 22 animals. Homogeneity of variance between the groups was checked by Levene's test. Multivariate analysis of variance was applied to determine differences in measured variables vs. MSTN genotypes. Fascicle length of anconeus and thickness of triceps brachii muscles showed significant differences between C/C and T/T genotypes (pFascicle-length-of-anconeus = 0.004, pthickness-of-triceps-brachii < 0.001). According to the primary outcome, there are associations between myostatin genotypes and cardiac variables. Aortic diameter at the sinus of Valsalva (end-diastole and end-systole) and aortic diameter at the valve (end-systole) indicated significant differences between C/C and T/T genotypes (paortic-diameter-at-the-sinus-of-Valsalva-end-diastole = 0.015, paortic-diameter-at-the-sinus-of-Valsalva-end-systole = 0.011, paortic-diameter-at-the-valve-end-systole = 0.014). Pearson correlation effect sizes were rFascicle-length-of-anconeus = 0.460, rthickness-of-triceps-brachii = 0.590, raortic-diameter-at-the-sinus-of-Valsalva-end-diastole = 0.423, raortic-diameter-at-the-sinus-of-Valsalva-end-systole = 0.450, and raortic-diameter-at-the-valve-end-systole = 0.462. C/C genotypes gave 22.1, 12.2, 6.3, 6.0, and 6.7% higher values compared to T/T genotypes, respectively. Differences regarding aortic diameter between genotype groups support the hypothesis that C/C animals have consequently increased cardiac output and aerobic capacity.
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Affiliation(s)
- Judit Kis
- Hungarian University of Agriculture and Life Sciences, Herceghalom, Hungary
| | - László Rózsa
- Hungarian University of Agriculture and Life Sciences, Keszthely, Hungary
| | - Ferenc Husvéth
- Hungarian University of Agriculture and Life Sciences, Keszthely, Hungary
| | | | - Szilvia Kovács
- University of Veterinary Medicine Budapest, Üllő, Hungary
| | - Zoltán Bakos
- University of Veterinary Medicine Budapest, Üllő, Hungary
| | - Attila Zsolnai
- Hungarian University of Agriculture and Life Sciences, Herceghalom, Hungary.
| | - István Anton
- Hungarian University of Agriculture and Life Sciences, Herceghalom, Hungary
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Khalesi H, Sakha M, Veshkini A, Rezakhani A. Assessing the cardiac valves conditions in athletic horses with poor performance. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2022; 13:423-429. [PMID: 36320295 PMCID: PMC9548239 DOI: 10.30466/vrf.2021.130366.2997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 05/08/2021] [Indexed: 11/21/2022]
Abstract
Heart murmurs and valvular regurgitation are common in horses and often have no effect on their performance. However, when structural changes occur in the heart size, they can affect performance adversely. This study aimed to examine the correlation between cardiac valves disease and poor performance in athletic horses. A total of 300 athletic Thoroughbred and mix-breed horses including 164 mares and 136 stallions, with a history of poor performance, were selected. Horses with cardiac murmurs were identified and further cardiac examination including precise auscultation, base-apex electrocardiogram for possible dysrhythmias at rest and after exercise, echocardiographic and hematological tests were conducted in two stages. The first was at admission time and the second examination was done four to six months later to evaluate the outcome of the possible disorders. Respiratory system and musculoskeletal diseases were diagnosed respectively in 93 and 149 out of 300 examined horses and 36 horses showed heart murmur without any other complications. Echocardiography was performed in horses with heart murmur and 25 of them showed regurgitation of the cardiac valve. During the first examination, 7 horses were diagnosed with regurgitation and changes in the size of cardiac chambers, whereas this number increased to 25 during the second examination. There was no significant relationship between degree of murmur and severity of regurgitant jet in horses. The valvular regurgitation can affect the performance when causing changes in the size of the cardiac chambers which can consequently jeopardize the athletic future of the horse.
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Affiliation(s)
- Hossein Khalesi
- Department of Clinical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mehdi Sakha
- Department of Clinical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran; ,Correspondence Mehdi Sakha. DVM, DVSc Department of Clinical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.
E-mail:
| | - Abbas Veshkini
- Department of Clinical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ali Rezakhani
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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8
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Cardiovascular changes in horses with atrial fibrillation and high thyroid hormone concentration: a case-control study. J Vet Cardiol 2022; 43:93-100. [DOI: 10.1016/j.jvc.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022]
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Deacon LJ, Navas de Solis C, Richardson DW, Polkes A, Reef VB. Closure of an Aortocardiac Fistula in a Horse. CASE 2022; 6:43-48. [PMID: 35243200 PMCID: PMC8883141 DOI: 10.1016/j.case.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An ACF developed in a hospitalized horse following orthopedic surgery. Spontaneous closure of the ACF occurred 6 weeks after initial diagnosis. Echocardiography is the primary imaging modality to confirm the presence of ACF in equids.
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Eberhardt C, Schwarzwald CC. Quantification of left atrial contractile function using two-dimensional speckle tracking echocardiography in horses after conversion of atrial fibrillation to sinus rhythm. J Vet Cardiol 2021; 35:108-120. [PMID: 33940552 DOI: 10.1016/j.jvc.2021.03.004] [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: 07/07/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION/OBJECTIVES In horses, persistent atrial dysfunction is a prognostic indicator of recurrence of atrial fibrillation (AF). The objective of this study was to quantify left atrial (LA) contractile function in Warmblood horses after successful cardioversion of AF to sinus rhythm, using standard two-dimensional echocardiography (2DE) and two-dimensional speckle tracking (2DST) analyses, and to provide proof-of-concept for use of 2DST to detect LA contractile dysfunction in horses. ANIMALS, MATERIALS, AND METHODS Nineteen Warmblood horses with AF and successful transvenous electrical cardioversion (TVEC) or medical cardioversion using quinidine sulfate (QS) were included. Echocardiography was performed at 24 hr, 72 hr, and 1-6 months after cardioversion. Conventional 2DE-derived indices of LA size and function and global longitudinal strain (SL) and longitudinal strain rate (SRL) during LA contractile function were measured to detect differences in LA size and function over time and between treatment modalities. The association between 2DE-derived indices and global SL and SRL, respectively, and the agreement of the variables to detect LA dysfunction were assessed. RESULTS Global SL and SRL, as well as active LA fractional area change (FAC) identified cases with LA dysfunction after TVEC and QS cardioversion and proved useful to demonstrate LA functional recovery over time. Agreement between active LA FAC and SL and SRL, respectively, to diagnose atrial dysfunction was substantial to fair at 24 hr after cardioversion and decreased with time. CONCLUSION This study shows that 2DST is useful to quantify LA contractile dysfunction in horses after cardioversion of AF.
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Affiliation(s)
- C Eberhardt
- University of Zurich, Vetsuisse Faculty, Equine Department, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
| | - C C Schwarzwald
- University of Zurich, Vetsuisse Faculty, Equine Department, Winterthurerstrasse 260, 8057, Zurich, Switzerland
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11
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Worsman FCF, Miller ZJ, Shaw DJ, Blissitt KJ, Keen JA. Real-time three-dimensional echocardiography for left atrial volume assessment in Thoroughbred racehorses: Observer variability and comparison with two-dimensional echocardiography. Equine Vet J 2020; 54:176-190. [PMID: 33345356 DOI: 10.1111/evj.13408] [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: 06/23/2020] [Revised: 10/13/2020] [Accepted: 12/03/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Left atrial size predicts cardiac morbidity and mortality in humans and dogs. Real-time three-dimensional echocardiography (3DE) may be reliable for assessing left atrial volume (LAV) in horses. OBJECTIVES To determine intra- and interobserver variability estimates of 3DE-LAV and compare it to that of 2DE-LAV estimates. STUDY DESIGN Method comparison. METHODS 3DE datasets were obtained from 40 horses, then graded for quality, creating a final study population of 22 horses. The 3DE and 2DE maximum LAV (LAVmax ) and minimum LAV (LAVmin ) were measured, and left atrial emptying volume (LA EV) and left atrial ejection fraction (LA EF) were calculated, from the same 3D dataset on four occasions using (a) a semi-automatic surface recognition algorithm and (b) a modified Simpson's method of discs. 3DE LAV measurements were repeated by a second observer. RESULTS For 3DE, median LAVmax was 596cm3 for observer one, and 852 cm3 for observer two, LAVmin was 373 cm3 for observer one and 533 cm3 for observer two. Low intraobserver measurement variation was observed for LAVmax and LAVmin , with horse-level intraclass correlation coefficients (ICChorse ) for both observers between 76% and 85% (horse added as random effect). The interobserver ICC was 58% for LAVmax and 50% for LAVmin on averaged measurements (with observer added as random effect), indicating consistent differences between observers. While intraobserver variation was similar for 2DE LAVmax measurements, it was greater for LAVmin (ICChorse = 67%). The intermethod ICC for 3DE vs 2DE was low at 14% for LAVmax and ~0% for LAVmin , indicating less-consistent differences with method. MAIN LIMITATIONS Small study population, low observer number, use of different imaging modalities (fundamental frequency and octave harmonics). CONCLUSIONS 3DE assessment of LAV was reliable, suggesting suitability for longitudinal evaluation of clinical cases. Clinicians should be aware of differences in LAV measurements between observers. More defined measurement guidelines may improve repeatability.
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Affiliation(s)
- Francesca C F Worsman
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK
| | - Zack J Miller
- Companion Care Vets Gloucester, Gloucester, Gloucestershire, UK
| | - Darren J Shaw
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK
| | - Karen J Blissitt
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK
| | - John A Keen
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK
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12
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Berthoud D, Schwarzwald CC. Echocardiographic assessment of left ventricular size and systolic function in Warmblood horses using linear measurements, area-based indices, and volume estimates: A retrospective database analysis. J Vet Intern Med 2020; 35:504-520. [PMID: 33247461 PMCID: PMC7848374 DOI: 10.1111/jvim.15968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/20/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background Echocardiographic assessment of left ventricular (LV) size and function using area‐based indices and volumetric estimates is not well established in horses. Objective To report reference intervals and measurement variability for uni‐, 2‐, and 3‐dimensional echocardiographic indices of LV size and systolic function in Warmblood horses and to provide proof of concept for allometric scaling of variables to body weight. Unidimensional indices were to be compared to area‐based indices and LV volume estimates to establish their clinical use. Animals Thirty healthy Warmblood horses and 70 Warmblood horses with a primary diagnosis of mitral regurgitation or aortic regurgitation. Methods Echocardiographic indices of LV size and systolic function were measured using an existing echocardiography database. Weight‐related variables were scaled to body weight (BWT). Reference intervals and measurement variability were calculated, the influence of valvular regurgitation on LV size and function was investigated and agreement between different variables for detection of reduced, normal, and increased LV size and systolic function was assessed. Results Reference values for healthy Warmblood horses were reported. Measurement variability was sufficiently low for clinical use of all variables. Allometric scaling was effective to correct diastolic LV dimensions and cardiac output for differences in BWT. Various echocardiographic indices resulted in different conclusions regarding identification of LV enlargement and systolic dysfunction in healthy horses and horses with valvular regurgitation. Conclusions and Clinical Importance Echocardiographic assessment of LV size and systolic function should include joint assessment of multiple uni‐ and multidimensional indices. Area‐based or volumetric indices that reflect LV long‐axis motion should be included.
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Affiliation(s)
- Djamila Berthoud
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Colin C Schwarzwald
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Vernemmen I, Vera L, Van Steenkiste G, van Loon G, Decloedt A. Reference values for 2-dimensional and M-mode echocardiography in Friesian and Warmblood horses. J Vet Intern Med 2020; 34:2701-2709. [PMID: 33098342 PMCID: PMC7694853 DOI: 10.1111/jvim.15938] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Echocardiographic reference intervals for Friesian horses are poorly described. OBJECTIVES To obtain reference intervals for echocardiographic measurements in Friesians and compare these with Warmbloods. ANIMALS One hundred healthy adult Friesians and 100 healthy adult Warmblood horses. METHODS Cross-sectional study. Two-dimensional and M-mode echocardiographic images were obtained. Echocardiographic measurements, including size, area, and volumetric measurements of left atrium, left and right ventricle, aorta, and pulmonary artery, were performed. Measurements were compared between the 2 breeds using an independent samples t test with Bonferroni correction for multiple comparisons. RESULTS Reference ranges for standard echocardiographic measurements in Friesians were obtained. Several left ventricular measurements were significantly smaller in Friesians compared to Warmbloods, such as the left ventricular end-diastolic volume using the 4-chamber modified Simpsons' method (99.85% confidence interval for the difference [CI] = -245 to -63). Also the right ventricular end-diastolic and peak-systolic internal diameter were smaller in Friesians (99.85% CI = -1.33 to -0.6 and 99.85% CI = -1.54 to -0.76, respectively). Fractional shortening (99.85% CI = 0.61-6) and ejection fraction (99.85% CI = 0.21-4.6) were significantly larger. No structural effects of systemic hypertension, such as concentric hypertrophy, were detected. CONCLUSIONS AND CLINICAL IMPORTANCE Our study provides reference intervals for echocardiographic measurements in Friesians useful in a clinical setting. In general, the left ventricular dimensions in Friesians were significantly smaller compared to Warmbloods, emphasizing the need for breed-specific reference intervals.
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Affiliation(s)
- Ingrid Vernemmen
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lisse Vera
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Glenn Van Steenkiste
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Gunther van Loon
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Annelies Decloedt
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Two-dimensional, M-mode and left atrial velocity echocardiographic measurements in healthy Norwegian-Swedish Coldblooded Trotters. J Vet Cardiol 2020; 29:60-73. [PMID: 32505882 DOI: 10.1016/j.jvc.2020.04.006] [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: 06/22/2019] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The Norwegian-Swedish Coldblooded Trotter (NSCT) is an important breed in Norwegian and Swedish harness racing. In spite of this, little is known about its cardiac measurements and factors that may influence these. The aims of this study were to establish reference intervals (RI) for a series of conventional echocardiographic variables, primarily of the left heart, in NSCTs in race training and to evaluate any effects age, gender, estimated body weight (EBW), number of starts and racing performance may have on these. ANIMALS Sixty-three apparently healthy NSCTs in race training. METHODS Observational study, convenience sampling. All horses were examined unsedated in their normal stabling environment. Auscultatory and echocardiographic examinations were performed. Means, standard deviations, medians and confidence intervals of the RI limits were used to summarize the data. The relationship between selected echocardiographic variables and age, gender, EBW, racing performance and number of starts were explored using linear regression analyses. RESULTS Reference intervals were determined for routinely used echocardiographic variables. Data for left atrial velocity were also obtained. Increasing age, number of starts and money earned significantly increased all cardiac measurements. Males had significantly higher ventricular measurements than females. Great vessel measurements increased with increasing EBW. Horses with faster recorded racing times had generally significantly increased cardiac measurements. Clinically insignificant valvular regurgitation was a common finding, particularly at the tricuspid and pulmonary valves. CONCLUSIONS The RIs described and the factors that may affect these will assist clinicians in interpreting echocardiograms of NSCTs with suspected cardiac disease or poor performance.
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Quantification of left atrial wall motion in healthy horses using two-dimensional speckle tracking. J Vet Cardiol 2020; 30:32-43. [PMID: 32645687 DOI: 10.1016/j.jvc.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The mechanical function of the left atrium (LA) plays a pivotal role in modulation of left ventricular filling. Assessment of LA function might be a clinically useful prognostic tool for horses with mitral regurgitation or atrial fibrillation. However, the most accurate, reliable, and clinically useful methods to assess LA myocardial function are yet to be determined. The objective of this study was to describe the methods for quantification of LA wall motion using two-dimensional speckle tracking (2DST) echocardiography in healthy Warmblood horses to quantify measurement variability, to calculate reference intervals for 2DST variables, and to investigate their relationship to sex, age, body weight, and heart rate. ANIMALS, MATERIALS, AND METHODS Twenty-six healthy Warmblood horses were included. 2DST analyses of LA wall motion were performed on digitally stored cine-loop recordings of a standardized right-parasternal four-chamber view focusing on the LA. Longitudinal strain, longitudinal strain rate, and time to peak LA contraction were measured to characterize LA contractile, reservoir, and conduit function. Intraobserver and interobserver measurement variability was quantified, and reference intervals were calculated. RESULTS The coefficient of variation for intraobserver and interobserver measurement variability ranged between 2.0-11.1% and 5.1-15.4%, respectively, for global strain, strain rate, and time to peak LA contraction. Reference intervals for healthy Warmblood horses were reported. CONCLUSION This study shows that 2DST is a feasible and reliable method to quantify LA wall motion throughout the cardiac cycle in healthy Warmblood horses. Further studies are required to establish the clinical value of 2DST for assessment of LA function.
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Scansen BA, Drees R. Joint virtual issue on recent advances in veterinary cardiac imaging. J Vet Intern Med 2020; 34:546-548. [PMID: 31943370 PMCID: PMC7096632 DOI: 10.1111/jvim.15669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Randi Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, United Kingdom
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Scansen BA, Drees R. Joint virtual issue on recent advances in veterinary cardiac imaging. Vet Radiol Ultrasound 2020; 61:127-129. [PMID: 31943510 DOI: 10.1111/vru.12841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Randi Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, UK
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Marchesotti F, Vezzosi T, Tognetti R, Marchetti F, Patata V, Contiero B, Zini E, Domenech O. Left atrial anteroposterior diameter in dogs: reference interval, allometric scaling, and agreement with the left atrial-to-aortic root ratio. J Vet Med Sci 2019; 81:1655-1662. [PMID: 31611490 PMCID: PMC6895628 DOI: 10.1292/jvms.19-0240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Left atrial enlargement (LAE) is a well-known negative prognostic factor in dogs with myxomatous mitral valve disease (MMVD). Left atrial-to-aortic root ratio (LA/Ao) is the most commonly
used method to evaluate left atrial (LA) size in dogs, while the left atrial anteroposterior diameter (LAD) has been proposed as an additional measurement of LA size in different species.
The aim of this study was to establish a normal reference range of LAD normalized to body weight (LADn) in dogs using allometric scales, and to evaluate the agreement between LADn and LA/Ao
in the detection of LAE in dogs with MMVD. This was a retrospective, multicenter, observational study. We included 330 healthy dogs, 30 dogs with MMVD in ACVIM stage B1, 30 dogs in ACVIM
stage B2, and 30 dogs in ACVIM stage C. The reference range for the LAD, depending on body weight, was between 16.91 mm and 49.68 mm. The reference range for the LADn in healthy dogs was
between 10.49 and 15.72. LADn was significantly greater in dogs with MMVD compared to healthy dogs, and a significant difference in LADn was noted between different ACVIM stages
(P<0.001). The most accurate cut-off value of LADn to differentiate between dogs in groups B2 and C was 20.3 (sensitivity, 83.3%; specificity, 83.3%). There was a
misclassification rate of 37% between LADn and LA/Ao in the detection of LAE in group B1. This study provides a normal reference range for LAD in dogs, which can be used as an additional
tool to assess LAE in dogs with MMVD.
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Affiliation(s)
- Federica Marchesotti
- Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - Tommaso Vezzosi
- Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy.,Department of Veterinary Sciences, University of Pisa, Via Livornese, 56122 San Piero a Grado, Pisa, Italy
| | - Rosalba Tognetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese, 56122 San Piero a Grado, Pisa, Italy
| | - Francesca Marchetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese, 56122 San Piero a Grado, Pisa, Italy
| | - Valentina Patata
- Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Viale dell'Università 16, 35020 Legnaro, Padova, Italy
| | - Eric Zini
- Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy.,Department of Animal Medicine, Production and Health, University of Padova, Viale dell'Università 16, 35020 Legnaro, Padova, Italy.,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - Oriol Domenech
- Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy
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Boegli J, Schwarzwald CC, Mitchell KJ. Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation. J Vet Intern Med 2019; 33:1446-1455. [PMID: 30938891 PMCID: PMC6524107 DOI: 10.1111/jvim.15494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 03/21/2019] [Indexed: 12/21/2022] Open
Abstract
Background Noninvasive blood pressures (NIBP) and pulse pressures (PP) have not been published in horses with aortic and mitral regurgitation (AR or MR). Objectives To investigate NIBP and PP in healthy Warmblood horses and horses with AR and MR and propose PP cutoffs to identify and stage AR severity. Animals Seventy‐three Warmblood horses (healthy, 10; AR, 31; MR, 32). Methods Retrospective study. All horses had NIBP and an echocardiogram recorded. Cases were categorized based on severity of regurgitation. Pulse pressures were compared among healthy, MR, and AR groups and among AR severity groups. Cutoffs were determined by receiver operating characteristic curve analyses. Results Horses with AR had higher PP than horses with MR (mean difference [95% confidence interval (CI)], +17 [9‐26] mm Hg, P < .001) and controls (+17 [5‐30] mm Hg; P =.004). Horses with severe AR had higher PP compared those with mild (+38 [20‐54] mm Hg; P < 0.001) and moderate AR (+33 [18‐47] mm Hg; P < .001). The PP cutoffs to distinguish AR from MR and controls were 38 mm Hg (sensitivity [Sn], 100%; specificity [Sp], 19%) for maximal Sn and 61 mm Hg (Sn, 43%; Sp, 100%) for maximal Sp. The PP cutoffs to distinguish severe AR from mild and moderate AR were 57 mm Hg (Sn, 100%; Sp, 70%) for maximal Sn and 77 mm Hg (Sn, 75%; Sp, 100%) for maximal Sp. Conclusions and Clinical Importance Horses with AR have increased PP. Noninvasive PP measurements interpreted with provided cutoffs may aid clinicians in diagnosing and staging severity of AR in horses.
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Affiliation(s)
- Julia Boegli
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Colin C Schwarzwald
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Katharyn J Mitchell
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Abstract
Degenerative myxomatous disease is common and is associated with aging. Poor prognostic indicators for equine aortic regurgitation specifically include ventricular ectopy, increased pulse pressure, and hyperkinetic pulses. Valvular prolapse is a functional abnormality diagnosed echocardiographically, about which knowledge is limited. A better understanding of its role in valvular regurgitation is needed. Infective endocarditis presents with fever and other systemic signs accompanying valvular regurgitation. The prognosis is poor, warranting aggressive therapy. Other forms of valvular disease occur rarely, but often presenting with severe regurgitation. Management of horses with valvular disease is focused on assessment of severity and regular clinical, echocardiographic, and electrocardiographic monitoring.
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Abstract
This article provides an overview on the principles of transthoracic echocardiography in horses. Indications for echocardiography, equipment, and technical considerations are discussed and a systematic approach for a complete echocardiographic examination in horses is described. Methods for assessment of chamber dimensions, allometric scaling of measurements, assessment of systolic and diastolic ventricular function, assessment of atrial function, hemodynamic assessment, and evaluation of valvular regurgitation are explained, focusing on traditional 2-dimensional (2D), motion-mode, and Doppler echocardiographic methods. Selected applications of newer echocardiographic methods, such as tissue Doppler imaging and 2D speckle tracking are also described.
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Affiliation(s)
- Colin C Schwarzwald
- Clinic for Equine Internal Medicine, Equine Department, Swiss Equine Cardiology Consulting, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich 8057, Switzerland.
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Ven S, Decloedt A, De Clercq D, Vera L, Rademakers F, van Loon G. Detection of subclinical left ventricular dysfunction by tissue Doppler imaging in horses with aortic regurgitation. Equine Vet J 2018; 50:587-593. [PMID: 29341213 DOI: 10.1111/evj.12805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 01/09/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Aortic regurgitation (AR) can have an important clinical impact and in some cases leads to left ventricular (LV) failure. Tissue Doppler imaging (TDI) is an echocardiographic technique that has been used in horses to detect LV dysfunction. OBJECTIVES To examine whether TDI detects changes in radial myocardial wall motion in horses with AR compared with control horses. STUDY DESIGN Case-control study. METHODS Echocardiography was performed in 30 healthy Warmblood horses and 34 Warmblood horses with AR, subdivided in groups with mild, moderate or severe AR. TDI measurements were performed on six segments of the short-axis images of the LV myocardial wall. Myocardial wall motion was evaluated by measuring velocity and deformation during isovolumetric contraction, systole, early and late diastole. Timing of different events was also measured. RESULTS In most segments, a significantly higher systolic myocardial velocity was found in horses with AR compared with controls. Horses with AR also had higher late diastolic velocity, although the difference was not significant in all segments. TDI measurement of timing intervals demonstrated less difference between groups. MAIN LIMITATIONS There was a significant difference in age between the control group and horses with AR, which may confound the results. The assessment of AR severity was based on subjective criteria as there is no gold standard. CONCLUSIONS TDI showed significant differences in radial systolic and late diastolic myocardial velocity in horses with AR. This could indicate an altered LV function in these horses, but further research is needed to investigate the prognostic value of these measurements.
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Affiliation(s)
- S Ven
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - A Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - D De Clercq
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - L Vera
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - F Rademakers
- Division of Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Atrial fibrillation management in a breeding stallion. J Vet Cardiol 2017; 19:299-307. [PMID: 28336184 DOI: 10.1016/j.jvc.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 12/21/2016] [Accepted: 02/08/2017] [Indexed: 11/23/2022]
Abstract
A 20-year-old warmblood breeding stallion presented to a University practice for semen collection and evaluation was incidentally diagnosed with atrial fibrillation (AF). Electrocardiogram recordings during breeding revealed inappropriately rapid tachycardia and occasional ventricular premature depolarizations/aberrant ventricular conduction. Transvenous electrical cardioversion was performed. After successful cardioversion the horse displayed supraventricular ectopy and atrial contractile dysfunction and was administered sotalol hydrochloride in an attempt to decrease the risk of AF recurrence. Supraventricular ectopy and echocardiographic evidence of atrial dysfunction gradually improved and normalized over 6 months. No direct adverse effects of the chronic anti-arrhythmic treatment were observed and libido and semen quality were unaffected. AF recurred 6 months after cardioversion and sotalol therapy was continued to control the ventricular ectopy/aberrant ventricular conduction during semen collection. Considerations regarding pathologic arrhythmias and inappropriately high heart rates in breeding stallions with AF may be similar to those in riding horses. Sotalol hydrochloride was a safe anti-arrhythmic drug in the management of this case.
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