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Partington C, Hodgkiss-Geere H, Woods GRT, Dukes-McEwan J, Flanagan J, Biourge V, German AJ. The effect of obesity and subsequent weight reduction on cardiac morphology and function in cats. BMC Vet Res 2024; 20:154. [PMID: 38658930 PMCID: PMC11040875 DOI: 10.1186/s12917-024-04011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND In people, obesity is a risk factor for cardiovascular disease, associated with systemic hypertension, cardiac remodelling and systolic and diastolic dysfunction. Weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. In cats, far less is known regarding the effects of obesity and subsequent weight reduction on cardiovascular morphology and function. This prospective study aimed to assess cardiac morphology and function, heart rate variability, cardiac biomarkers and body composition before and after controlled weight reduction in cats with obesity. Body composition analysis (by dual energy x-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, systemic arterial systolic blood pressure, electrocardiography, plasma cardiac biomarkers) were performed prior to weight management in twenty cats with obesity. These investigations were repeated in eleven cats that reached target weight. RESULTS At baseline, systemic hypertension was not documented, but the majority of cats with obesity (15 out of 19) showed echocardiographic evidence of diastolic dysfunction. Eleven of 20 cats had increased maximal end-diastolic septal or left ventricular free wall thickness (≥ 6.0 mm) at baseline. Median (interquartile range) percentage of weight lost in the cats reaching target weight was 26% (17-29%), with a median reduction in body fat mass of 45% (26-64%). Both the end-diastolic left ventricular free wall (median magnitude of change -0.85 mm, IQR -0.05 mm to -1.55 mm, P = 0.019; median percentage reduction 14.0%) and end-diastolic interventricular septum (median magnitude of change -0.5 mm, IQR -0.2 mm to -1.225 mm, P = 0.047; median percentage reduction 7.9%) thickness decreased after weight reduction. Following weight reduction, pulsed wave tissue Doppler imaging of the left ventricular free wall was consistent with improved diastolic function in 4 out of 8 cats, however there was no significant difference in overall diastolic function class. Further, there was no change in heart rate variability or cardiac biomarkers with weight reduction. CONCLUSION An increase in left ventricular wall thickness and diastolic dysfunction were common echocardiographic features in cats with obesity within our study and may be reversible with successful weight and fat mass loss. Further studies are required to clarify the clinical consequences of these findings.
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Affiliation(s)
- Catheryn Partington
- Institute of Infection, Veterinary, Ecological and Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK.
- Present address: Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK.
| | - Hannah Hodgkiss-Geere
- Institute of Infection, Veterinary, Ecological and Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| | - Georgia R T Woods
- Institute of Life Course and Medical Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| | - Joanna Dukes-McEwan
- Institute of Infection, Veterinary, Ecological and Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
| | | | | | - Alexander J German
- Institute of Life Course and Medical Sciences, Department of Small Animal Clinical Sciences, Teaching Hospital, University of Liverpool, Neston, UK
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Sun HY, Lin XY. Analysis of the management and therapeutic performance of diabetes mellitus employing special target. World J Diabetes 2023; 14:1721-1737. [PMID: 38222785 PMCID: PMC10784800 DOI: 10.4239/wjd.v14.i12.1721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/31/2023] [Accepted: 10/23/2023] [Indexed: 12/14/2023] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic condition characterized predominantly by hyperglycemia. The most common causes contributing to the pathophysiology of diabetes are insufficient insulin secretion, resistance to insulin's tissue-acting effects, or a combination of both. Over the last 30 years, the global prevalence of diabetes increased from 4% to 6.4%. If no better treatment or cure is found, this amount might climb to 430 million in the coming years. The major factors of the disease's deterioration include age, obesity, and a sedentary lifestyle. Finding new therapies to manage diabetes safely and effectively without jeopardizing patient compliance has always been essential. Among the medications available to manage DM on this journey are glucagon-like peptide-1 agonists, thiazolidinediones, sulphonyl urease, glinides, biguanides, and insulin-targeting receptors discovered more than 10 years ago. Despite the extensive preliminary studies, a few clinical observations suggest this process is still in its early stages. The present review focuses on targets that contribute to insulin regulation and may be employed as targets in treating diabetes since they may be more efficient and secure than current and traditional treatments.
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Affiliation(s)
- Hong-Yan Sun
- Department of Endocrine and Metabolic Diseases, Yantaishan Hospital, Yantai 264003, Shandong Province, China
| | - Xiao-Yan Lin
- Department of Endocrine and Metabolic Diseases, Yantaishan Hospital, Yantai 264003, Shandong Province, China
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Cheng WC, Lawson C, Liu HH, Wilkie L, Dobromylskyj M, Luis Fuentes V, Dudhia J, Connolly DJ. Exploration of Mediators Associated with Myocardial Remodelling in Feline Hypertrophic Cardiomyopathy. Animals (Basel) 2023; 13:2112. [PMID: 37443910 DOI: 10.3390/ani13132112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) affects both humans and cats and exhibits considerable interspecies similarities that are exemplified by underlying pathological processes and clinical presentation to the extent that developments in the human field may have direct relevance to the feline disease. Characteristic changes on histological examination include cardiomyocyte hypertrophy and interstitial and replacement fibrosis. Clinically, HCM is characterised by significant diastolic dysfunction due to a reduction in ventricular compliance and relaxation associated with extracellular matrix (ECM) remodelling and the development of ventricular hypertrophy. Studies in rodent models and human HCM patients have identified key protein mediators implicated in these pathological changes, including lumican, lysyl oxidase and TGF-β isoforms. We therefore sought to quantify and describe the cellular location of these mediators in the left ventricular myocardium of cats with HCM and investigate their relationship with the quantity and structural composition of the ECM. We identified increased myocardial content of lumican, LOX and TGF-β2 mainly attributed to their increased expression within cardiomyocytes in HCM cats compared to control cats. Furthermore, we found strong correlations between the expressions of these mediators that is compatible with their role as important components of cellular pathways promoting remodelling of the left ventricular myocardium. Fibrosis and hypertrophy are important pathological changes in feline HCM, and a greater understanding of the mechanisms driving this pathology may facilitate the identification of potential therapies.
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Affiliation(s)
- Wan-Ching Cheng
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
| | - Charlotte Lawson
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London NW1 0TU, UK
| | - Hui-Hsuan Liu
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London NW1 0TU, UK
| | - Lois Wilkie
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
| | | | - Virginia Luis Fuentes
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
| | - Jayesh Dudhia
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
| | - David J Connolly
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
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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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Lutz B, Betting A, Kovacevic A, Durand A, Gurtner C, Kaiponen TS, Kooistra H, Campos M, Cui Y. Dilated cardiomyopathy in a cat with congenital hyposomatotropism. JFMS Open Rep 2022; 8:20551169221086437. [PMID: 35368737 PMCID: PMC8973070 DOI: 10.1177/20551169221086437] [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] [Indexed: 11/17/2022] Open
Abstract
Case summary A 7-month-old domestic shorthair cat was presented for evaluation of stunted growth, recurrent hypoglycaemia during the first months of its life and altered mentation. Complete blood count and biochemistry were unremarkable, except for mildly elevated serum creatinine concentration (despite low muscle mass) and concurrent isosthenuria. Hyposomatotropism was diagnosed based on persistent low circulating insulin-like growth factor 1 concentrations and a lack of response of circulating growth hormone (GH) concentration after the administration of GH-releasing hormone. Other endocrinopathies such as hypothyroidism and hypoadrenocorticism were excluded. MRI of the brain revealed a fluid-filled empty sella tursica, consistent with a pituitary cyst and atrophy/hypoplasia of the pituitary. Echocardiography was unremarkable at the time of diagnosis of hyposomatotropism. Three months later, ovariohysterectomy revealed immature ovaries, raising the suspicion of luteinising and follicle-stimulating hormone deficiency. At 1 year of age, the cat developed congestive heart failure secondarily to dilated cardiomyopathy (DCM) with severely reduced left ventricular systolic function and died a few days later. Pathology showed atrophy of the adenohypophysis, epithelial delineation of the pituitary cysts, mild cardiomegaly, multifocal fibrosis of the left ventricle and a mild, multifocal, chronic epicarditis. Relevance and novel information GH deficiency is a very rare endocrinopathy in cats. This is the first case to describe the development of DCM with concurrent hyposomatotropism, which has previously been reported in human medicine. Other notable abnormalities that could be related to GH deficiency are juvenile self-limiting hypoglycaemia, behavioural changes and possible nephropathy.
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Affiliation(s)
- Bérénice Lutz
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Adeline Betting
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Alan Kovacevic
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Alexane Durand
- Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Corinne Gurtner
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Taina S Kaiponen
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Hans Kooistra
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Miguel Campos
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Yi Cui
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
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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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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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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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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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10
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Liu M, Köster LS, Fosgate GT, Chadwick CC, Sanz-González Í, Eckersall PD, Wotton PR, French AT. Cardiovascular-renal axis disorder and acute-phase proteins in cats with congestive heart failure caused by primary cardiomyopathy. J Vet Intern Med 2020; 34:1078-1090. [PMID: 32395893 PMCID: PMC7255652 DOI: 10.1111/jvim.15757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/12/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Currently, the pathogenesis of congestive heart failure (CHF) in cats is not fully understood. OBJECTIVE To identify novel biomarkers for CHF in cats caused by primary cardiomyopathy, particularly related to cardiovascular-renal axis disorder and systemic inflammatory response. ANIMALS Twenty-five cats in CHF caused by primary cardiomyopathy, 12 cats with preclinical cardiomyopathy, and 20 healthy controls. METHODS Case control and observational case series. The following serum biomarkers were compared among the 3 cat groups: a cardiorenal profile that included N-terminal pro-brain natriuretic peptide (NT-proBNP), symmetric dimethylarginine (SDMA), and creatinine and an inflammatory profile that included 7 acute-phase proteins (APPs). Survival analyses and longitudinal studies were performed in CHF cats. RESULTS All cardiorenal biomarkers were positively correlated and higher in CHF cats, and high NT-proBNP and SDMA were associated with poor clinical outcome. Cats with CHF had significantly higher leucine-rich alpha-2-glycoprotein 1, serum amyloid A, and ceruloplasmin, and these APPs were positively correlated with NT-proBNP and left atrial size. In a multivariable survival analysis, alpha-1-acid glycoprotein concentration (P = .01), body weight (P = .02) and left atrial-to-aortic root ratio (P = .01) were independent prognostic factors for CHF in these cats. CONCLUSIONS AND CLINICAL IMPORTANCE In cats, CHF is an inflammatory disorder and outcome in CHF may be determined by the extent of inflammation and possibly the amount of residual renal function. These novel biomarkers have potential use for the clinical management, prognosis, and future research into CHF and cardiomyopathy in cats.
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Affiliation(s)
- Mengmeng Liu
- Department of Small Animal Clinical Sciences, Small Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Liza S Köster
- Department of Small Animal Clinical Sciences, Small Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Geoffrey T Fosgate
- Faculty of Veterinary Science, Department of Production Animal Studies, University of Pretoria, Onderstepoort, South Africa
| | | | - Íñigo Sanz-González
- Department of Small Animal Clinical Sciences, Small Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Peter David Eckersall
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Paul R Wotton
- Department of Small Animal Clinical Sciences, Small Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Anne T French
- Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis
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van Hoek I, Hodgkiss-Geere H, Bode EF, Hamilton-Elliott J, Mõtsküla P, Palermo V, Pereira YM, Culshaw GJ, Ivanova A, Dukes-McEwan J. Associations among echocardiography, cardiac biomarkers, insulin metabolism, morphology, and inflammation in cats with asymptomatic hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:591-599. [PMID: 32045061 PMCID: PMC7096615 DOI: 10.1111/jvim.15730] [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: 06/17/2019] [Accepted: 01/31/2020] [Indexed: 12/27/2022] Open
Abstract
Background Insulin, insulin‐like growth factor‐1 (IGF‐1), and inflammation possibly are involved in cats with asymptomatic hypertrophic cardiomyopathy (aHCM). Objectives To evaluate echocardiography, morphology, cardiac and inflammatory markers, insulin and IGF‐1 in cats with aHCM. Animals Fifty‐one client‐owned cats with aHCM. Methods Observational descriptive study. Variables (body weight [BW], body condition score [BCS], echocardiography, and serum concentrations of N‐terminal pro‐B‐type natriuretic peptide [NT‐proBNP], ultra‐sensitive troponin‐I [c‐TnI], serum amyloid A [SAA], insulin, glucose and IGF‐1) were evaluated for significant increases above echocardiography cutoff values and laboratory reference ranges, associations and effect of left atrial (LA) remodeling and generalized hypertrophy. Results Cats with aHCM had BCS ≥6/9 (P = .01) and insulin (P < .001), NT‐proBNP (P = .001) and cTn‐I (P < .001) above laboratory reference ranges. Associations were present between NT‐proBNP and maximum end‐diastolic interventricular septum thickness (IVSd; ρ = .32; P = .05), maximum end‐diastolic left ventricular free wall thickness;(ρ = .41; P = .01), LA/Aorta (ρ = .52; P = .001) and LA diameter (LA‐max; ρ = .32; P = .05); c‐TnI and LA/Aorta (ρ = .49; P = .003) and LA‐max (ρ = .28; P = .05); and SAA and number of IVSd regions ≥6 mm thickness (ρ = .28; P = .05). Body weight and BCS were associated with IGF‐1 (r = 0.44; P = .001), and insulin (ρ = .33; P = .02), glucose (ρ = .29; P = .04) and IGF‐1 (ρ = .32; P = .02), respectively. Concentrations of NT‐proBNP (P = .02) and c‐TnI (P = .01), and SAA (P = .02), were higher in cats with LA remodeling, and generalized hypertrophy, respectively. Conclusions and clinical importance Results suggest potential implications of insulin, IGF‐1, and inflammation in cats with aHCM, but it remains to be confirmed whether these findings represent a physiological process or a part of the pathogenesis and development of disease.
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Affiliation(s)
| | - Hannah Hodgkiss-Geere
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
| | - Elizabeth F Bode
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
| | - Julie Hamilton-Elliott
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
| | - Paul Mõtsküla
- The Cardiology Clinic, Anderson Moores Veterinary Specialists, Hampshire, UK
| | - Valentina Palermo
- The Cardiology Clinic, Anderson Moores Veterinary Specialists, Hampshire, UK
| | - Yolanda M Pereira
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Geoff J Culshaw
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Anna Ivanova
- Center for statistics, University of Hasselt, Hasselt, Belgium
| | - Jo Dukes-McEwan
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
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