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Fries RC. Current use of cardiac MRI in animals. J Vet Cardiol 2023; 51:13-23. [PMID: 38052149 DOI: 10.1016/j.jvc.2023.11.006] [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: 11/04/2022] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023]
Abstract
Cardiovascular magnetic resonance (CMR) imaging has evolved to become an indispensable tool in human cardiology. It is a non-invasive technique that enables objective assessment of myocardial function, size, and tissue composition. Recent innovations in magnetic resonance imaging scanner technology and parallel imaging techniques have facilitated the generation of parametric mapping to explore tissue characteristics, and the emergence of strain imaging has enabled cardiologists to evaluate cardiac function beyond conventional metrics. As veterinary cardiology continues to utilize CMR beyond the reference standard, clinical application of CMR will further expand our capabilities. This article describes the current use of CMR and adoption of more recent advances such as T1/T2 mapping in veterinary cardiology.
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Affiliation(s)
- R C Fries
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign College of Veterinary Medicine, Urbana, IL, USA.
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Fries R. Hypertrophic Cardiomyopathy-Advances in Imaging and Diagnostic Strategies. Vet Clin North Am Small Anim Pract 2023; 53:1325-1342. [PMID: 37423845 DOI: 10.1016/j.cvsm.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Hypertrophic cardiomyopathy (HCM) is the most important and prevalent cardiac disease in cats. Due to the highly variable nature of HCM, a multimodal approach including physical examination, genetic evaluation, cardiac biomarkers, and imaging are all essential elements to appropriate and timely diagnosis. These foundational elements are advancing rapidly in veterinary medicine. Newer biomarkers such as galectin-3 are currently being researched and advances in tissue speckle-tracking and contrast-enhanced echocardiography are readily available. Advanced imaging techniques, such as cardiac MRI, are providing previously unavailable information about myocardial fibrosis and paving the way for enhanced diagnostic capabilities and risk-stratification in cats with HCM.
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Affiliation(s)
- Ryan Fries
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 West Hazelwood Drive, Urbana, IL 61802, USA.
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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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Fries RC, Kadotani S, Keating SCJ, Stack JP. Cardiac extracellular volume fraction in cats with preclinical hypertrophic cardiomyopathy. J Vet Intern Med 2021; 35:812-822. [PMID: 33634479 PMCID: PMC7995366 DOI: 10.1111/jvim.16067] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 12/22/2022] Open
Abstract
Background Cardiac magnetic resonance imaging (CMR) allows for detection of fibrosis in hypertrophic cardiomyopathy (HCM) by quantification of the extracellular volume fraction (ECV). Hypothesis/Objectives To quantify native T1 mapping and ECV in cats. We hypothesize that native T1 mapping and ECV will be significantly increased in HCM cats compared with healthy cats. Animals Seventeen healthy and 12 preclinical HCM, age‐matched, client‐owned cats. Methods Prospective observational study. Tests performed included indirect blood pressure, CBC, biochemical analysis including total thyroid, urinalysis, transthoracic echocardiogram, and CMR. Cats were considered healthy if all tests were within normal limits and a diagnosis of HCM was determined by the presence of left ventricular concentric hypertrophy ≥6 mm on echocardiography. Results There were statistically significant differences in LV mass (healthy = 5.87 g, HCM = 10.3 g, P < .0001), native T1 mapping (healthy = 1122 ms, HCM = 1209 ms, P = .004), and ECV (healthy = 26.0%, HCM = 32.6%, P < .0001). Variables of diastolic function including deceleration time of early diastolic transmitral flow (DTE), ratio between peak velocity of early diastolic transmitral flow and peak velocity of late diastolic transmitral flow (E : A), and peak velocity of late diastolic transmitral flow (A wave) were significantly correlated with ECV (DTE; r = 0.73 P = .007, E : A; r = −0.75 P = .004, A wave; r = 0.76 P = .004). Conclusions and Clinical Importance Quantitative assessment of cardiac ECV is feasible and can provide additional information not available using echocardiography.
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Affiliation(s)
- Ryan C Fries
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Saki Kadotani
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Stephanie C J Keating
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Jonathan P Stack
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
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Dennler M, Toaldo MB, Makara M, Lautenschläger IE, Ribbers G, Wang-Leandro A, Waschk M, Richter H, Glaus TM. Recommendations for standardized plane definition in canine cardiac MRI. Vet Radiol Ultrasound 2020; 61:696-704. [PMID: 32996225 DOI: 10.1111/vru.12911] [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: 04/30/2020] [Revised: 07/05/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022] Open
Abstract
With the growing interest in cardiac magnetic resonance imaging (cMRI), veterinary radiologists will increasingly be asked to use this modality to answer complex cardiological questions. Plane alignment is crucial for reproducible assessment of the heart. Anesthesia time is a limiting factor in cMRI. Aims of this prospective experimental study were to introduce a flow chart for standardized cMRI-examination in dogs, to test it for reproducibility using a cardiac CT simulation and to estimate time requirements needed to complete the examination accurately. Six operators (3 radiologists, 1 cardiologist, 1 imaging-resident, 1 technician) simulated a cMRI examination on CT-scans of 6 healthy Beagle dogs twice within two to four weeks. Assessment included qualitative and quantitative scoring of plane quality and time requirements. The quality of planes was high for the left and moderate for the right side of the heart. The intraclass correlation coefficient (ICC) of linear measurements of structures on the left was good to excellent (ICC-range: 0.789-0.948) but dropped to moderate to poor levels for the right side (ICC-range: 0.429-0.738). The median time required to complete a full examination was 30 (range: 13-103) min in the first and 24 (range: 15-62) min in the second evaluation. It differed significantly between operators and was consistently shorter for the left than for the right side. In conclusion, a new standardized scheme for cMRI can be quickly adopted by radiologists with some expertise in cross sectional imaging. Qualitative and quantitative results were highly reproducible for the left but less for the right side.
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Affiliation(s)
- Matthias Dennler
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Marco Baron Toaldo
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Mariano Makara
- Centre for Veterinary Education, University Veterinary Teaching Hospital, University of Sydney, New South Wales, Australia
| | - Ines E Lautenschläger
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Gianna Ribbers
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Adriano Wang-Leandro
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Maja Waschk
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Henning Richter
- Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Tony M Glaus
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Anatomical assessment of intrathoracic cardiovascular structures using fast spin-echo double inversion recovery and steady-state free precession magnetic resonance imaging in a normal cat. J Vet Cardiol 2019; 24:28-35. [PMID: 31405552 DOI: 10.1016/j.jvc.2019.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022]
Abstract
In human medicine, non-contrast cardiac magnetic resonance imaging (CMRI) is routinely used to assess the cardiovascular system. In this study, using non-contrast CMRI, we provide a thorough description of the normal appearance of the intrathoracic cardiovascular structures in one healthy cat using a magnet operating at a field of 1.5-Tesla. The CMRI protocol was based on the use of fast spin-echo double inversion recovery and steady-state free precession pulse sequences in oblique short-axis, vertical long-axis, and horizontal long-axis imaging planes. After imaging the feline heart, four cadaver cats injected with latex substance into their arterial and venous systems were sectioned to facilitate interpretation of the intrathoracic cardiovascular structures to the corresponding CMRI. The fast spin-echo double inversion recovery images showed the best evaluation of gross intrathoracic anatomy, giving excellent contrast of the myocardium and vessels walls as they appeared with intermediate signal intensity compared to the lumen that appeared with low signal intensity. By contrast, steady-state free precession images showed details of the heart cavities and vascular lumen due to the high signal intensity of fast-flowing blood. The results of this study provide some anatomic detail for the heart and associated vessels as seen by non-contrast CMRI in the domestic cat.
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Richter H, Kircher PR, Joerger FB, Bruellmann E, Dennler M. Assessment of Myocardial Perfusion at Rest and During Stress Using Dynamic First-Pass Contrast-Enhanced Magnetic Resonance Imaging in Healthy Dogs. Front Vet Sci 2018; 5:211. [PMID: 30234137 PMCID: PMC6131641 DOI: 10.3389/fvets.2018.00211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/14/2018] [Indexed: 01/24/2023] Open
Abstract
Objective: To assess the feasibility of myocardial perfusion analysis in healthy dogs using dynamic contrast-enhanced cardiac magnetic resonance (DCE-MR) imaging at rest and during simulated stress with two doses of adenosine. Animals: Ten healthy beagle dogs. Procedures: Dogs were anesthetized and positioned in dorsal recumbency in a 3.0 Tesla MR scanner. Electrocardiogram-triggered dynamic T1-weighted ultrafast gradient echo images of three slices in short-axis orientation of the heart were acquired during breath holds and the first pass of gadolinium contrast. Image acquisition was performed after 4 min infusion of 140 μg/kg/min and 280 μg/kg/min adenosine and, after a washout period, without adenosine, respectively. Images were processed by dividing each slice into 6 radial segments and perfusion analysis was performed from signal intensity-time data. Results: No differences in perfusion parameters were found between segments within any of the slices, but significant differences were found between slices for peak enhancement, accumulated enhancement, and the maximum upslope. In addition, significant differences were found within each slice between data at rest and during adenosine-induced stress for the relative and absolute maximum upslope, relative peak enhancement, time to peak, and accumulated enhancement although inter-individual variation was large and no difference was found between the two stress tests for some parameters. Conclusion and Clinical Relevance: Results of this study showed that rest and stress myocardial perfusion can be assessed using DCE-CMR in dogs using the methods described. Both, adenosine dose and slice appear to affect perfusion parameters in healthy dogs and individual response to adenosine was variable.
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Affiliation(s)
- Henning Richter
- Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Patrick R Kircher
- Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Fabiola B Joerger
- Division of Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Matthias Dennler
- Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Lee Y, Jung J, Park J, Jeong J, Jeon S, Park S, Chang J, Kang JH, Lee C, Chang D. CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Vet Radiol Ultrasound 2016; 58:62-75. [DOI: 10.1111/vru.12446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/13/2016] [Indexed: 01/20/2023] Open
Affiliation(s)
- Youngjae Lee
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jaihyun Jung
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Junyong Park
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jiyoon Jeong
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Seokho Jeon
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Sunyoung Park
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jinhwa Chang
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Ji-Houn Kang
- Laboratory of Veterinary Internal Medicine; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Chulhyun Lee
- Bioimaging Research Team; Korea Basic Science Institute; Cheongju Korea
| | - Dongwoo Chang
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
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MAI WILFRIED, WEISSE CHICK, SLEEPER MEGM. CARDIAC MAGNETIC RESONANCE IMAGING IN NORMAL DOGS AND TWO DOGS WITH HEART BASE TUMOR. Vet Radiol Ultrasound 2010; 51:428-35. [DOI: 10.1111/j.1740-8261.2010.01673.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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The potential role of MRI in veterinary clinical cardiology. Vet J 2010; 183:124-34. [DOI: 10.1016/j.tvjl.2008.11.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Revised: 11/20/2008] [Accepted: 11/23/2008] [Indexed: 01/19/2023]
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MacDonald KA, Kittleson MD, Larson RF, Kass P, Klose T, Wisner ER. The Effect of Ramipril on Left Ventricular Mass, Myocardial Fibrosis, Diastolic Function, and Plasma Neurohormones in Maine Coon Cats with Familial Hypertrophic Cardiomyopathy without Heart Failure. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb00707.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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