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Kuo MYW, Häggström J, Gordon SG, Höglund K, Côté E, Lu TL, Dirven M, Rishniw M, Hung YW, Ljungvall I. Veterinary echocardiographers' preferences for left atrial size assessment in dogs: the BENEFIT project. J Vet Cardiol 2023; 51:157-171. [PMID: 38128421 DOI: 10.1016/j.jvc.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/13/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION/OBJECTIVES Veterinary echocardiographers' preferences for left atrial (LA) size assessment in dogs have never been systematically investigated. The primary aim of this international survey study was to investigate echocardiographers' preferences for LA size assessment in dogs. The secondary aim was to investigate echocardiographers' preferences for assessing LA size in subgroups based on geographic, demographic, and professional profiles. ANIMALS, MATERIALS, AND METHODS An online survey instrument was designed, verified, and distributed globally to the veterinary echocardiographers. RESULTS A total of 670 echocardiographers from 54 countries on six continents completed the survey. Most echocardiographers (n = 621) used linear two-dimensional (2D)-based methods to assess LA size, 379 used subjective assessment, and 151 used M-mode-based methods. Most commonly, echocardiographers combined linear 2D-based methods with subjective assessment (n = 222), whereas 191 used linear 2D-based methods alone. Most echocardiographers (n = 436) using linear 2D-based methods preferred the right parasternal short-axis view and indexed the LA to the aorta. Approximately 30% (n = 191) of the echocardiographers who performed linear measurements from 2D echocardiograms shared the same preferences regarding dog position, acquisition view, indexing method, and identification of the time-point used for the measurement. The responses were comparably homogeneous across geographic location, training level, years of performing echocardiography, and type of practice. DISCUSSION/CONCLUSION Most veterinary echocardiographers assessed LA size in dogs using linear 2D echocardiography from a right parasternal short-axis view, and by indexing the LA to the aorta. The respondents' preferences were similar across geographic, demographic, and professional backgrounds.
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Affiliation(s)
- M Y-W Kuo
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S G Gordon
- Department of Small Animal Clinical Science, Texas A&M University, College Station, TX, USA
| | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - E Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - T-L Lu
- Chuan Animal Hospital, Taipei, Taiwan
| | - M Dirven
- Evidensia Södra Animal Hospital, Kungens Kurva, Sweden
| | - M Rishniw
- Veterinary Information Network, Davis, CA, USA
| | - Y-W Hung
- Cardiospecial Veterinary Hospital, Taipei, Taiwan
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Kuo MYW, Häggström J, Gordon SG, Höglund K, Côté E, Lu TL, Dirven M, Rishniw M, Hung YW, Ljungvall I. Veterinary echocardiographers' preferences for left atrial size assessment in cats: the BENEFIT project. J Vet Cardiol 2023; 51:145-156. [PMID: 38128420 DOI: 10.1016/j.jvc.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/13/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION/OBJECTIVES Veterinary echocardiographers' preferences for left atrial (LA) size assessment in cats have not been systematically investigated. The primary aim of this prospective exploratory study was to investigate echocardiographers' preferences concerning LA size assessment in cats. A secondary aim was to investigate echocardiographers' preferences for assessing LA size in subgroups based on geographic, demographic, and professional profiles. ANIMALS, MATERIALS, AND METHODS An online survey instrument was designed, verified, and distributed globally to veterinary echocardiographers. RESULTS A total of 655 veterinary echocardiographers from six continents and 54 countries, working in specialty practice (56%) and in general practice (38%), provided data. Linear two-dimensional (2D) technique was favored by most echocardiographers (n = 612) for LA size assessment. Most commonly, respondents combined linear 2D with subjective assessment (n = 227), while 209 used linear 2D-based methods alone. Most echocardiographers using linear 2D-based methods preferred the right parasternal short-axis view and to index the LA to the aorta (Ao). Approximately 10% of the respondents obtained LA dimensions from a right parasternal long-axis four-chamber view. Approximately one-third of echocardiographers that made linear measurements from 2D echocardiograms shared the same preferences regarding cat position, acquisition view, indexing method and time point identification for the LA measurement. The responses were comparably homogeneous across geographic location, level of training, years performing echocardiography, and type of practice. DISCUSSION/CONCLUSION Most veterinary echocardiographers assessed LA size in cats using linear 2D echocardiography from a right parasternal short-axis view, and indexed LA to Ao. Respondents' preferences were similar over geographic, demographic, and professional backgrounds.
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Affiliation(s)
- M Y-W Kuo
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S G Gordon
- Department of Small Animal Clinical Science, Texas A&M University, College Station, TX, USA
| | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - E Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - T-L Lu
- Chuan Animal Hospital, Taipei, Taiwan
| | - M Dirven
- Evidensia Södra Animal Hospital, Kungens Kurva, Sweden
| | - M Rishniw
- Veterinary Information Network, Davis, CA, USA
| | - Y-W Hung
- Cardiospecial Veterinary Hospital, Taipei, Taiwan
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Dimopoulou M, Engdahl K, Ladlow J, Andersson G, Hedhammar Å, Skiöldebrand E, Ljungvall I. The epidemiology of upper respiratory tract disorders in a population of insured Swedish dogs (2011-2014), and its association to brachycephaly. Sci Rep 2023; 13:8765. [PMID: 37253809 DOI: 10.1038/s41598-023-35466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
Upper respiratory tract (URT) disorders are common in dogs but neither general nor breed-related epidemiological data are widely reported. This study´s aims were to describe the epidemiology of URT disorders in a Swedish population of dogs and to investigate whether brachycephalic breeds were overrepresented among high-risk breeds. A cohort of dogs insured by Agria Djurförsäkring in Sweden (2011-2014) was used to calculate overall and breed-specific incidence rate (IR), age at first URT diagnosis and relative risk (RR) for URT disorders. For breeds with high RR for URT disorders, co-morbidities throughout the dog's insurance period and age at death were investigated. The cohort included approximately 450,000 dogs. URT disorders had an overall IR of 50.56 (95% CI; 49.14-52.01) per 10,000 dog years at risk. Among 327 breeds, the English bulldog, Japanese chin, Pomeranian, Norwich terrier and pug had highest RR of URT disorders. Eight of 13 breeds with high RR for URT disorders were brachycephalic. The median age at first URT diagnosis was 6.00 years (interquartile range 2.59-9.78). French bulldogs with URT diagnoses had a significantly shorter life span (median = 3.61 years) than other breeds with URT diagnosis (median = 7.81 years). Dogs with high risk for URT disorders had more co-morbidities than average.
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Affiliation(s)
- M Dimopoulou
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - K Engdahl
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J Ladlow
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - G Andersson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Å Hedhammar
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - E Skiöldebrand
- Department of Biomedical Science and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Kriström K, Häggström J, Tidholm A, Yu JZ, Fascetti AJ, Ljungvall I. Impact of blood tube additives and timing of sampling on blood taurine concentrations in clinically healthy dogs. J Vet Cardiol 2023; 45:59-70. [PMID: 36702086 DOI: 10.1016/j.jvc.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 12/16/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Dilated cardiomyopathy can be associated with taurine deficiency in dogs. Blood taurine concentrations can be analyzed in whole blood (WB) and plasma. The study objectives were to investigate agreement between taurine concentrations measured in WB, heparin plasma, and EDTA plasma, determine intraindividual variation in healthy dogs, and evaluate if time from feeding to sampling impacts concentrations. ANIMALS Ten English Cocker spaniels and 10 dogs of various breeds. MATERIALS AND METHODS Dogs were fasted 12 h prior to initial blood sampling, and the blood was collected at five occasions over eight h. Food was offered immediately after first and one h after fourth sampling time point. RESULTS Agreement between taurine concentrations in EDTA plasma and heparinized plasma was good (mean difference 4.5 nmol/mL, 95% confidence interval (CI) 36.8-45.8 nmol/mL). Whole blood concentrations were systematically higher than EDTA and heparin plasma concentrations (mean difference 132.7 nmol/mL, 95% CI 23.6-241.8 nmol/mL, and 127.6 nmol/mL, 95% CI 28.6-226.6 nmol/mL, respectively, all P < 0.001). Intraindividual daily variations in taurine concentration were seen in all additives, with largest variations in plasma (P < 0.001). Taurine concentration in heparinized plasma was higher at first and fifth sampling time points compared to the fourth (P = 0.014). DISCUSSION Agreement was found between taurine concentrations measured in different additives, with expected higher concentration in WB than plasma. Taurine concentrations measured in heparinized plasma varied with sampling time point. Intraindividual daily variations were observed in all additives, but mainly in plasma samples. CONCLUSION Taurine concentrations in dogs with suspected deficiency should be interpreted with caution.
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Affiliation(s)
- K Kriström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden; Anicura Albano Small Animal Hospital, Rinkebyvägen 21A, SE-182 36 Danderyd, Sweden.
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - A Tidholm
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden; Anicura Albano Small Animal Hospital, Rinkebyvägen 21A, SE-182 36 Danderyd, Sweden
| | - J Z Yu
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
| | - A J Fascetti
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
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Pelander L, Brunchault V, Buffin-Meyer B, Klein J, Breuil B, Zürbig P, Magalhães P, Mullen W, Elliott J, Syme H, Schanstra JP, Häggström J, Ljungvall I. Urinary peptidome analyses for the diagnosis of chronic kidney disease in dogs. Vet J 2019; 249:73-79. [PMID: 31239169 DOI: 10.1016/j.tvjl.2019.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 12/17/2022]
Abstract
Chronic kidney disease (CKD) is clinically important in canine medicine. Current diagnostic tools lack sensitivity for detection of subclinical CKD. The aim of the present study was to evaluate urinary peptidome analysis for diagnosis of CKD in dogs. Capillary electrophoresis coupled to mass spectrometry analysis demonstrated presence of approximately 5400 peptides in dog urine. Comparison of urinary peptide abundance of dogs with and without CKD led to the identification of 133 differentially excreted peptides (adjusted P for each peptide <0.05). Sequence information was obtained for 35 of these peptides. This 35 peptide subset and the total group of 133 peptides were used to construct two predictive models of CKD which were subsequently validated by researchers masked to results in an independent cohort of 20 dogs. Both models diagnosed CKD with an area under the receiver operating characteristic (ROC) curve of 0.88 (95% confidence intervals [CI], 0.72-1.0). Most differentially excreted peptides represented fragments of collagen I, indicating possible association with fibrotic processes in CKD (similar to the equivalent human urinary peptide CKD model, CKD273). This first study of the urinary peptidome in dogs identified peptides that were associated with presence of CKD. Future studies are needed to validate the utility of this model for diagnosis and prediction of progression of canine CKD in a clinical setting.
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Affiliation(s)
- L Pelander
- Department of Clinical Sciences, University of Agricultural Sciences, Ulls väg 12, 750 07 Uppsala, Sweden.
| | - V Brunchault
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Equipe 12, 1 Avenue Jean Poulhès, BP 84225, 31432 Toulouse Cedex 4, France; Université Toulouse III Paul-Sabatier Toulouse, France
| | - B Buffin-Meyer
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Equipe 12, 1 Avenue Jean Poulhès, BP 84225, 31432 Toulouse Cedex 4, France; Université Toulouse III Paul-Sabatier Toulouse, France
| | - J Klein
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Equipe 12, 1 Avenue Jean Poulhès, BP 84225, 31432 Toulouse Cedex 4, France; Université Toulouse III Paul-Sabatier Toulouse, France
| | - B Breuil
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Equipe 12, 1 Avenue Jean Poulhès, BP 84225, 31432 Toulouse Cedex 4, France; Université Toulouse III Paul-Sabatier Toulouse, France
| | - P Zürbig
- Department of Pediatric Nephrology, Hannover Medical School, Hannover, Germany; Mosaiques Diagnostics GmbH, Hannover, Germany
| | - P Magalhães
- Department of Pediatric Nephrology, Hannover Medical School, Hannover, Germany; Mosaiques Diagnostics GmbH, Hannover, Germany
| | - W Mullen
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - J Elliott
- Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - H Syme
- Clinical Science and Services, Royal Veterinary College, North Mymms, UK
| | - J P Schanstra
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Equipe 12, 1 Avenue Jean Poulhès, BP 84225, 31432 Toulouse Cedex 4, France; Université Toulouse III Paul-Sabatier Toulouse, France
| | - J Häggström
- Department of Clinical Sciences, University of Agricultural Sciences, Ulls väg 12, 750 07 Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, University of Agricultural Sciences, Ulls väg 12, 750 07 Uppsala, Sweden
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Rishniw M, Caivano D, Dickson D, Swift S, Rouben C, Dennis S, Sammarco C, Lustgarten J, Ljungvall I. Breed does not affect the association between murmur intensity and disease severity in dogs with pulmonic or subaortic stenosis. J Small Anim Pract 2019; 60:493-498. [PMID: 31032935 DOI: 10.1111/jsap.13015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 03/01/2019] [Accepted: 03/28/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine whether breed affects the ability of murmur intensity to predict the severity of stenosis in dogs with pulmonic stenosis or subaortic stenosis. MATERIALS AND METHODS Retrospective multi-investigator study of dogs with pulmonic stenosis or subaortic stenosis. Murmur intensity, assessed by a four-level classification scheme, was compared with echocardiographically-determined pressure gradient across the affected valve. Breeds represented by at least 10 dogs at any murmur intensity were compared to determine the effect, if any, of breed. RESULTS A total of 1088 dogs (520 with pulmonic stenosis and 568 with subaortic stenosis, representing 106 breeds and the mixed breed group) were included; 208 dogs had soft, 210 had moderate, 283 had loud and 387 had palpable murmurs. Fifteen breeds were represented by at least 10 dogs: five breeds with at least 10 dogs had soft murmurs (132 dogs), nine breeds had moderate murmurs (149 dogs), 10 breeds had loud murmurs (188 dogs), and 11 breeds had palpable murmurs (286 dogs). No breeds differed in stenosis severity from any other breeds within any murmur grade. Post hoc power calculations suggested that we would have been able to detect at least a moderate or large effect size, had one existed. Several dogs with soft murmurs had more-than-mild disease severity. CLINICAL SIGNIFICANCE Despite anecdotally perceived differences in the detection of heart murmurs between breeds, which have been proposed to potentially affect the interpretation of stenosis severity, we found no obvious breed effect in the ability to predict severity of stenosis.
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Affiliation(s)
- M Rishniw
- Veterinary Information Network, Davis, California, 95616, USA
| | - D Caivano
- Department of Veterinary Medicine, University of Perugia, Perugia, 06126, Italy
| | - D Dickson
- HeartVets, Porthcawl, Wales, CF36 5LD, UK
| | - S Swift
- Department of Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, 32610, USA
| | - C Rouben
- Department of Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, 32610, USA
| | - S Dennis
- Hope Veterinary Specialists, Malvern, Pennsylvania, 19355, USA
| | - C Sammarco
- Red Bank Veterinary Hospital, Tinton Falls, New Jersey, 07724, USA
| | - J Lustgarten
- Red Bank Veterinary Hospital, Tinton Falls, New Jersey, 07724, USA
| | - I Ljungvall
- Department of Clinical Sciences, University Animal Hospital, Swedish University of Agricultural Science, Uppsala, SE-750 07, Sweden
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Rohdin C, Häggström J, Ljungvall I, Nyman Lee H, De Decker S, Bertram S, Lindblad-Toh K, Hultin Jäderlund K. Presence of thoracic and lumbar vertebral malformations in pugs with and without chronic neurological deficits. Vet J 2018; 241:24-30. [DOI: 10.1016/j.tvjl.2018.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 09/08/2018] [Accepted: 09/11/2018] [Indexed: 02/08/2023]
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Höglund K, Häggström J, Hanås S, Merveille AC, Gouni V, Wiberg M, Lundgren Willesen J, Entee KM, Mejer Sørensen L, Tiret L, Seppälä EH, Lohi H, Chetboul V, Fredholm M, Lequarré AS, Ljungvall I. Interbreed variation in serum serotonin (5-hydroxytryptamine) concentration in healthy dogs. J Vet Cardiol 2018; 20:244-253. [PMID: 29921518 DOI: 10.1016/j.jvc.2018.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/04/2018] [Accepted: 05/14/2018] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Serotonin (5-hydroxytryptamine [5-HT]) has several biological functions. In different species, excessive 5-HT has been linked to valvular lesions, similar to those seen in dogs with myxomatous mitral valve disease. Previous studies suggest higher 5-HT in healthy Cavalier King Charles Spaniels (CKCSs), a breed highly affected by myxomatous mitral valve disease, compared to other breeds. OBJECTIVE To investigate potential interbreed variation in serum 5-HT in healthy dogs. ANIMALS 483 healthy dogs of nine breeds aged 1-7 years. METHODS Dogs were examined at five European centers. Absence of cardiovascular, organ-related, or systemic diseases was ensured by thorough clinical investigations including echocardiography. Serum was frozen and later analyzed by enzyme-linked immunosorbent assay (ELISA). RESULTS Median 5-HT concentration was 252.5 (interquartile range = 145.5-390.6) ng/mL. Overall breed difference was found (p<0.0001), and 42% of pairwise breed comparisons were significant. Univariate regression analysis showed association between serum 5-HT concentration and breed, center of examination, storage time, and sex, with higher 5-HT in females. In multiple regression analysis, the final model had an adjusted R2 of 0.27 with breed (p<0.0001), center (p<0.0001), and storage time (p=0.014) remaining significant. Within centers, overall breed differences were found at 3/5 centers (p≤0.028), and pairwise comparisons within those centers showed breed differences in 42% of comparisons. Among the included breeds, Newfoundlands, Belgian Shepherds and CKCSs had highest 5-HT concentrations. CONCLUSIONS Interbreed variation in serum 5-HT concentration was found in healthy dogs aged 1-7 years. These differences should be taken into account when designing clinical studies.
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Affiliation(s)
- K Höglund
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Science, Uppsala, Sweden.
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - S Hanås
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden; Evidensia Animal Clinic, 723 41 Västerås, Sweden
| | - A-C Merveille
- Department of Clinical Sciences, University of Liège, Belgium
| | - V Gouni
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie d'Alfort, Maisons-Alfort Cedex, France; Inserm, U955, Equipe 3, Créteil Cedex, France
| | - M Wiberg
- Department of Equine and Small Animal Medicine, University of Helsinki, Finland
| | - J Lundgren Willesen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - K Mc Entee
- Department of Clinical Sciences, University of Liège, Belgium; Laboratory of Physiology and Pharmacology, Université Libre de Bruxelles, Belgium
| | - L Mejer Sørensen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - L Tiret
- U955 IMRB, Team 10, Inserm, Ecole nationale vétérinaire d'Alfort, UPEC, Maisons-Alfort, France
| | - E H Seppälä
- Research Programs Unit, Molecular Neurology, University of Helsinki and Folkhälsan Institute of Genetics, Finland
| | - H Lohi
- Research Programs Unit, Molecular Neurology, University of Helsinki and Folkhälsan Institute of Genetics, Finland
| | - V Chetboul
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie d'Alfort, Maisons-Alfort Cedex, France; Inserm, U955, Equipe 3, Créteil Cedex, France
| | - M Fredholm
- Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
| | - A-S Lequarré
- Department of Clinical Sciences, University of Liège, Belgium
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
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Boswood A, Gordon SG, Häggström J, Wess G, Stepien RL, Oyama MA, Keene BW, Bonagura J, MacDonald KA, Patteson M, Smith S, Fox PR, Sanderson K, Woolley R, Szatmári V, Menaut P, Church WM, O'Sullivan ML, Jaudon JP, Kresken JG, Rush J, Barrett KA, Rosenthal SL, Saunders AB, Ljungvall I, Deinert M, Bomassi E, Estrada AH, Fernandez Del Palacio MJ, Moise NS, Abbott JA, Fujii Y, Spier A, Luethy MW, Santilli RA, Uechi M, Tidholm A, Schummer C, Watson P. Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study. J Vet Intern Med 2017; 32:72-85. [PMID: 29214723 PMCID: PMC5787203 DOI: 10.1111/jvim.14885] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/21/2017] [Accepted: 10/23/2017] [Indexed: 11/30/2022] Open
Abstract
Background Changes in clinical variables associated with the administration of pimobendan to dogs with preclinical myxomatous mitral valve disease (MMVD) and cardiomegaly have not been described. Objectives To investigate the effect of pimobendan on clinical variables and the relationship between a change in heart size and the time to congestive heart failure (CHF) or cardiac‐related death (CRD) in dogs with MMVD and cardiomegaly. To determine whether pimobendan‐treated dogs differ from dogs receiving placebo at onset of CHF. Animals Three hundred and fifty‐four dogs with MMVD and cardiomegaly. Materials and Methods Prospective, blinded study with dogs randomized (ratio 1:1) to pimobendan (0.4–0.6 mg/kg/d) or placebo. Clinical, laboratory, and heart‐size variables in both groups were measured and compared at different time points (day 35 and onset of CHF) and over the study duration. Relationships between short‐term changes in echocardiographic variables and time to CHF or CRD were explored. Results At day 35, heart size had reduced in the pimobendan group: median change in (Δ) LVIDDN −0.06 (IQR: −0.15 to +0.02), P < 0.0001, and LA:Ao −0.08 (IQR: −0.23 to +0.03), P < 0.0001. Reduction in heart size was associated with increased time to CHF or CRD. Hazard ratio for a 0.1 increase in ΔLVIDDN was 1.26, P = 0.0003. Hazard ratio for a 0.1 increase in ΔLA:Ao was 1.14, P = 0.0002. At onset of CHF, groups were similar. Conclusions and Clinical Importance Pimobendan treatment reduces heart size. Reduced heart size is associated with improved outcome. At the onset of CHF, dogs treated with pimobendan were indistinguishable from those receiving placebo.
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Affiliation(s)
- A Boswood
- department of Veterinary Clinical Sciences, The Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - S G Gordon
- Small Animal Clinical Science, Texas A&M University, College Station, TX
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - G Wess
- Clinic of Small Animal Medicine, University of Munich, Munich, Germany
| | - R L Stepien
- Medical Sciences, University of Wisconsin Madison School of Veterinary Medicine, Madison, WI
| | - M A Oyama
- Clinical Studies-Philadelphia, MJR-VHUP-Cardiology, University of Pennsylvania, Philadelphia, PA
| | - B W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - J Bonagura
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | | | - M Patteson
- HeartVets @ Vale Referrals, The Animal Hospital, Dursley, Gloucestershire, UK
| | - S Smith
- Sarah Smith Cardiology, Derby, UK
| | - P R Fox
- Animal Medical Center, New York, NY
| | - K Sanderson
- Rocky Mountain Veterinary Cardiology, Boulder, CO
| | - R Woolley
- Cardio Respiratory Pet Referrals Victoria, Mordialloc, Vic., Australia
| | - V Szatmári
- Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P Menaut
- Internal Medicine and Cardiology, Clinique Vétérinaire Aquivet, Eysines, France
| | - W M Church
- Desert Veterinary Medical Specialists, Phoenix, AZ
| | - M L O'Sullivan
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - J-P Jaudon
- Clinique Veterinaire Des Etangs, Villars Les Dombes, France
| | - J-G Kresken
- Clinic for Small Animals Kaiserberg, Duisburg, Germany
| | - J Rush
- Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA
| | - K A Barrett
- Cardiology, VCA West Los Angeles, Los Angeles, CA
| | | | - A B Saunders
- Small Animal Clinical Science, Texas A&M University, College Station, TX
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - M Deinert
- Tierklinik am Sandpfad, Wiesloch, Germany
| | - E Bomassi
- Cardiology, Centre Hospitalier Vétérinaire des Cordeliers, Meaux, France
| | - A H Estrada
- Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
| | | | - N S Moise
- Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - J A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA
| | - Y Fujii
- Surgery 1, Azabu University, Sagamihara, Kanagawa, Japan
| | - A Spier
- Blue Pearl Veterinary Partners, Tampa, FL
| | - M W Luethy
- Chicago Veterinary Emergency and Specialty Center, Chicago, IL
| | - R A Santilli
- Cardiology, Clinica Veterinaria Malpensa, Gallarate, Varese, Italy
| | - M Uechi
- Japan Animal Specialty Medical Institute Inc., JASMINE Veterinary Cardiovascular Medical Center, Yokohama, Japan
| | - A Tidholm
- Djursjukhuset Albano, Danderyd, Sweden
| | - C Schummer
- Animal Health, Boehringer Ingelheim, Ingelheim am Rhein, Germany
| | - P Watson
- Animal Health, Boehringer Ingelheim, Ingelheim am Rhein, Germany
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10
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Pelander L, Häggström J, Ley CJ, Ljungvall I. Cardiac Troponin I and Amino-Terminal Pro B-Type Natriuretic Peptide in Dogs With Stable Chronic Kidney Disease. J Vet Intern Med 2017; 31:805-813. [PMID: 28370332 PMCID: PMC5435054 DOI: 10.1111/jvim.14703] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/06/2017] [Accepted: 02/27/2017] [Indexed: 01/17/2023] Open
Abstract
Background Increased concentrations of N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and cardiac troponin I (cTnI) in dogs with azotemia have been documented. Knowledge of mechanisms behind increased concentrations of cardiac biomarkers in dogs with azotemia is warranted for correct interpretation of test results. Objectives The aim of the article was to investigate possible associations between plasma concentrations of cTnI and NT‐proBNP, respectively, and patient characteristics, glomerular filtration rate (GFR), a plasma volume factor (PVF) derived from scintigraphic examination (PVf), systolic blood pressure (SBP), selected hematologic and biochemical variables, and echocardiographic measurements in dogs with stable chronic kidney disease (CKD) and in healthy dogs. Animals Fifty student‐, staff‐, and client‐owned dogs were included. Twenty‐three of the dogs were healthy and 27 were diagnosed with CKD. Methods In this cross‐sectional observational study, dogs with a previous diagnosis of CKD and healthy control dogs were included. At inclusion, all dogs were characterized by physical examination, repeated blood pressure measurements, complete urinalysis, hematology and biochemistry panel, echocardiography, abdominal ultrasound examination of the entire urinary tract, and scintigraphic examination for measurement of GFR. Results Plasma volume factor and PCV were independently associated with NT‐proBNP (Radj2 = 0.42; P < .0001). Age, body weight (BW), and SBP were independently associated with cTnI (Radj2 = 0.50; P < .0001). Conclusions and Clinical Importance Neither NT‐proBNP nor cTnI concentrations were independently associated with measured GFR. Thus, findings were not suggestive of passive accumulation of either marker, suggesting that increased circulating concentrations of cTnI and NT‐proBNP can be interpreted similarly in dogs with stable CKD as in dogs without CKD.
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Affiliation(s)
- L Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - C J Ley
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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11
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Menciotti G, Borgarelli M, Aherne M, Wesselowski S, Häggström J, Ljungvall I, Lahmers S, Abbott J. Mitral valve morphology assessed by three-dimensional transthoracic echocardiography in healthy dogs and dogs with myxomatous mitral valve disease. J Vet Cardiol 2017; 19:113-123. [DOI: 10.1016/j.jvc.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 12/12/2016] [Accepted: 01/02/2017] [Indexed: 01/15/2023]
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12
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Tidholm A, Bodegård-Westling A, Höglund K, Häggström J, Ljungvall I. Real-Time 3-Dimensional Echocardiographic Assessment of Effective Regurgitant Orifice Area in Dogs With Myxomatous Mitral Valve Disease. J Vet Intern Med 2017; 31:303-310. [PMID: 28109120 PMCID: PMC5354031 DOI: 10.1111/jvim.14642] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 11/01/2016] [Accepted: 11/22/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Effective regurgitant orifice area (EROA), calculated from the vena contracta width (VCW) as the narrowest portion of the proximal regurgitant jet, might be used to estimate severity of mitral regurgitation. However, this simplified assumption only holds when the EROA is circular, which might not be true in dogs with myxomatous mitral valve disease (MMVD). HYPOTHESIS Effective regurgitant orifice area in dogs with MMVD is noncircular, and using color Doppler real-time 3-dimensional (RT3D) echocardiography, measured EROA in the en face view will be significantly different from calculated EROA. ANIMALS Hundred and fifty-eight privately owned dogs with naturally occurring MMVD. MATERIALS AND METHODS Prospective observational study comparing en face view of EROA with calculated EROA using VCW in 4-chamber (4Ch) and 2-chamber (2Ch) view only or combined 4Ch and 2Ch views using RT3D echocardiography. RESULTS The calculated EROA using the 2Ch view showed a systematic underestimation of 17% compared with the measured en face EROA corrected for body surface area. The calculated EROA using 4Ch and 4Ch + 2Ch views showed less agreement with the en face EROA, and the difference between methods increased with increasing EROA. The difference between calculated and measured EROA showed a systematic underestimation of the calculated EROA by 36% (4Ch) and 33% (4Ch + 2Ch), respectively, compared to measured en face EROA. CONCLUSION AND CLINICAL IMPORTANCE When replacing measured EROA with calculated EROA using VCW measurements, the 2Ch view is preferred in dogs with MMVD.
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Affiliation(s)
- A Tidholm
- Anicura Albano Animal Hospital, Danderyd, Sweden.,Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
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13
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Boswood A, Häggström J, Gordon SG, Wess G, Stepien RL, Oyama MA, Keene BW, Bonagura J, MacDonald KA, Patteson M, Smith S, Fox PR, Sanderson K, Woolley R, Szatmári V, Menaut P, Church WM, O'Sullivan ML, Jaudon JP, Kresken JG, Rush J, Barrett KA, Rosenthal SL, Saunders AB, Ljungvall I, Deinert M, Bomassi E, Estrada AH, Fernandez Del Palacio MJ, Moise NS, Abbott JA, Fujii Y, Spier A, Luethy MW, Santilli RA, Uechi M, Tidholm A, Watson P. Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study-A Randomized Clinical Trial. J Vet Intern Med 2016; 30:1765-1779. [PMID: 27678080 PMCID: PMC5115200 DOI: 10.1111/jvim.14586] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/08/2016] [Accepted: 08/23/2016] [Indexed: 11/27/2022] Open
Abstract
Background Pimobendan is effective in treatment of dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Its effect on dogs before the onset of CHF is unknown. Hypothesis/Objectives Administration of pimobendan (0.4–0.6 mg/kg/d in divided doses) to dogs with increased heart size secondary to preclinical MMVD, not receiving other cardiovascular medications, will delay the onset of signs of CHF, cardiac‐related death, or euthanasia. Animals 360 client‐owned dogs with MMVD with left atrial‐to‐aortic ratio ≥1.6, normalized left ventricular internal diameter in diastole ≥1.7, and vertebral heart sum >10.5. Methods Prospective, randomized, placebo‐controlled, blinded, multicenter clinical trial. Primary outcome variable was time to a composite of the onset of CHF, cardiac‐related death, or euthanasia. Results Median time to primary endpoint was 1228 days (95% CI: 856–NA) in the pimobendan group and 766 days (95% CI: 667–875) in the placebo group (P = .0038). Hazard ratio for the pimobendan group was 0.64 (95% CI: 0.47–0.87) compared with the placebo group. The benefit persisted after adjustment for other variables. Adverse events were not different between treatment groups. Dogs in the pimobendan group lived longer (median survival time was 1059 days (95% CI: 952–NA) in the pimobendan group and 902 days (95% CI: 747–1061) in the placebo group) (P = .012). Conclusions and Clinical Importance Administration of pimobendan to dogs with MMVD and echocardiographic and radiographic evidence of cardiomegaly results in prolongation of preclinical period and is safe and well tolerated. Prolongation of preclinical period by approximately 15 months represents substantial clinical benefit.
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Affiliation(s)
- A Boswood
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, SE
| | - S G Gordon
- Small Animal Clinical Science, Texas A&M University, College Station, TX
| | - G Wess
- Clinic of Small Animal Medicine, University of Munich, Munich, Germany
| | - R L Stepien
- Medical Sciences, University of Wisconsin Madison School of Veterinary Medicine, Madison, WI
| | - M A Oyama
- Clinical Studies-Philadelphia, MJR-VHUP-Cardiology, University of Pennsylvania, Philadelphia, PA
| | - B W Keene
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, NC
| | - J Bonagura
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH
| | | | - M Patteson
- HeartVets @ Vale Referrals, The Animal Hospital, Dursley, Gloucestershire, UK
| | - S Smith
- Sarah Smith Cardiology, Derby, UK
| | - P R Fox
- Animal Medical Center, New York, NY
| | - K Sanderson
- Rocky Mountain Veterinary Cardiology, Boulder, CO
| | - R Woolley
- Cardio Respiratory Pet Referrals Victoria, Mordialloc, Vic, Australia
| | - V Szatmári
- Faculty of Veterinary Medicine, Clinical Sciences of Companion Animals, Utrecht University, Utrecht, Utrecht, Netherlands
| | - P Menaut
- Internal Medicine and Cardiology, Clinique Vétérinaire Aquivet, Eysines, France
| | - W M Church
- Desert Veterinary Medical Specialists, Phoenix, AZ
| | - M L O'Sullivan
- Deptartment of Clinical Studies, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada
| | - J-P Jaudon
- Clinique Veterinaire Des Etangs, Villars Les Dombes, France
| | - J-G Kresken
- Clinic for Small Animals Kaiserberg, Duisburg, Germany
| | - J Rush
- Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA
| | - K A Barrett
- Cardiology, VCA West Los Angeles, Los Angeles, CA
| | | | - A B Saunders
- Small Animal Clinical Science, Texas A&M University, College Station, TX
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, SE
| | - M Deinert
- Tierklinik am Sandpfad, Wiesloch, Germany
| | - E Bomassi
- Cardiology, Centre Hospitalier Vétérinaire des Cordeliers, Meaux, France
| | - A H Estrada
- Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL
| | | | - N S Moise
- Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - J A Abbott
- Department of Small Animal Clinical Sciences, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA
| | - Y Fujii
- Azabu University, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - A Spier
- Blue Pearl Veterinary Partners, Tampa, FL
| | - M W Luethy
- Chicago Veterinary Emergency and Specialty Center, Chicago, IL
| | - R A Santilli
- Cardiology, Clinica Veterinaria Malpensa, Viale Marconi, Varese, Italy
| | - M Uechi
- JASMINE Veterinary Cardiovascular Medical Center, Japan Animal Specialty Medical Institute Inc., Yokohama, Japan
| | - A Tidholm
- Djursjukhuset Albano, Danderyd, Sweden
| | - P Watson
- Boehringer Ingelheim, Animal Health, Ingelheim am Rhein, Germany
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14
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Häggström J, Andersson ÅO, Falk T, Nilsfors L, OIsson U, Kresken JG, Höglund K, Rishniw M, Tidholm A, Ljungvall I. Effect of Body Weight on Echocardiographic Measurements in 19,866 Pure-Bred Cats with or without Heart Disease. J Vet Intern Med 2016; 30:1601-1611. [PMID: 27573384 PMCID: PMC5032876 DOI: 10.1111/jvim.14569] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 06/14/2016] [Accepted: 08/02/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Echocardiography is a cost-efficient method to screen cats for presence of heart disease. Current reference intervals for feline cardiac dimensions do not account for body weight (BW). OBJECTIVE To study the effect of BW on heart rate (HR), aortic (Ao), left atrial (LA) and ventricular (LV) linear dimensions in cats, and to calculate 95% prediction intervals for these variables in normal adult pure-bred cats. ANIMALS 19 866 pure-bred cats. METHODS Clinical data from heart screens conducted between 1999 and 2014 were included. Associations between BW, HR, and cardiac dimensions were assessed using univariate linear models and allometric scaling, including all cats, and only those considered normal, respectively. Prediction intervals were created using 95% confidence intervals obtained from regression curves. RESULTS Associations between BW and echocardiographic dimensions were best described by allometric scaling, and all dimensions increased with increasing BW (all P<0.001). Strongest associations were found between BW and Ao, LV end diastolic, LA dimensions, and thickness of LV free wall. Weak linear associations were found between BW and HR and left atrial to aortic ratio (LA:Ao), for which HR decreased with increasing BW (P<0.001), and LA:Ao increased with increasing BW (P<0.001). Marginal differences were found for prediction formulas and prediction intervals when the dataset included all cats versus only those considered normal. CONCLUSIONS AND IMPORTANCE BW had a clinically relevant effect on echocardiographic dimensions in cats, and BW based 95% prediction intervals may help in screening cats for heart disease.
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Affiliation(s)
- J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Uppsala, Sweden.
| | | | - T Falk
- Din Veterinär, Helsingborg, Sweden
| | | | | | - J G Kresken
- Clinic for Small Animals Kaiserberg, Duisburg, Germany
| | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Sciences, Uppsala, Sweden
| | - M Rishniw
- Veterinary Information Network, Davis, CA
| | - A Tidholm
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Uppsala, Sweden
- Albano Animal Hospital, Danderyd, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Uppsala, Sweden
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15
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Menciotti G, Borgarelli M, Aherne M, Häggström J, Ljungvall I, Lahmers S, Abbott J. Assessment of mitral valve morphology using three-dimensional echocardiography. Feasibility and reference values. J Vet Cardiol 2016; 18:156-67. [DOI: 10.1016/j.jvc.2015.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/23/2015] [Accepted: 11/23/2015] [Indexed: 01/04/2023]
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16
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Höglund K, Lequarré AS, Ljungvall I, Mc Entee K, Merveille AC, Wiberg M, Gouni V, Lundgren Willesen J, Hanås S, Wess G, Mejer Sørensen L, Tiret L, Kierczak M, Forsberg SKG, Seppälä E, Lindblad-Toh K, Lohi H, Chetboul V, Fredholm M, Häggström J. Effect of Breed on Plasma Endothelin-1 Concentration, Plasma Renin Activity, and Serum Cortisol Concentration in Healthy Dogs. J Vet Intern Med 2016; 30:566-73. [PMID: 26812988 PMCID: PMC4913606 DOI: 10.1111/jvim.13829] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND There are breed differences in several blood variables in healthy dogs. OBJECTIVE Investigate breed variation in plasma endothelin-1 (ET-1) concentration, plasma renin activity, and serum cortisol concentration. ANIMALS Five-hundred and thirty-one healthy dogs of 9 breeds examined at 5 centers (2-4 breeds/center). METHODS Prospective observational study. Circulating concentrations of ET-1 and cortisol, and renin activity, were measured using commercially available assays. Absence of organ-related or systemic disease was ensured by thorough clinical investigations, including blood pressure measurement, echocardiography, ECG, blood and urine analysis. RESULTS Median ET-1 concentration was 1.29 (interquartile range [IQR], 0.97-1.82) pg/mL, median cortisol concentration 46.0 (IQR, 29.0-80.8) nmol/L, and median renin activity 0.73 (IQR, 0.48-1.10) ng/mL/h in all dogs. Overall, breed differences were found in ET-1 and cortisol concentrations, and renin activity (P < .0001 for all). Pair-wise comparisons between breeds differed in 67% of comparisons for ET-1, 22% for cortisol, and 19% for renin activity, respectively. Within centers, breed differences were found at 5/5 centers for ET-1, 4/5 centers for cortisol, and 2/5 centers for renin activity. Newfoundlands had highest median ET-1 concentration, 3 times higher than Cavalier King Charles Spaniels, Doberman Pinschers, and Dachshunds. Median renin activity was highest in Dachshunds, twice the median value in Newfoundlands and Boxers. Median cortisol concentration was highest in Finnish Lapphunds, almost 3 times higher than in Boxers. CONCLUSIONS AND CLINICAL IMPORTANCE Breed variation might be important to take into consideration when interpreting test results in clinical studies.
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Affiliation(s)
- K Höglund
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - A-S Lequarré
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - I Ljungvall
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - K Mc Entee
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - A-C Merveille
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - M Wiberg
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - V Gouni
- Ecole nationale vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil, France.,Inserm, U955, Equipe 3, Créteil, France
| | - J Lundgren Willesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Hanås
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Evidensia Animal Clinic, Västerås, Sweden
| | - G Wess
- Ludwig-Maximilians-Universität, Munich, Germany
| | - L Mejer Sørensen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L Tiret
- Ecole nationale vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil, France.,Inserm, U955 IMRB, Equipe 10 BNMS, Créteil, France
| | - M Kierczak
- Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - S K G Forsberg
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - E Seppälä
- University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - K Lindblad-Toh
- Faculty of Medicine, Uppsala University, Uppsala, Sweden.,Broad Institute of MIT and Harvard, Cambridge, MA
| | - H Lohi
- University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - V Chetboul
- Ecole nationale vétérinaire d'Alfort, Université Paris-Est Créteil, Créteil, France.,Inserm, U955, Equipe 3, Créteil, France
| | - M Fredholm
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Häggström
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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17
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Porciello F, Rishniw M, Ljungvall I, Ferasin L, Haggstrom J, Ohad D. Sleeping and resting respiratory rates in dogs and cats with medically-controlled left-sided congestive heart failure. Vet J 2016; 207:164-168. [DOI: 10.1016/j.tvjl.2015.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/04/2015] [Accepted: 08/12/2015] [Indexed: 11/25/2022]
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18
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Borgarelli M, Abbott J, Braz-Ruivo L, Chiavegato D, Crosara S, Lamb K, Ljungvall I, Poggi M, Santilli RA, Haggstrom J. Prevalence and prognostic importance of pulmonary hypertension in dogs with myxomatous mitral valve disease. J Vet Intern Med 2015; 29:569-74. [PMID: 25818210 PMCID: PMC4895522 DOI: 10.1111/jvim.12564] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/08/2014] [Accepted: 01/28/2015] [Indexed: 12/31/2022] Open
Abstract
Background Pulmonary hypertension (PH) is common in dogs with myxomatous mitral valve disease (MMVD) but its effect on clinical outcome has not been investigated. Hypothesis/objectives The presence of PH worsens the outcome in dogs with MMVD. To compare survival times of dogs with MMVD and PH to those without PH. Animals Two hundred and twelve client‐owned dogs. Methods Case review study. Medical records of dogs diagnosed with ACVIM stage B2 and C MMVD between January 2010 and December 2011 were retrospectively reviewed. Long‐term outcome was determined by telephone interview or from the medical record. End of the observation period was March 2013. PH was identified if tricuspid regurgitation peak velocity was >3 m/s. Results Two hundred and twelve were identified. Eighty‐three dogs (39%) had PH. PH was more commonly identified in stage C compared to B2 (P < .0001). One hundred and five (49.5%) dogs died during the observation period. Median survival time for the entire study population was 567 days (95% CI 512–743). Stage C (P = .003), the presence of PH (P = .009), left atrial to aortic root ratio (LA/Ao) >1.7 (P = .0002), normalized left‐ventricular end‐diastolic diameter (LVEDn) >1.73 (P = .048), and tricuspid regurgitation pressure gradient (TRPG) >55 mmHg (P = .009) were associated with worse outcomes in the univariate analyses. The presence of TRPG >55 mmHg (HR 1.8 95% CI 1–2.9; P = .05) and LA/Ao > 1.7 (HR 2 95% CI 1.2–3.4; P = .01) remained significant predictors of worse outcome in the multivariate analysis. Conclusions and Clinical Importance In dogs with MMVD, moderate to severe PH worsens outcome.
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Affiliation(s)
- M Borgarelli
- Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA
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19
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Tidholm A, Höglund K, Häggström J, Ljungvall I. Diagnostic Value of Selected Echocardiographic Variables to Identify Pulmonary Hypertension in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med 2015; 29:1510-7. [PMID: 26365438 PMCID: PMC4895671 DOI: 10.1111/jvim.13609] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 07/21/2015] [Accepted: 08/03/2015] [Indexed: 11/27/2022] Open
Abstract
Background Pulmonary hypertension (PH) is commonly associated with myxomatous mitral valve disease (MMVD). Because dogs with PH present without measureable tricuspid regurgitation (TR), it would be useful to investigate echocardiographic variables that can identify PH. Aim To investigate associations between estimated systolic TR pressure gradient (TRPG) and dog characteristics and selected echocardiographic variables. Animals 156 privately owned dogs. Materials and Methods Prospective observational study comparing the estimations of TRPG with dog characteristics and selected echocardiographic variables in dogs with MMVD and measureable TR. Results Tricuspid regurgitation pressure gradient was significantly (P < .05) associated with body weight corrected right (RVIDDn) and left (LVIDDn) ventricular end‐diastolic and systolic (LVIDSn) internal diameters, pulmonary arterial (PA) acceleration to deceleration time ratio (AT/DT), heart rate, left atrial to aortic root ratio (LA/Ao), and the presence of congestive heart failure. Four variables remained significant in the multiple regression analysis with TRPG as a dependent variable: modeled as linear variables LA/Ao (P < .0001) and RVIDDn (P = .041), modeled as second order polynomial variables: AT/DT (P = .0039) and LVIDDn (P < .0001) The adjusted R2‐value for the final model was 0.45 and receiver operating characteristic curve analysis suggested the model's performance to predict PH, defined as 36, 45, and 55 mmHg as fair (area under the curve [AUC] = 0.80), good (AUC = 0.86), and excellent (AUC = 0.92), respectively. Conclusion and Clinical Importance In dogs with MMVD, the presence of PH might be suspected with the combination of decreased PA AT/DT, increased RVIDDn and LA/Ao, and a small or great LVIDDn.
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Affiliation(s)
- A Tidholm
- Albano Animal Hospital, Danderyd, Sweden.,Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - K Höglund
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Pelander L, Ljungvall I, Egenvall A, Syme H, Elliott J, Häggström J. Incidence of and mortality from kidney disease in over 600,000 insured Swedish dogs. Vet Rec 2015; 176:656. [PMID: 25940343 DOI: 10.1136/vr.103059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2015] [Indexed: 11/03/2022]
Abstract
Kidney disease is an important cause of morbidity and mortality in dogs. Knowledge about the epidemiology of kidney disease in the dog population is valuable and large-scale epidemiological studies are needed. The aim of the present study was to use insurance data to estimate kidney-related morbidity and mortality in the Swedish dog population. Insurance company data from insured dogs during the years 1995-2006 were studied retrospectively. Incidence and mortality were calculated for the whole group of dogs as well as divided by sex and breed. The total number of veterinary care insured dogs was 665,245. The total incidence of kidney disease in this group of dogs was 15.8 (15.3-16.2) cases/10,000 dog-years at risk. The number of dogs in the life insurance was 548,346 and in this group the total kidney-related mortality was 9.7 (9.3-10.2) deaths/10,000 dog-years at risk. The three breeds with the highest incidence of kidney disease were the Bernese mountain dog, miniature schnauzer and boxer. The three breeds with the highest mortality caused by kidney disease were the Bernese mountain dog, Shetland sheepdog and flat-coated retriever. In conclusion, the epidemiological information provided in this study concerning kidney disease in dogs can provide valuable information for future research.
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Affiliation(s)
- L Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - I Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - A Egenvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - H Syme
- Clinical Science and Services, Royal Veterinary College, North Mymms, UK
| | - J Elliott
- Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - J Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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21
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Ljungvall I, Rishniw M, Porciello F, Ferasin L, Ohad DG. Murmur intensity in small-breed dogs with myxomatous mitral valve disease reflects disease severity. J Small Anim Pract 2014; 55:545-50. [DOI: 10.1111/jsap.12265] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/17/2014] [Accepted: 07/21/2014] [Indexed: 11/27/2022]
Affiliation(s)
- I. Ljungvall
- Department of Clinical Sciences; University Animal Hospital, Swedish University of Agricultural Science; SE-750 07 Uppsala Sweden
| | - M. Rishniw
- Veterinary Information Network; Davis CA 95616 USA
| | - F. Porciello
- Department of Clinical Sciences; School of Veterinary Medicine, University of Perugia; Perugia 06100 Italy
| | - L. Ferasin
- Wey Referrals; 25 Chertsey Rd, Woking Surrey GU21 5BP
| | - D. G. Ohad
- Department of Clinical Sciences; The Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, Hebrew University of Jerusalem; Rehovot 76100 Israel
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22
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Cremer SE, Singletary GE, Olsen LH, Wallace K, Häggström J, Ljungvall I, Höglund K, Reynolds CA, Pizzinat N, Oyama MA. Serotonin concentrations in platelets, plasma, mitral valve leaflet, and left ventricular myocardial tissue in dogs with myxomatous mitral valve disease. J Vet Intern Med 2014; 28:1534-40. [PMID: 25146933 PMCID: PMC4895588 DOI: 10.1111/jvim.12420] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 05/08/2014] [Accepted: 06/19/2014] [Indexed: 11/29/2022] Open
Abstract
HYPOTHESIS/OBJECTIVES Altered serotonin (5-hydroxytryptamine, 5HT) signaling is postulated in development and progression of canine myxomatous mitral valve disease (MMVD). Little is known regarding platelet, plasma, valvular, or myocardial 5HT concentration ([5HT]) in affected dogs. We quantified [5HT] in platelet-rich plasma (PRP), platelet-poor plasma (PPP), mitral valve leaflets (MV), and left ventricular myocardium (LV). ANIMALS Forty-five dogs comprised 4 plasma groups of Cavalier King Charles Spaniels (CKCS) or non-CKCS, either healthy (CON) or MMVD affected: CKCS CON (n = 12); non-CKCS CON (n = 8); CKCS MMVD (n = 14); non-CKCS MMVD (n = 11). Twenty-four dogs comprised 3 tissue groups: MMVD (n = 8); other-HD (heart disease) (n = 7); non-HD, extracardiac disease (n = 9). METHODS High-performance liquid chromatography measured PRP, PPP, MV, and LV [5HT]. RESULTS Platelet-rich plasma platelet [5HT] was greater in CKCS CON (1.83 femtograms/platelet [fg/plt]; range, 0.20-4.76; P = .002), CKCS MMVD (1.58 fg/plt; range, 0.70-4.03; P = .005), and non-CKCS MMVD (1.72 fg/plt; range, 0.85-4.44; P = .003) versus non-CKCS CON (0.92 fg/plt; range, 0.63-1.30). There was no group difference in PPP [5HT]. MV [5HT] was significantly higher in MMVD (32.4 ng/mg; range, 8.4-106.7) versus non-HD (3.6 ng/mg; range, 0-28.3; P = .01) and LV [5HT] was significantly higher in MMVD (11.9 ng/mg; range, 4.0-104.8) versus other-HD (0.9 ng/mg; range, 0-10.1; P = .011) and non-HD (2.5 ng/mg; range, 0-6.9; P = .001). CONCLUSIONS AND CLINICAL IMPORTANCE Platelet [5HT] was highest in healthy CKCS and both MMVD groups, but plasma [5HT] showed no group differences. Tissue [5HT] was highest in MV and LV of MMVD-affected dogs, suggesting altered 5HT signaling as a potential feature of MMVD. Interactions of platelet, valvular, and myocardial 5HT signaling warrant further investigation.
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Affiliation(s)
- S E Cremer
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg, Denmark
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23
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Sjöstrand K, Wess G, Ljungvall I, Häggström J, Merveille AC, Wiberg M, Gouni V, Lundgren Willesen J, Hanås S, Lequarré AS, Mejer Sørensen L, Wolf J, Tiret L, Kierczak M, Forsberg S, McEntee K, Battaille G, Seppälä E, Lindblad-Toh K, Georges M, Lohi H, Chetboul V, Fredholm M, Höglund K. Breed differences in natriuretic peptides in healthy dogs. J Vet Intern Med 2014; 28:451-7. [PMID: 24495256 PMCID: PMC4857989 DOI: 10.1111/jvim.12310] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/26/2013] [Accepted: 12/18/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Measurement of plasma concentration of natriuretic peptides (NPs) is suggested to be of value in diagnosis of cardiac disease in dogs, but many factors other than cardiac status may influence their concentrations. Dog breed potentially is 1 such factor. OBJECTIVE To investigate breed variation in plasma concentrations of pro-atrial natriuretic peptide 31-67 (proANP 31-67) and N-terminal B-type natriuretic peptide (NT-proBNP) in healthy dogs. ANIMALS 535 healthy, privately owned dogs of 9 breeds were examined at 5 centers as part of the European Union (EU) LUPA project. METHODS Absence of cardiovascular disease or other clinically relevant organ-related or systemic disease was ensured by thorough clinical investigation. Plasma concentrations of proANP 31-67 and NT-proBNP were measured by commercially available ELISA assays. RESULTS Overall significant breed differences were found in proANP 31-67 (P < .0001) and NT-proBNP (P < .0001) concentrations. Pair-wise comparisons between breeds differed in approximately 50% of comparisons for proANP 31-67 as well as NT-proBNP concentrations, both when including all centers and within each center. Interquartile range was large for many breeds, especially for NT-proBNP. Among included breeds, Labrador Retrievers and Newfoundlands had highest median NT-proBNP concentrations with concentrations 3 times as high as those of Dachshunds. German Shepherds and Cavalier King Charles Spaniels had the highest median proANP 31-67 concentrations, twice the median concentration in Doberman Pinschers. CONCLUSIONS AND CLINICAL IMPORTANCE Considerable interbreed variation in plasma NP concentrations was found in healthy dogs. Intrabreed variation was large in several breeds, especially for NT-proBNP. Additional studies are needed to establish breed-specific reference ranges.
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Affiliation(s)
- K Sjöstrand
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Rasmussen CE, Falk T, Domanjko Petrič A, Schaldemose M, Zois NE, Moesgaard SG, Ablad B, Nilsen HY, Ljungvall I, Höglund K, Häggström J, Pedersen HD, Bland JM, Olsen LH. Holter monitoring of small breed dogs with advanced myxomatous mitral valve disease with and without a history of syncope. J Vet Intern Med 2014; 28:363-70. [PMID: 24417236 PMCID: PMC4857997 DOI: 10.1111/jvim.12290] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 10/08/2013] [Accepted: 11/26/2013] [Indexed: 11/30/2022] Open
Abstract
Background Syncope is a transient loss of consciousness occasionally occurring in dogs with advanced myxomatous mitral valve disease (MMVD). Objective (1) To study ECG changes during syncopal episodes in dogs with advanced MMVD and (2) to compare the occurrence of arrhythmias and changes in heart rate variability (HRV) between dogs with advanced MMVD with and without a history of syncope. Animals Forty‐three privately owned dogs (<15 kg) with advanced MMVD: 21 with and 22 without a history of syncope. Methods Prospective study with dogs recruited for an evaluation including history, physical examination, echocardiography, and arrhythmia and HRV analysis performed on 24‐hour Holter recordings. Results A syncopal episode was observed during Holter monitoring in 4 dogs: 3 dogs had sinus rhythm and 1 dog had sinus arrest followed by escape rhythm. An arrhythmia variable representing sinus arrhythmia was significantly lower in dogs with a history of syncope than in those without (P = .008). Eight of 26 HRV variables were significantly different between dogs with and without a history of syncope. Conclusions and Clinical Importance Compared with dogs without a history of syncope, dogs with advanced MMVD and a history of syncope did not have a higher occurrence of arrhythmias, but had less sinus arrhythmia, and had changes in HRV variables representing decreased overall HRV, decreased parasympathetic, and increased sympathetic modulation of heart rate.
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Affiliation(s)
- C E Rasmussen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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Häggström J, Lord PF, Höglund K, Ljungvall I, Jöns O, Kvart C, Hansson K. Short-term hemodynamic and neuroendocrine effects of pimobendan and benazapril in dogs with myxomatous mitral valve disease and congestive heart failure. J Vet Intern Med 2013; 27:1452-62. [PMID: 24128373 DOI: 10.1111/jvim.12217] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 08/12/2013] [Accepted: 09/04/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pimobendan and benazepril are frequently used with diuretics to treat dogs in congestive heart failure (CHF) caused by myxomatous mitral valve disease (MMVD). AIM To compare the short-term effects of pimobendan versus benazepril on pump function, heart size, and neuroendocrine profile in dogs with CHF caused by MMVD. ANIMALS Sixteen client-owned dogs. MATERIAL AND METHODS Seven-day prospective single-blinded study of dogs stabilized on furosemide monotherapy, randomized to pimobendan (0.4-0.6 mg/kg/day) or benazepril (0.25-1.0 mg/kg/day). Dogs had first-pass radionuclide angiocardiography, and heart size was measured by radiography and echocardiography. Circulating neuroendocrine hormones were measured. RESULTS Baseline variables did not differ between treatment groups. Greater decreases in the pimobendan than in the benazepril group were found for heart rate (P = .001), heart rate-normalized pulmonary transit time (P = .02), left atrial size (P = .03), and systolic and diastolic left ventricular diameters (P < .001 and P = .03, respectively) and volumes (P < .001 and P = .02, respectively), whereas ejection fraction increased more (P = .02) in the pimobendan group. Of the neuroendocrine hormones, only N-terminal proatrial natriuretic peptide (NT-ProANP) differed (P = .04) between groups. Within groups, plasma aldosterone increased (P = .01), and NT-proANP (P = .01) and NT-proB-type (P = .02) natriuretic peptide decreased in the pimobendan group, and NT-proANP (P = .02) and plasma vasopressin (P = .01) decreased in the benazepril group. CONCLUSIONS AND CLINICAL IMPORTANCE Pimobendan improves short-term cardiac function more than benazepril in dogs with CHF caused by MMVD. Pimobendan treatment enables the heart to work at smaller end-systolic and diastolic dimensions while maintaining adequate forward stroke volume. Some of the treatment responses found in neuroendocrine profile might have therapeutic relevance.
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Affiliation(s)
- J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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26
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Carnabuci C, Hanås S, Ljungvall I, Tidholm A, Bussadori C, Häggström J, Höglund K. Assessment of cardiac function using global and regional left ventricular endomyocardial and epimyocardial peak systolic strain and strain rate in healthy Labrador retriever dogs. Res Vet Sci 2013; 95:241-8. [DOI: 10.1016/j.rvsc.2013.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 02/01/2013] [Indexed: 01/21/2023]
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27
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Ljungvall I, Höglund K, Lilliehöök I, Oyama MA, Tidholm A, Tvedten H, Häggström J. Serum serotonin concentration is associated with severity of myxomatous mitral valve disease in dogs. J Vet Intern Med 2013; 27:1105-12. [PMID: 23865457 DOI: 10.1111/jvim.12137] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 04/26/2013] [Accepted: 05/28/2013] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The neurotransmitter serotonin (5-hydroxytryptamine, 5-HT) has recently been suggested to play a role in the development of naturally acquired myxomatous mitral valve disease (MMVD) in dogs. AIM To investigate the association between serum 5-HT concentration and MMVD severity in dogs, and to assess potential associations between serum 5-HT concentrations and dog characteristics, echocardiographic variables, heart rate, systolic blood pressure, presence of macrothrombocytosis, and plateletcrit. ANIMALS A total of 120 client-owned dogs. MATERIAL AND METHODS Dogs were prospectively recruited and were classified by standard echocardiography into healthy (dogs of breeds predisposed to MMVD, but without echocardiographic evidence of the disease), mild, moderate, or severe MMVD groups. Serum 5-HT concentrations were analyzed using an ELISA. RESULTS Dogs with severe MMVD had lower serum 5-HT concentrations than healthy dogs (P = .0025) and dogs with mild MMVD (P = .0011). Unilinear and multiple regression analyses showed that serum 5-HT concentrations decreased with increasing left atrial to aortic root ratio (LA/Ao), were higher in Cavalier King Charles Spaniel (CKCS) dogs compared to dogs of other breeds, and were higher in female dogs than in male dogs. The LA/Ao was the variable most strongly associated with serum 5-HT concentration. CONCLUSIONS AND CLINICAL IMPORTANCE The finding of higher serum 5-HT concentrations in dogs of breeds predisposed to the early onset of MMVD (CKCS) and dogs with mild MMVD suggests that alterations in 5-HT signaling might play a role in progression of early stages of MMVD.
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Affiliation(s)
- I Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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28
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Tidholm A, Höglund K, Häggström J, Bodegård-Westling A, Ljungvall I. Left Atrial Ejection Fraction Assessed by Real-Time 3-Dimensional Echocardiography in Normal Dogs and Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med 2013; 27:884-9. [DOI: 10.1111/jvim.12113] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 12/20/2012] [Accepted: 04/17/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - K. Höglund
- Department of Anatomy, Physiology and Biochemistry; Swedish University of Agricultural Sciences; Uppsala Sweden
| | - J. Häggström
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala Sweden
| | | | - I. Ljungvall
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala Sweden
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29
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Falk T, Ljungvall I, Zois N, Höglund K, Olsen L, Pedersen HD, Häggström J. Cardiac Troponin-I Concentration, Myocardial Arteriosclerosis, and Fibrosis in Dogs with Congestive Heart Failure because of Myxomatous Mitral Valve Disease. J Vet Intern Med 2013; 27:500-6. [DOI: 10.1111/jvim.12075] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 12/07/2012] [Accepted: 02/04/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- T. Falk
- Department of Clinical and Animal Sciences; Faculty of Health and Medical Sciences; University of Copenhagen; Fredriksberg Denmark
| | - I. Ljungvall
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala Sweden
| | - N.E. Zois
- Department of Clinical and Animal Sciences; Faculty of Health and Medical Sciences; University of Copenhagen; Fredriksberg Denmark
| | - K. Höglund
- Department of Anatomy; Physiology and Biochemistry; Swedish University of Agricultural Sciences; Uppsala Sweden
| | - L.H. Olsen
- Department of Veterinary Disease Biology; Faculty of Health and Medical Sciences; University of Copenhagen; Fredriksberg Denmark
| | | | - J. Häggström
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala Sweden
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30
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Höglund K, Hanås S, Carnabuci C, Ljungvall I, Tidholm A, Häggström J. Blood Pressure, Heart Rate, and Urinary Catecholamines in Healthy Dogs Subjected to Different Clinical Settings. J Vet Intern Med 2012; 26:1300-8. [DOI: 10.1111/j.1939-1676.2012.00999.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 06/15/2012] [Accepted: 08/13/2012] [Indexed: 11/27/2022] Open
Affiliation(s)
- K. Höglund
- Department of Anatomy, Physiology and Biochemistry; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - S. Hanås
- Strömsholm Specialist Animal Hospital Dog and Cat; Strömsholm; Sweden
| | - C. Carnabuci
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - I. Ljungvall
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - A. Tidholm
- Albano Animal Hospital; Danderyd; Sweden
| | - J. Häggström
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala; Sweden
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31
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Rishniw M, Ljungvall I, Porciello F, Häggström J, Ohad DG. Sleeping respiratory rates in apparently healthy adult dogs. Res Vet Sci 2012; 93:965-9. [PMID: 22240295 DOI: 10.1016/j.rvsc.2011.12.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/15/2011] [Accepted: 12/16/2011] [Indexed: 11/29/2022]
Abstract
Respiratory rate monitoring of cardiac patients is recommended by many cardiologists. However, little objective data exist about respiratory rates in apparently healthy dogs when collected in the home environment. We measured sleeping respiratory rates (SRR) in apparently healthy dogs and compared sleeping and resting respiratory rates (RRR) with a cross-sectional prospective study. Participants collected 12-14 one-minute SRR over a period ranging from 1 week to 2 months on 114 privately owned adult dogs. Selected participants simultaneously collected RRR. Mean within-dog average SRR (SRR(mean)) was 13breaths per minute (breaths/min). No dog had SRR(mean) >23 breaths/min; three dogs had instantaneous SRR measurements >30 breaths/min. Dogs had higher RRR(mean) (19 breaths/min) than SRR(mean) (15 breaths/min) (P<0.05). Canine SRR(mean) was unaffected by age, bodyweight or geographic location. Data acquisition was considered relatively simple by most participants. This study shows that apparently healthy adult dogs generally have SRR(mean) <30 breaths/min and rarely exceed this rate at any time.
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Affiliation(s)
- M Rishniw
- Veterinary Information Network, 777 West Covell Blvd, Davis, CA 95616, USA.
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32
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Tidholm A, Bodegård-Westling A, Höglund K, Ljungvall I, Häggström J. Comparisons of 2- and 3-Dimensional Echocardiographic Methods for Estimation of Left Atrial Size in Dogs with and without Myxomatous Mitral Valve Disease. J Vet Intern Med 2011; 25:1320-7. [DOI: 10.1111/j.1939-1676.2011.00812.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 07/24/2011] [Accepted: 08/15/2011] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - K. Höglund
- Department of Anatomy; Physiology and Biochemistry ; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - I. Ljungvall
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala; Sweden
| | - J. Häggström
- Department of Clinical Sciences; Faculty of Veterinary Medicine; Swedish University of Agricultural Sciences; Uppsala; Sweden
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Madsen MB, Olsen LH, Haggstrom J, Hoglund K, Ljungvall I, Falk T, Wess G, Stephenson H, Dukes-McEwan J, Chetboul V, Gouni V, Proschowsky HF, Cirera S, Karlskov-Mortensen P, Fredholm M. Identification of 2 Loci Associated with Development of Myxomatous Mitral Valve Disease in Cavalier King Charles Spaniels. J Hered 2011; 102 Suppl 1:S62-7. [DOI: 10.1093/jhered/esr041] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tidholm A, Westling A, Höglund K, Ljungvall I, Häggström J. Comparisons of 3-, 2-Dimensional, and M-Mode Echocardiographical Methods for Estimation of Left Chamber Volumes in Dogs with and without Acquired Heart Disease. J Vet Intern Med 2010; 24:1414-20. [DOI: 10.1111/j.1939-1676.2010.0596.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Affiliation(s)
- L. Pelander
- Department of Clinical Sciences; University of Agricultural Sciences; 750 07 Uppsala Sweden
| | - I. Ljungvall
- Department of Clinical Sciences; University of Agricultural Sciences; 750 07 Uppsala Sweden
| | - J. Häggström
- Department of Clinical Sciences; University of Agricultural Sciences; 750 07 Uppsala Sweden
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Ljungvall I, Höglund K, Tidholm A, Olsen L, Borgarelli M, Venge P, Häggström J. Cardiac Troponin I Is Associated with Severity of Myxomatous Mitral Valve Disease, Age, and C-Reactive Protein in Dogs. J Vet Intern Med 2010; 24:153-9. [DOI: 10.1111/j.1939-1676.2009.0428.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Tidholm A, Ljungvall I, Höglund K, Westling A, Häggström J. Tissue Doppler and Strain Imaging in Dogs with Myxomatous Mitral Valve Disease in Different Stages of Congestive Heart Failure. J Vet Intern Med 2009; 23:1197-207. [DOI: 10.1111/j.1939-1676.2009.0403.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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