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A Case of a Small-Breed Dog with Diet-Related Dilated Cardiomyopathy Showing Marked Improvements in Cardiac Morphology and Function after Dietary Modification. Vet Sci 2022; 9:vetsci9110593. [DOI: 10.3390/vetsci9110593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/03/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
An 11-year-old intact female Papillion weighing 2.1 kg was referred to our institution with the main complaint of shallow, rapid breathing. At the first visit (day 0), although clinical signs improved due to the use of medication from the primary hospital, transthoracic radiography and echocardiography revealed left heart enlargement and left ventricular dysfunction. A clinical diagnosis of dilated cardiomyopathy (DCM) was made and oral administration of pimobendan, temocapril, and taurine was initiated. However, on day 10, the respiratory status worsened and furosemide was prescribed. On day 54, no significant improvement in heart size was observed. Additionally, the diet that this patient received met the recommendation for diet-related DCM by the U.S. Food and Drug Administration, and the patient’s diet was changed from a grain-free diet to a grain-containing diet. On day 1191, the patient’s respiratory status was stable and no clinical signs were observed. Transthoracic radiography and echocardiography revealed an improvement in left heart size. Additionally, improvements in the left and right ventricular myocardial strains were observed after changing the diet. We suggest that it may be necessary to suspect a dietary association with dilated cardiomyopathy, and a good prognosis might be expected by dietary modification, even in small-breed dogs.
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Role of Two-Dimensional Speckle-Tracking Echocardiography in Early Detection of Left Ventricular Dysfunction in Dogs. Animals (Basel) 2021; 11:ani11082361. [PMID: 34438818 PMCID: PMC8388726 DOI: 10.3390/ani11082361] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/24/2021] [Accepted: 08/07/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Two-dimensional speckle-tracking echocardiography represents an advanced imaging technique that allows the analysis of global and regional myocardial function, cardiac rotation and synchronicity using deformation imaging. It has gained growing importance over the last decade, especially in human medicine as a method of evaluating myocardial function. This review aims to give an overview of the current understanding of this technique and its clinical applicability in the field of veterinary medicine with a focus on early detection of left ventricular dysfunction in dogs. Abstract Two-dimensional speckle-tracking echocardiography (2D–STE) is an advanced echocardiographic technique based on deformation imaging that allows comprehensive evaluation of the myocardial function. Clinical application of 2D–STE holds great potential for its ability to provide valuable information on both global and regional myocardial function and to quantify cardiac rotation and synchronicity, which are not readily possible with the conventional echocardiography. It has gained growing importance over the past decade, especially in human medicine, and its application includes assessment of myocardial function, detection of subclinical myocardial dysfunction and serving as a prognostic indicator. This review illustrates the fundamental concepts of deformation analysis and gives an overview of the current understanding and its clinical application of this technique in veterinary medicine, with a focus on early detection of left ventricular (LV) dysfunction in dogs.
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Morita T, Nakamura K, Osuga T, Takiguchi M. Repeatability, reproducibility, and reference intervals for indices of right atrial longitudinal strain derived from speckle-tracking echocardiography in healthy dogs. Am J Vet Res 2021; 82:274-279. [PMID: 33764827 DOI: 10.2460/ajvr.82.4.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine repeatability, reproducibility, and reference intervals of indices of right atrial longitudinal strain (RALS) derived from speckle-tracking echocardiography (STE) in dogs without heart disease. ANIMALS 110 client-owned dogs and 10 laboratory Beagles. PROCEDURES To determine intraobserver within-day (repeatability) and interobserver (reproducibility) coefficients of variation, RALS during ventricular systole (ϵS), ventricular early diastole (ϵE), and atrial systole (ϵA), as derived with STE, were obtained by 2 investigators for 5 randomly selected client-owned dogs and analyzed by linear regression. Reference intervals were estimated from the results of all dogs. Correlations between RALS indices (ϵS, ϵE, and ϵA) and sex, age, body weight, heart rate, and blood pressure were determined. RESULTS RALS derived from STE showed good intraobserver within-day repeatability and interobserver reproducibility, with coefficients of variation of < 20%. Both ϵS and ϵE were significantly negatively correlated with age, but ϵA was not correlated with age. Indices were not correlated with sex, body weight, or blood pressure. CONCLUSIONS AND CLINICAL RELEVANCE RALS indices derived from STE were repeatable and reproducible and were affected by the age of dogs without heart disease. Age should be considered in the interpretation of RALS indices in clinical settings. Further studies are needed to apply RALS indices for assessing dogs with heart disease.
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Vatnikov YA, Rudenko AA, Usha BV, Kulikov EV, Notina EA, Bykova IA, Khairova NI, Bondareva IV, Grishin VN, Zharov AN. Left ventricular myocardial remodeling in dogs with mitral valve endocardiosis. Vet World 2020; 13:731-738. [PMID: 32546918 PMCID: PMC7245723 DOI: 10.14202/vetworld.2020.731-738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/06/2020] [Indexed: 01/19/2023] Open
Abstract
Background and Aim: Left ventricular myocardial remodeling could play an important role in the progression of chronic heart failure (CHF) syndrome in dogs with mitral valve endocardiosis. The aim of this study was to evaluate the left ventricular myocardial remodeling in dogs with mitral valve endocardiosis and to study the dependence of the incidence of this pathological phenomenon on the functional class (FC) of progression of the CHF syndrome. Materials and Methods: A total of 108 afflicted dogs and 36 clinically healthy dogs were examined using transthoracic echocardiography. The following structural and geometric parameters of the left ventricular remodeling were evaluated: Myocardial mass and its index, sphericity index at the end of systole and diastole, end-systolic and end-diastolic relative wall thickness, and integral remodeling index. Results: In all clinically healthy dogs, a normal type of the left ventricular chamber geometry was revealed, whereas, in dogs with mitral valve endocardiosis, the normal geometry of the left ventricle occurred in 56.4%, eccentric hypertrophy in 24.1%, concentric remodeling in 10.2%, and concentric hypertrophy in 9.3% of the cases. In patients with endocardiosis, there was no dilatation type of cardiac remodeling observed. Conclusion: When compared to the clinically healthy animals, the dogs with mitral valve endocardiosis presented with indicators of structural and geometric remodeling, such as increased myocardial mass, myocardial mass index, and sphericity index at the end of systole and diastole, as well as relatively reduced integral systolic index of remodeling and systolic relative thickness of the walls of the heart. The parameters of the left ventricular myocardial remodeling correlated significantly with the FC of CHF syndrome.
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Affiliation(s)
- Yury A Vatnikov
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Andrey A Rudenko
- Department of Veterinary Medicine, Moscow State University of Food Production, 125080 Moscow, Russia
| | - Boris V Usha
- Department of Veterinary Medicine, Moscow State University of Food Production, 125080 Moscow, Russia
| | - Evgeny V Kulikov
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Elena A Notina
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Irina A Bykova
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Nadiya I Khairova
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Irina V Bondareva
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Victor N Grishin
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Andrey N Zharov
- Department of Veterinary Medicine, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia
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Decloedt A, Ven S, De Clercq D, Rademakers F, van Loon G. Assessment of left ventricular function in horses with aortic regurgitation by 2D speckle tracking. BMC Vet Res 2020; 16:93. [PMID: 32197611 PMCID: PMC7085189 DOI: 10.1186/s12917-020-02307-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/10/2020] [Indexed: 12/26/2022] Open
Abstract
Background Aortic regurgitation (AR) may lead to left ventricular (LV) dilatation, cardiac arrhythmias and heart failure. Close follow-up of horses with AR is therefore paramount to detect onset of cardiac decompensation. The aim of this study was to examine whether two-dimensional speckle tracking (2DST) can be used to detect altered myocardial function in horses with chronic AR compared to control horses. Speckle tracking was performed on short axis and long axis images of the LV in 29 healthy Warmblood horses and 57 Warmblood horses with AR. Radial, circumferential and longitudinal strain, strain rate and displacement were measured for each segment separately and the average was calculated over all segments. Data generated from the apical segments were not included in the analysis. Results Radial (SR) and circumferential (SC) strain were significantly higher in horses with moderate AR (average SR 75.5 ± 24.3%, SC 19.3 ± 3.2%) but not in horses with severe AR (SR 65.5 ± 26.2%, SC 16.3 ± 3.5%), compared to control horses (SR 54.5 ± 18.0%, SC 16.8 ± 3.0%). Longitudinal strain did not show significant differences, but longitudinal displacement (DL) was larger in horses with moderate (average DL 29.5 ± 4.1 cm) and severe AR (DL 32.4 ± 6.1 cm) compared to control horses (DL 25.7 ± 4.0 cm), especially in the interventricular septum. Diastolic longitudinal strain rate was lower in early diastole in horses with severe AR (0.93 ± 0.18/s) compared to controls (1.13 ± 0.13/s). Conclusions 2DST is able to detect altered myocardial motion in horses with AR, which showed significantly higher radial and circumferential strain. Further research is needed to determine whether these findings contribute to a more accurate diagnosis and prognosis in clinical cases.
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Affiliation(s)
- A Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
| | - S Ven
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - D De Clercq
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - F Rademakers
- Division of Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Santarelli G, Baron Toaldo M, Bouvard J, Glaus TM, Fernández Del Palacio J. Variability among strain variables derived from two-dimensional speckle tracking echocardiography in dogs by use of various software. Am J Vet Res 2019; 80:347-357. [PMID: 30919673 DOI: 10.2460/ajvr.80.4.347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine variability of global longitudinal strain (GLS) and strain rate (SR) measurements in dogs with and without cardiac disease derived from 2-D speckle tracking echocardiography (STE) by use of various software. ANIMALS 2 cohorts comprising 44 dogs (23 cardiovascularly healthy and 21 with cardiac disease) and 40 dogs (18 cardiovascularly healthy and 22 with cardiac disease). PROCEDURES Transthoracic echocardiographic images in each cohort were analyzed with vendor-independent software and vendor-specific 2-D STE software for each of 2 vendors. Values for GLS and SR obtained from the same left parasternal apical views with various software were compared. Intraobserver and interobserver variability was determined, and agreement among results for the various software was assessed. RESULTS Strain analysis was not feasible with vendor-independent software for 20% of images obtained with the ultrasonography system of vendor 1. Intraobserver and interobserver coefficient of variation was < 10% for GLS values, whereas SR measurements had higher variance. There was a significant difference in GLS and SR obtained for each cohort with different software. Evaluation of Bland-Altman plots revealed wide limits of agreement, with variance for GLS of up to 6.3 units in a single dog. CONCLUSIONS AND CLINICAL RELEVANCE Results of longitudinal strain analysis were not uniform among software, and GLS was the most reproducible measurement. Significant variability in results among software warrants caution when referring to reference ranges or comparing serial measurements in the same patient because changes of < 6.5% in GLS might be within measurement error for different postprocessing software.
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Usefulness of pulsed-wave tissue Doppler imaging at the mitral annulus for prediction of new-onset atrial fibrillation in dogs. J Vet Cardiol 2018; 20:425-437. [DOI: 10.1016/j.jvc.2018.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/19/2022]
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Evaluation of the right parasternal four-chamber view for the assessment of left ventricular longitudinal strain and strain rate by two-dimensional speckle tracking echocardiography in dogs. Res Vet Sci 2018; 120:78-85. [PMID: 30268987 DOI: 10.1016/j.rvsc.2018.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 08/09/2018] [Accepted: 08/30/2018] [Indexed: 11/21/2022]
Abstract
Two-dimensional (2-D) speckle tracking echocardiography (STE) is a relatively new imaging technique, introduced in veterinary medicine to aid the assessment of left ventricular (LV) myocardial function. Among other indices, LV longitudinal strain and strain rate (SR) can be measured with this modality, and in dogs they are usually obtained from the left apical four-chamber (LAp4Ch) view. However, in this species, a good quality right parasternal four-chamber (RP4Ch) view can generally be attained, and the aim of this study was therefore to determine its feasibility and reliability for longitudinal strain and SR assessment, and to establish whether the two projections can be used interchangeably. Fifty-one healthy dogs and twenty-five dogs with various cardiac diseases were examined. Longitudinal global and segmental strains and global SR of the LV were obtained with 2-D STE by use of RP4Ch and LAp4Ch views. Intra-observer (within-day and between-day) and inter-observer variabilities were established, and strain and SR values obtained from the two views were compared. The RP4Ch view demonstrated to be feasible for the assessment of longitudinal strain and SR by use of 2-D STE in healthy and diseased dogs. However, out of sector motion of the apical segments could occur and induce tracking errors. The deformation parameters obtained from this view and the LAp4Ch view were often significantly different, and therefore they should not be used interchangeably. Further, the software employed in the present study performed better global than segmental strain analysis for both views.
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Spalla I, Locatelli C, Zanaboni AM, Brambilla P, Bussadori C. Echocardiographic Assessment of Cardiac Function by Conventional and Speckle-Tracking Echocardiography in Dogs with Patent Ductus Arteriosus. J Vet Intern Med 2018; 30:706-13. [PMID: 27177624 PMCID: PMC4913585 DOI: 10.1111/jvim.13938] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 02/01/2016] [Accepted: 03/02/2016] [Indexed: 11/28/2022] Open
Abstract
Background Patent ductus arteriosus (PDA) is one of the most common congenital heart defects in dogs. Advanced echocardiographic techniques such as speckle‐tracking echocardiography (STE) have not been extensively used to evaluate cardiac function in affected dogs. Hypothesis Advanced echocardiographic techniques are more sensitive than standard echocardiographic techniques in analyzing systolic function in dogs with PDA. Animals Forty‐four client‐owned dogs: 34 dogs with PDA (preoperative evaluation) and 10 healthy sex‐ and weight‐matched controls. Methods Prospective study. Dogs were recruited over a 2‐year period. Complete echocardiographic evaluation was performed, including conventional (end‐diastolic volumes indexed to body surface area in B and M‐mode [EDVIB/M], end‐systolic volumes indexed to body surface area in B and M‐mode [ESVIB/M], allometric scaling in diastole and systole [AlloD/S], pulmonary flow to systemic flow [Qp/Qs], ejection fraction [EF] and fractional shortening [FS]) and speckle‐tracking echocardiography ([STE]: global longitudinal, radial and circumferential strain [S] and strain rate [SR]). Results Dogs with PDA had significantly different EDVIB/M, ESVIB/M, AlloD/S, Qp/Qs and all STE‐derived parameters (global longitudinal S and SR, global circumferential S and SR, global radial S and SR)compared to healthy dogs. No correlation was found between standard techniques (EDVIB/M, ESVIB/M, AlloD/S, Qp/Qs) and STE‐derived parameters (global longitudinal, circumferential and radial S and SR). Conclusion and Clinical Importance Conventional parameters routinely used to assess systolic function (EF and FS) were not different between the groups; STE‐derived parameters identified subtle changes in cardiac systolic function and contractility between the 2 groups of dogs. Based on these findings, STE may be a more appropriate tool to assess cardiac contractility in dogs with PDA.
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Affiliation(s)
- I Spalla
- Università degli Studi di Milano, Gallarate, Italy
| | - C Locatelli
- Università degli Studi di Milano, Gallarate, Italy
| | - A M Zanaboni
- Università degli Studi di Milano, Gallarate, Italy
| | - P Brambilla
- Università degli Studi di Milano, Gallarate, Italy
| | - C Bussadori
- Clinica Veterinaria Gran Sasso, Milano, Italy
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Menciotti G, Borgarelli M. Review of Diagnostic and Therapeutic Approach to Canine Myxomatous Mitral Valve Disease. Vet Sci 2017; 4:vetsci4040047. [PMID: 29056705 PMCID: PMC5753627 DOI: 10.3390/vetsci4040047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/09/2017] [Accepted: 09/20/2017] [Indexed: 01/11/2023] Open
Abstract
The most common heart disease that affects dogs is myxomatous mitral valve disease. In this article, we review the current diagnostic and therapeutic approaches to this disease, and we also present some of the latest technological advancements in this field.
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Affiliation(s)
- Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
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Dickson D, Shave R, Rishniw M, Patteson M. Echocardiographic assessments of longitudinal left ventricular function in healthy English Springer spaniels. J Vet Cardiol 2017; 19:339-350. [DOI: 10.1016/j.jvc.2017.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/15/2017] [Accepted: 04/10/2017] [Indexed: 11/27/2022]
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The repeatability and characteristics of right ventricular longitudinal strain imaging by speckle-tracking echocardiography in healthy dogs. J Vet Cardiol 2017; 19:351-362. [DOI: 10.1016/j.jvc.2017.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 11/19/2022]
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Santarelli G, López JT, del Palacio JF. Effects of a combination of acepromazine maleate and butorphanol tartrate on conventional and two-dimensional speckle tracking echocardiography in healthy dogs. Am J Vet Res 2017; 78:158-167. [DOI: 10.2460/ajvr.78.2.158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dickson D, Shave R, Rishniw M, Harris J, Patteson M. Reference intervals for transthoracic echocardiography in the English springer spaniel: a prospective, longitudinal study. J Small Anim Pract 2016; 57:520-528. [DOI: 10.1111/jsap.12536] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/28/2016] [Accepted: 05/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | - R. Shave
- Cardiff School of Sport; Cardiff Metropolitan University; Cardiff CF23 6XD
| | - M. Rishniw
- Veterinary Information Network; Davis CA 95616 USA
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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] [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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Caivano D, Rishniw M, Patata V, Giorgi M, Birettoni F, Porciello F. Left atrial deformation and phasic function determined by 2-dimensional speckle tracking echocardiography in healthy dogs. J Vet Cardiol 2016; 18:146-55. [DOI: 10.1016/j.jvc.2016.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
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Visser LC, Im MK, Johnson LR, Stern JA. Diagnostic Value of Right Pulmonary Artery Distensibility Index in Dogs with Pulmonary Hypertension: Comparison with Doppler Echocardiographic Estimates of Pulmonary Arterial Pressure. J Vet Intern Med 2016; 30:543-52. [PMID: 26893108 PMCID: PMC4913611 DOI: 10.1111/jvim.13911] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/01/2015] [Accepted: 01/28/2016] [Indexed: 11/28/2022] Open
Abstract
Background Noninvasive diagnosis of pulmonary hypertension (PH) primarily relies upon Doppler echocardiography of tricuspid regurgitation (TR). However, TR might be absent or difficult to measure. Hypothesis/Objectives To determine the diagnostic value of right pulmonary artery distensibility (RPAD) index for prediction of Doppler‐derived estimates of pulmonary artery (PA) pressure compared to other indices of PH in dogs. Animals Sixty‐nine client‐owned dogs with TR. Methods Prospective observational study. Dogs were allocated to groups according to TR pressure gradient (TRPG): TRPG <36 mmHg (control, n = 22), TRPG 36–50 (n = 16), TRPG 50–75 (n = 14) and TRPG >75 mmHg (n = 17). Right pulmonary artery distensibility index, acceleration time to peak PA flow (AT), AT: ejection time of PA flow (AT:ET) and main PA size: aorta size (MPA:Ao) were calculated in each dog. Results Right pulmonary artery distensibility index demonstrated the strongest correlation (r = −0.90; P < .0001) to TRPG followed by MPA:Ao (r = 0.78; P < .0001), AT (r = −0.69; P < .0001) and AT:ET (r = −0.68; P < .0001). RPAD index possessed the most accurate cutoff (<29.5%; Sensitivity [Sn] 0.84, Specificity [Sp] 0.95) to predict TRPG >50 mmHg compared to AT (<53.9 ms; Sn 0.74, Sp 0.87), AT:ET (<0.30; Sn 0.61, Sp 0.97) and MPA:Ao (>1.04; Sn 0.94, Sp 0.74). All intra‐ and interobserver measurement variabilities exhibited coefficients of variation ≤13%. Conclusions and Clinical Importance Right pulmonary artery distensibility index is an accurate predictor of TRPG and should be particularly useful if TR is absent or difficult to measure.
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Affiliation(s)
- L C Visser
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - M K Im
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - L R Johnson
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - J A Stern
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA
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Al-Wakeel N, Fernandes JF, Amiri A, Siniawski H, Goubergrits L, Berger F, Kuehne T. Hemodynamic and energetic aspects of the left ventricle in patients with mitral regurgitation before and after mitral valve surgery. J Magn Reson Imaging 2015; 42:1705-12. [DOI: 10.1002/jmri.24926] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/07/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Nadya Al-Wakeel
- German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology; Berlin Germany
| | - Joao Filipe Fernandes
- German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology; Berlin Germany
| | - Aref Amiri
- German Heart Institute Berlin, Department of Cardiothoracic and Vascular Surgery; Berlin Germany
| | - Henryk Siniawski
- German Heart Institute Berlin, Department of Cardiothoracic and Vascular Surgery; Berlin Germany
| | - Leonid Goubergrits
- German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology; Berlin Germany
| | - Felix Berger
- German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology; Berlin Germany
| | - Titus Kuehne
- German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology; Berlin Germany
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Chen HY, Lien YH, Huang HP. Assessment of left ventricular function by two-dimensional speckle-tracking echocardiography in small breed dogs with hyperadrenocorticism. Acta Vet Scand 2014; 56:88. [PMID: 25551792 PMCID: PMC4300024 DOI: 10.1186/s13028-014-0088-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 12/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyperadrenocorticism (HAC) is associated with an increased prevalence of hypertension. This study investigated the left ventricular function using two-dimensional speckle-tracking echocardiography (2D-STE) in small breed dogs affected with spontaneous HAC. Age-matched healthy controls (n = 9), dogs with pituitary-dependent hyperadrenocorticism (PDH, n = 10), and dogs with adrenal-dependent hyperadrenocorticism (ADH, n = 9) were included in this study. Conventional echocardiography, global longitudinal and circumferential strain, and strain rate were assessed. RESULTS On group-wise comparison, left ventricular free wall (LVFWd) and interventricular septal thickness in diastole (IVSd) were thickest in the ADH group, followed by the PDH and controls (P = 0.014 and P = 0.001, respectively). Neither LVFWd nor IVSd was correlated with systemic blood pressure (P = 0.238 and P = 0.113, respectively). The values of all variables derived from the global strain and strain rate in longitudinal and circumferential directions followed the same pattern: highest in the controls, followed by PDH and then ADH (all P < 0.05, respectively). On multiple regression analyses, global longitudinal strain, global longitudinal strain rate in systole and early diastole, and global circumferential strain all decreased linearly with increased IVSd (all P < 0.05). CONCLUSIONS Left ventricular hypertrophy (LVH) was more prevalent in the HAC group compared to the control group. Association between hypertension and development of LVH was not identified. Decreased global longitudinal and circumferential strains were associated with increased IVSd. 2D-STE revealed significant decreases in systolic functions that were undetected using conventional echocardiography in the ADH and PDH groups.
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Echocardiographic assessment of left ventricular function in mitral regurgitation. Cardiovasc Endocrinol 2014. [DOI: 10.1097/xce.0000000000000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Longitudinal strain and strain rate by two-dimensional speckle tracking in non-sedated healthy cats. Res Vet Sci 2013; 95:1175-80. [DOI: 10.1016/j.rvsc.2013.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 06/15/2013] [Accepted: 07/16/2013] [Indexed: 11/22/2022]
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Suzuki R, Matsumoto H, Teshima T, Koyama H. Effect of age on myocardial function assessed by two-dimensional speckle-tracking echocardiography in healthy beagle dogs. J Vet Cardiol 2013; 15:243-52. [PMID: 24054982 DOI: 10.1016/j.jvc.2013.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 05/15/2013] [Accepted: 07/07/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the effect of age on myocardial function assessed by two-dimensional speckle-tracking echocardiography (2D-STE) in healthy dogs. ANIMALS Thirty-two healthy Beagles were used. METHODS Myocardial function was assessed in each dog by using 2D-STE, and the results were compared between young and old dogs. RESULTS The myocardial deformations in systole, besides the apical rotation rate, were not significantly different between young and old dogs. In contrast, the early diastolic circumferential strain rate, basal rotation rate, and torsion rate were significantly lower in old dogs than in young dogs (P = 0.03, P = 0.033, and P = 0.015, respectively). Late diastolic longitudinal and radial strain rates were significantly higher in old dogs than in young dogs (P = 0.002 and P = 0.018, respectively). CONCLUSIONS Young and old dogs showed similar systolic myocardial deformations, but significant differences in the values of some diastolic deformation variables were found between young and old dogs, highlighting the need for using age-matched control subjects in studies of diastolic function.
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Affiliation(s)
- Ryohei Suzuki
- Division of Veterinary Internal Medicine, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan.
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Zois NE, Olsen NT, Moesgaard SG, Rasmussen CE, Falk T, Häggström J, Pedersen HD, Møller JE, Olsen LH. Left ventricular twist and circumferential strain in dogs with myxomatous mitral valve disease. J Vet Intern Med 2013; 27:875-83. [PMID: 23731222 DOI: 10.1111/jvim.12114] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 02/24/2013] [Accepted: 04/17/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND During the cardiac cycle, the ventricle undergoes a twisting motion because of the oblique orientation of the left ventricular (LV) myofibers. This can be quantified by speckle-tracking echocardiography (STE). In mitral regurgitation (MR) in humans, the short axis deformation has been suggested as being pivotal to LV function. Decreased and delayed LV twist has been described in experimental MR, but has not been studied in myxomatous mitral valve disease (MMVD). HYPOTHESES (1) Magnitude (CSt) and rate (CSRs) of systolic circumferential deformation decrease before the onset of congestive heart failure (CHF); (2) magnitude and rate of LV twist decrease, and onset of untwist is delayed, with increasing MMVD severity. ANIMALS A total of 97 privately owned small- to medium-sized dogs. METHODS Severity of MMVD was assessed by echocardiography and presence of clinical signs of CHF. Magnitude and rate of LV twist and circumferential deformation were evaluated by STE. RESULTS Dogs with CHF receiving treatment had increased CSt, CSRs, early diastolic untwisting rate, and delayed onset of untwist compared to dogs with minimal MMVD and increased systolic twist compared to dogs with mild MMVD (all P < .01). CSt and time to onset of untwist increased with echocardiographic variables of MR severity (all P < .002). CSRs and several LV twist variables decreased with increasing systolic LV internal diameter (all P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE No STE-derived variable was decreased before onset of CHF. In dogs with CHF receiving treatment, the delayed onset of relaxation might indicate LV dysfunction and the hyperdynamic CSt and LV twist reflect compensatory mechanisms.
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Affiliation(s)
- N E Zois
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
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Suzuki R, Matsumoto H, Teshima T, Koyama H. Clinical assessment of systolic myocardial deformations in dogs with chronic mitral valve insufficiency using two-dimensional speckle-tracking echocardiography. J Vet Cardiol 2013; 15:41-9. [PMID: 23429036 DOI: 10.1016/j.jvc.2012.09.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 09/12/2012] [Accepted: 09/13/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The objective of this study was to clinically assess myocardial deformations in dogs with chronic mitral valve insufficiency (CMVI) using two-dimensional speckle-tracking echocardiography (2D-STE). ANIMALS 87 dogs with CMVI. METHODS Dogs were placed into 1 of 3 classes, based on the International Small Animal Cardiac Health Council classification. In addition, 20 weight- and age-matched healthy dogs were enrolled as controls. The dogs were examined for myocardial deformations using 2D-STE, and strain and strain rate in the longitudinal, circumferential, and radial directions were evaluated. RESULTS Class II and III dogs had higher circumferential strain than class I dogs (P = 0.002 and P = 0.001, respectively) and controls (P < 0.001 and P < 0.001, respectively). Class III dogs had higher radial strain than class I dogs (P = 0.001) and controls (P < 0.001). Class III dogs had higher radial strain rate than class I dogs (P = 0.006) and controls (P = 0.001). Other deformations, including longitudinal deformations, were not significantly different between classes of CMVI or between CMVI dogs and controls. CONCLUSIONS In the clinical progression of CMVI in dogs, myocardial deformations, as assessed by 2D-STE, differed according to myocardial contractile direction. Thus, assessments of multidirectional myocardial deformations may be important for better assessment of clinical cardiac function in dogs with CMVI.
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Affiliation(s)
- Ryohei Suzuki
- Division of Veterinary Internal Medicine, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan.
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Zois NE, Tidholm A, Nägga KM, Moesgaard SG, Rasmussen CE, Falk T, Häggström J, Pedersen HD, Åblad B, Nilsen HY, Olsen LH. Radial and longitudinal strain and strain rate assessed by speckle-tracking echocardiography in dogs with myxomatous mitral valve disease. J Vet Intern Med 2012; 26:1309-19. [PMID: 23113772 DOI: 10.1111/j.1939-1676.2012.01017.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 07/25/2012] [Accepted: 09/05/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Assessment of left ventricular (LV) function using conventional echocardiographic methods is difficult in mitral regurgitation (MR) owing to altered hemodynamic loading conditions. Newer methods such as speckle-tracking echocardiography (STE) provide assessment of LV strain (St) and strain rates (SR). HYPOTHESES Global St and SR are 1) decreased in dogs with clinical signs of congestive heart failure (CHF) due to myxomatous mitral valve disease (MMVD) compared with clinically healthy dogs, and are 2) associated with conventional echocardiographic indices of MMVD severity. ANIMALS The study subjects were 93 privately owned dogs with different MMVD severities. METHODS Prospectively recruited dogs were grouped according to MMVD severity based on echocardiographic evaluation of MR and presence of clinical signs. Global radial and longitudinal St, SR, and indices of LV dyssynchrony were assessed. RESULTS On group-wise comparisons, dogs with CHF had increased global longitudinal St, global longitudinal and radial SR in systole (SRs), and early diastole (SRe) compared with dogs with no or minimal MR (all P < .04). On multiple regression analyses, these global STE variables increased with degree of MR, but associations with left atrial-to-aortic root ratio (LA/Ao) were best described by second-order polynomial equations. Thus, curvilinear relationships were found for LA/Ao and longitudinal St, SRs, and SRe (all P < .002) and radial St and SRe (all P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE Assessed by STE, LV function appeared to be augmented in moderate-to-severe disease. However, at CHF stages with greatly enlarged atria, a decrease to levels comparable to dogs with no or minimal MR was observed.
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Affiliation(s)
- N E Zois
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
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