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Szlosek DA, Castaneda EL, Grimaldi DA, Spake AK, Estrada AH, Gentile-Solomon J. Frequency of arrhythmias detected in 9440 feline electrocardiograms by breed, age, and sex. J Vet Cardiol 2023; 51:116-123. [PMID: 38128417 DOI: 10.1016/j.jvc.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES The purpose of this study was to describe the frequency of arrhythmias detected in unsedated feline patients from general practice settings. ANIMALS A total 10,638 feline electrocardiograms (ECGs) were retrospectively collected of which 9440 met the inclusion criteria. METHODS Recordings were evaluated by a board-certified cardiologist. If an arrhythmia was present in the ECG tracing, the cardiologist categorized the arrhythmia using pre-established keywords. RESULTS At least one arrhythmia was observed in 249 cases (2.64%, 95% confidence interval (CI): 2.34-2.98, 249/9440), with the most common arrhythmia encountered being ventricular premature complexes (1.63%, 95% CI: 1.39%-1.91%, 154/9440). Ragdoll cats had the highest odds of arrhythmia (odds ratio (OR): 3.17, 95% CI: 1.43-6.17, P=0.036). Both geriatric (Age: 13+ years, OR: 1.70, 95% CI: 1.24-2.34, P=0.013) and senior (Age: 10-13 years, OR: 1.68, 95% CI: 1.19-2.37, P=0.003) cats had higher odds of having an arrhythmia than adult cats. The odds of male cats having an arrhythmia were slightly higher than female (OR: 1.36, 95% CI: 1.06-1.76, P=0.018). CONCLUSIONS AND RELEVANCE Of the 9440 ECGs included in this study, at least one arrhythmia was detected in 249 distinct cases. Arrhythmias were more common in older cats, male cats and the Ragdoll cat breed. While it is important to note that the presence of an arrhythmia alone does not always indicate the presence of heart disease, further research on the association between breed cardiac health is needed.
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Affiliation(s)
- D A Szlosek
- IDEXX Laboratories Inc., One IDEXX Drive, Westbrook, ME, 04092, USA.
| | - E L Castaneda
- Department of Small Animal Medicine, College of Veterinary Medicine, University of Florida, 2089 SW 16th Ave, Gainesville, FL, 32608, USA
| | - D A Grimaldi
- Department of Small Animal Medicine, College of Veterinary Medicine, University of Florida, 2089 SW 16th Ave, Gainesville, FL, 32608, USA
| | - A K Spake
- IDEXX Laboratories Inc., One IDEXX Drive, Westbrook, ME, 04092, USA
| | - A H Estrada
- Department of Small Animal Medicine, College of Veterinary Medicine, University of Florida, 2089 SW 16th Ave, Gainesville, FL, 32608, USA
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Novo Matos J, Payne JR. Predicting Development of Hypertrophic Cardiomyopathy and Disease Outcomes in Cats. Vet Clin North Am Small Anim Pract 2023; 53:1277-1292. [PMID: 37500329 DOI: 10.1016/j.cvsm.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Echocardiography is the gold standard imaging modality to diagnose hypertrophic cardiomyopathy (HCM) in cats. Echocardiographic features can predict both cats at an increased risk of developing HCM and cats with HCM at an increased risk of developing cardiovascular events or experiencing cardiac death. Left atrial dysfunction seems to be an important feature of HCM, as it is an early phenotypic abnormality and is also associated with worse outcome.
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Affiliation(s)
- Jose Novo Matos
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
| | - Jessie Rose Payne
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford House, Langford BS40 5DU, UK
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Sugimoto K, Mochizuki Y, Akashi N, Kanda T, Hoshi F. Effects of Intravenous Pimobendan on Cardiovascular Parameters in Healthy Sedated Cats. Top Companion Anim Med 2023; 53-54:100769. [PMID: 36813230 DOI: 10.1016/j.tcam.2023.100769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/25/2022] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
This study aimed to investigate the effects of intravenous pimobendan on cardiovascular function and to determine the appropriate dose for clinical usage in cats. Six purpose-bred cats received one of the following treatments: intravenous pimobendan at a single dose of 0.075 mg/kg (low dose [LD] group), 0.15 mg/kg (middle dose [MD] group), 0.3 mg/kg (high dose [HD] group), or saline at 0.1 mL/kg (placebo group). Echocardiography and blood pressure measurements were performed before and 5, 15, 30, 45, and 60 minute after drug administration for each treatment. In the MD and HD groups, the fractional shortening, peak systolic velocity, cardiac output, and heart rate increased significantly. There were no significant differences in blood pressure among the groups. Intravenous pimobendan at 0.15-0.3 mg/kg increased the fractional shortening, peak systolic velocity, cardiac output in healthy cats.
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Affiliation(s)
- Keisuke Sugimoto
- Department of Veterinary Medicine, Okayama University of Science, Ehime, Japan
| | - Yohei Mochizuki
- Department of Veterinary Medicine, Okayama University of Science, Ehime, Japan.
| | - Natsuki Akashi
- Department of Veterinary Medicine, Okayama University of Science, Ehime, Japan
| | - Teppei Kanda
- Department of Veterinary Medicine, Okayama University of Science, Ehime, Japan
| | - Fumio Hoshi
- Department of Veterinary Medicine, Okayama University of Science, Ehime, Japan
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Bastos RF, Tuleski GLR, Sousa MG. QT interval instability and QRS interval dispersion in healthy cats and cats with a hypertrophic cardiomyopathy phenotype. J Feline Med Surg 2023; 25:1098612X231151479. [PMID: 36745542 PMCID: PMC10812083 DOI: 10.1177/1098612x231151479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats. Electrocardiographic (ECG) analysis can help with the diagnosis of HCM and also in the investigation of the secondary consequences of the disease. This study investigated ECG markers of QT interval variability (total instability [TI], short-term instability [STI], long-term instability [LTI], QT variance [QTv]), mean QT interval (QTa) and QT interval corrected for heart rate (QTac), as well as the duration (QRSd) and dispersion (QRSv) of the QRS interval in healthy cats and in those with HCM. METHODS Data were collected from 63 domestic cats: 40 in the control group and 23 in the HCM group. Fifty consecutive QT intervals were recorded for all cats and then QTa, QTac, QTv, TI, LTI and STI were calculated. QRSd and QRSv were also obtained for all animals. A Mann-Whitney U-test was used for group comparison. Receiver operating characteristic curves were plotted to evaluate the sensitivity and specificity of all markers for HCM. Logistic regression analysis was performed to assess the risks of cats having HCM, based on the studied indexes. RESULTS QTa (P <0.01), QTac (P <0.01), QRSd (P <0.01) and STI (P = 0.02) were higher in the HCM group. QTa >158.8 ms, QTac >27.4 ms and QRSd >0.045 s had an accuracy of 77.4%, 68.2% and 80.9%, respectively, in detecting HCM. Logistic regression showed that cats with QTa >158 ms, QTac >27.4 ms and QRSd >0.045 s had a 1.58-, 1,23- and 6.5-fold higher risk, respectively, of developing HCM. CONCLUSIONS AND RELEVANCE Cats with HCM had higher ventricular instability as assessed by STI and showed a prolongation of the QT and QRS intervals via the QTa, QTac and QRSd markers. These markers show potential as ancillary screening tools for identifying the presence of HCM.
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Affiliation(s)
- Rodrigo Franco Bastos
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Giovana LR Tuleski
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Marlos Gonçalves Sousa
- Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Paraná (UFPR), Curitiba, Brazil
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Walker AL, Ueda Y, Crofton AE, Harris SP, Stern JA. Ambulatory electrocardiography, heart rate variability, and pharmacologic stress testing in cats with subclinical hypertrophic cardiomyopathy. Sci Rep 2022; 12:1963. [PMID: 35121794 PMCID: PMC8817045 DOI: 10.1038/s41598-022-05999-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/21/2022] [Indexed: 11/09/2022] Open
Abstract
The utility of ambulatory electrocardiography (AECG) to evaluate cats with subclinical hypertrophic cardiomyopathy (HCM) for arrhythmias and heart rate variability (HRV) is not well defined but may provide information regarding risk stratification. This prospective study used AECG to evaluate ectopy and HRV in subclinical HCM cats compared to healthy controls and is the first to implement a pharmacologic cardiac stress test. Twenty-three purpose-bred, Maine coon cross cats (16 HCM, 7 control) underwent 48-h of continuous AECG. Terbutaline (0.2-0.3 mg/kg) was administered orally at 24 and 36 h. Heart rate, ectopy frequency and complexity and HRV parameters, including standard deviation of normal R-R intervals (SDNN), were compared pre-terbutaline and post-terbutaline and across phenotype, genotype and sex. Genotype for an HCM-causative mutation was significantly associated with the frequency of supraventricular (P = 0.033) and ventricular (P = 0.026) ectopy across all cats. Seven HCM cats and zero healthy cats had a sinus arrhythmia. Mean heart rate was significantly higher post-terbutaline (p < 0.0001). HCM cats had significantly greater HRV compared to controls (SDNN: p = 0.0006). Male cats had significantly higher HRV (SDNN: p = 0.0001) and lower mean heart rates (p = 0.0001). HRV decreased post-terbutaline (SDNN: p = 0.0008) and changes in HRV observed between sexes were attenuated by terbutaline.
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Affiliation(s)
- Ashley L Walker
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, 2108 Tupper Hall, Davis, CA, 95616-8732, USA
| | - Yu Ueda
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA
| | - Amanda E Crofton
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, 2108 Tupper Hall, Davis, CA, 95616-8732, USA
| | - Samantha P Harris
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, 85724, USA
| | - Joshua A Stern
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, 2108 Tupper Hall, Davis, CA, 95616-8732, USA.
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Abstract
PRACTICAL RELEVANCE The feline cardiomyopathies are the most prevalent type of heart disease in adult domestic cats. Several forms have been identified (see Parts 2 and 3), with hypertrophic cardiomyopathy (HCM) being the most common. Clinically the cardiomyopathies are often indistinguishable. Cats with subclinical cardiomyopathy may or may not have characteristic physical examination findings (eg, heart murmur, gallop sound), or radiographic cardiomegaly. Cats with severe disease may develop signs of heart failure (eg, dyspnea, tachypnea) or systemic arterial thromboembolism (ATE; eg, pain and paralysis). Sudden death is possible. Treatment usually does not alter the progression from subclinical to clinical disease and often the treatment approach, once clinical signs are apparent, is the same regardless of the type of cardiomyopathy. However, differentiating cardiomyopathy from normal variation may be important prognostically. PATIENT GROUP Domestic cats of any age from 3 months upward, of either sex and of any breed, can be affected. Mixed-breed cats are most commonly affected but certain breeds are disproportionately prone to developing HCM. DIAGNOSTICS Subclinical feline cardiomyopathies may be suspected based on physical examination findings, thoracic radiographs and cardiac biomarker results but often the disease is clinically silent. The definitive clinical confirmatory test is echocardiography. Left heart failure (pulmonary edema and/or pleural effusion) is most commonly diagnosed radiographically, but point-of-care ultrasound and amino terminal pro-B-type natriuretic peptide (NT-proBNP) biomarker testing can also be useful, especially when the stress of taking radiographs is best avoided. KEY FINDINGS Knowledge of pathophysiological mechanisms helps the practitioner identify the feline cardiomyopathies and understand how these diseases progress and how they manifest clinically (heart failure, ATE). Existing diagnostic tests have strengths and limitations, and being aware of these can help a practitioner deliver optimal recommendations regarding referral. CONCLUSIONS Several types of feline cardiomyopathies exist in both subclinical (mild to severe disease) and clinical (severe disease) phases. Heart failure and ATE are the most common clinical manifestations of severe cardiomyopathy and are therapeutic targets regardless of the type of cardiomyopathy. The long-term prognosis is often guarded or poor once overt clinical manifestations are present. AREAS OF UNCERTAINTY Some cats with presumed cardiomyopathy do not have echocardiographic features that fit the classic cardiomyopathies (cardiomyopathy - nonspecific phenotype). Although no definitive treatment is usually available, understanding how cardiomyopathies evolve remains worthy of investigation.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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7
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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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8
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Fujii Y, Sugimoto K, Omichi M, Kanai K, Orito K. A pilot study investigating the effect of pimobendan on the cardiac rhythm and selected echocardiographic parameters of healthy cats. J Vet Cardiol 2021; 35:74-83. [PMID: 33887666 DOI: 10.1016/j.jvc.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The effects of pimobendan on the heart rhythm in cats are unknown. The purpose of this pilot study was to evaluate the effect of pimobendan on the cardiac rhythm and selected echocardiographic parameters of cats. ANIMALS, MATERIALS, AND METHODS Six clinically healthy cats received each of four medication protocols for 15 days, with a washout period of at least one month between each protocol. The protocols were, pimobendan 0.5 mg/kg twice daily (high dosage group), pimobendan 0.25 mg/kg twice daily (standard dosage group), pimobendan 0.125 mg/kg twice daily (low dosage group), and Biofermin R, one tablet twice daily (placebo group). Twenty-four-hour ambulatory electrocardiogram recordings, blood pressure measurements, and echocardiographic examinations were performed after two weeks of each medication protocol. Electrocardiographic, echocardiographic, and blood pressure parameters were compared between the four groups. RESULTS The total number of escape/idioventricular/idiojunctional complexes in the high dosage group was significantly higher compared with the placebo, low dosage, and standard dosage groups (p < 0.001). The blood pressure; total number of heart beats per day; and mean, minimum, and maximum heart rates were not significantly different between the groups. The longitudinal strain rate and calculated cardiac output were significantly increased in the high and standard dosage groups. CONCLUSIONS The administration of pimobendan, especially at high doses, was associated with increased numbers of escape/idioventricular/idiojunctional complexes in some cats and echocardiographic parameters. Further studies are warranted to investigate both the mechanism underlying the observed changes and what, if any, clinical implications these changes might have in cats with heart disease.
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Affiliation(s)
- Y Fujii
- Laboratory of Small Animal Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa, Japan.
| | - K Sugimoto
- Laboratory of Small Animal Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa, Japan
| | - M Omichi
- Laboratory of Small Animal Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa, Japan
| | - K Kanai
- Laboratory of Small Animal Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa, Japan
| | - K Orito
- Laboratory of Physiology II, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-shi, Kanagawa, Japan
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Ward JL, Kussin EZ, Tropf MA, Tou SP, DeFrancesco TC, Keene BW. Retrospective evaluation of the safety and tolerability of pimobendan in cats with obstructive vs nonobstructive cardiomyopathy. J Vet Intern Med 2020; 34:2211-2222. [PMID: 33026124 PMCID: PMC7694854 DOI: 10.1111/jvim.15920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Pimobendan is frequently used off-label for treatments of cats with congestive heart failure (CHF). Concern exists regarding the safety of pimobendan in cats with outflow tract obstruction (OTO). OBJECTIVES In cats treated with pimobendan, incidence of adverse effects will not differ between cats with OTO vs cats with nonobstructive cardiomyopathy. ANIMALS Two-hundred sixty cats with CHF (57 with OTO, 203 with nonobstructive disease). METHODS Retrospective medical record review. Groups were compared using 2-sample t-tests, Wilcoxon rank-sum tests, and Fisher exact tests. RESULTS Compared to cats with nonobstructive cardiomyopathy, cats with OTO were younger (8.9 [interquartile range (IQR) 6.6] vs 10.8 [6.3] years, P = .0036), more likely to have a heart murmur (51/57 [90%] vs 76/203 [37.8%] cats, P < .0001), more likely to manifest CHF as pulmonary edema (53/57 [83%] vs 144/203 [70.9%] cats, P = .0004), and less likely to have pleural effusion (19/57 [33%] vs 122/203 [60.1%] cats, P = .0005). Adverse effects suspected to be related to pimobendan administration occurred in 12/260 cats (4.6%), including 11/203 cats (5.4%) with nonobstructive cardiomyopathy and 1/57 cat (2%) with OTO (P = .7). Pimobendan was discontinued due to adverse effects in 4/260 cats (1.5%), 3 with nonobstructive disease and 1 with OTO (P = 1.0). Acute adverse hemodynamic effects after pimobendan administration were not detected in any cats. CONCLUSIONS AND CLINICAL IMPORTANCE Pimobendan is well tolerated in cats with cardiomyopathy and CHF, regardless of the presence of OTO.
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Affiliation(s)
- Jessica L Ward
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Efrem Z Kussin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Melissa A Tropf
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Sandra P Tou
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Teresa C DeFrancesco
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Bruce W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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10
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Ferasin L, Ferasin H, Borgeat K. Twenty-four-hour ambulatory (Holter) electrocardiographic findings in 13 cats with non-hypertrophic cardiomyopathy. Vet J 2020; 264:105537. [PMID: 33012440 DOI: 10.1016/j.tvjl.2020.105537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
Detection and characterisation of cardiac arrhythmias in cats with hypertrophic cardiomyopathy (HCM) has already been documented in various studies. However, similar studies have not been reported for other forms of feline cardiomyopathy. The clinical records of 13 client-owned cats diagnosed with restrictive cardiomyopathy (RCM), arrhythmogenic right ventricular cardiomyopathy (ARVC) and non-specific cardiomyopathy (NSCM) that underwent Holter recording at the time of diagnosis were reviewed retrospectively. Eight cats had signs of congestive heart failure at presentation, one cat had a history of recurrent syncope and the remaining four cats were asymptomatic. The average heart rate was 138 ± 22 (range 97-181) beats per minute (bpm) with the lowest value (97 bpm) recorded in a cat with third degree atrioventricular block (3-AVB) and the highest value (181 bpm) observed in a cat with atrial fibrillation (AF). The median number of ventricular ectopic beats (VEB) over 24 h was 2031 (338-8305), mostly represented by single isolated VPCs (803, 123-2221). Cardiac pauses were observed in three cats, with the longest pause lasting more than 6 s. A survival analysis was not performed due to the small number of cats and limited follow-up information. Holter recording revealed cardiac arrhythmias in all 13 cats, while 8/13 cats (61.5%) had an unremarkable resting electrocardiogram (ECG). The average daily heart rate in these cats did not appear affected by the presence of heart failure, although periods of sinus arrhythmia were absent in all individuals.
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Affiliation(s)
- L Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd, Alton, Hampshire, United Kingdom.
| | - H Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd, Alton, Hampshire, United Kingdom
| | - K Borgeat
- Langford Vets, University of Bristol, Somerset, United Kingdom
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11
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Laudhittirut T, Rujivipat N, Saringkarisate K, Soponpattana P, Tunwichai T, Surachetpong SD. Accuracy of methods for diagnosing heart diseases in cats. Vet World 2020; 13:872-878. [PMID: 32636581 PMCID: PMC7311870 DOI: 10.14202/vetworld.2020.872-878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/07/2020] [Indexed: 01/04/2023] Open
Abstract
Aim This study aimed to determine the accuracy of the current methods for diagnosing heart diseases in cats. Materials and Methods The data of 58 cats were retrospectively retrieved. Cats were classified into two groups: Thirty-eight cats with heart diseases and 20 healthy cats. Echocardiography was the gold standard method for diagnosing heart disease. The results of seven methods were retrieved: (1) Vertebral heart score (VHS) with a cutoff value >8, (2) VHS with a cutoff value >8.5, (3) multiplication of cardiac length (L) and width (W), (4) multiplication of cardiac L and W divided by the L of the fourth sternal thoracic bone, (5) N-terminal Pro-B-type natriuretic peptide (NT-proBNP) point-of-care test, (6) subjective ultrasonographic assessment of the left atrial size, and (7) subjective radiographic assessment of the left atrial size. Cross-tabulation was used to calculate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for each test. This study found that using the NT-proBNP point-of-care test was optimal in the diagnosis of cats with heart disease. Results The subjective ultrasonographic assessment of the left atrial size was good for diagnosing hypertrophic cardiomyopathy and congestive heart failure. Conclusion This study showed that the more tests used, the higher the reliability of the diagnosis.
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Affiliation(s)
- Tanarut Laudhittirut
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Natrada Rujivipat
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Kornnicha Saringkarisate
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Peeraya Soponpattana
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Teerawat Tunwichai
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
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12
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Luis Fuentes V, Abbott J, Chetboul V, Côté E, Fox PR, Häggström J, Kittleson MD, Schober K, Stern JA. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med 2020; 34:1062-1077. [PMID: 32243654 PMCID: PMC7255676 DOI: 10.1111/jvim.15745] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022] Open
Abstract
Cardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are well‐tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death. Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk of life‐threatening complications and those at higher risk. Based on the available literature, we offer recommendations for the approach to diagnosis and staging of cardiomyopathies, as well as for management at each stage.
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Affiliation(s)
- Virginia Luis Fuentes
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Valérie Chetboul
- Alfort Cardiology Unit (UCA), Université Paris-Est, École Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Maisons-Alfort cedex, France
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Mark D Kittleson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Karsten Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA
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Gil-Ortuño C, Sebastián-Marcos P, Sabater-Molina M, Nicolas-Rocamora E, Gimeno-Blanes JR, Fernández Del Palacio MJ. Genetics of feline hypertrophic cardiomyopathy. Clin Genet 2020; 98:203-214. [PMID: 32215921 DOI: 10.1111/cge.13743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/29/2022]
Abstract
Hypertrophic cardiomyopathy (HCM) is characterized by an abnormal increase in myocardial mass that affects cardiac structure and function. HCM is the most common inherited cardiovascular disease in humans (0.2%) and the most common cardiovascular disease in cats (14.7%). Feline HCM phenotype is very similar to the phenotype found in humans, but the time frame for the development of the disease is significantly shorter. Similar therapeutic agents are used in its treatment and it has the same complications, such as heart failure, thromboembolism and sudden cardiac death. In contrast to humans, in whom thousands of genetic variants have been identified, genetic studies in cats have been limited to fragment analysis of two sarcomeric genes identifying two variants in MYBPC3 and one in MYH7. Two of these variants have also been associated with human disease. The high prevalence of the reported variants in non-affected cats hinders the assumption of their pathogenicity in heterozygotes. An in-depth review of the literature about genetic studies on feline HCM in comparison with the same disease in humans is presented here. The close similarity in the phenotype and genotype between cats and humans makes the cat an excellent model for the pathophysiological study of the disease and future therapeutic agents.
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Affiliation(s)
- Cristina Gil-Ortuño
- Cardiogenetic Laboratory, Inherited Cardiac Disease Unit, IMIB University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain
| | | | - María Sabater-Molina
- Cardiogenetic Laboratory, Inherited Cardiac Disease Unit, IMIB University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain.,Internal Medicine Department, University of Murcia, Murcia, Spain
| | - Elisa Nicolas-Rocamora
- Cardiogenetic Laboratory, Inherited Cardiac Disease Unit, IMIB University Hospital Virgen de la Arrixaca-IMIB, Murcia, Spain
| | - Juan R Gimeno-Blanes
- Internal Medicine Department, University of Murcia, Murcia, Spain.,Department of Cardiology, Inherited Cardiac Disease Unit, University Hospital Virgen de la Arrixaca, Murcia, Spain
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