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Suzuki R, Saito T, Yuchi Y, Kanno H, Teshima T, Matsumoto H, Koyama H. Detection of Congestive Heart Failure and Myocardial Dysfunction in Cats With Cardiomyopathy by Using Two-Dimensional Speckle-Tracking Echocardiography. Front Vet Sci 2021; 8:771244. [PMID: 34869741 PMCID: PMC8634135 DOI: 10.3389/fvets.2021.771244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Congestive heart failure (CHF) is a life-threatening condition in cats with cardiomyopathy. We hypothesized that myocardial dysfunction may induce progression to CHF pathophysiology in cats with cardiomyopathy. However, no previous studies have evaluated the involvement of myocardial dysfunction in cats with CHF. In this study, we aimed to evaluate the relationship between CHF and myocardial function assessed using two-dimensional speckle-tracking echocardiography (2D-STE). Sixteen client-owned healthy cats and 32 cats with cardiomyopathy were enrolled in this study. Cats were classified into three groups: healthy cats, cardiomyopathy without CHF (CM group), and cardiomyopathy with CHF (CHF group). Left ventricular (LV) longitudinal and circumferential strains (SL and SC, respectively), and right ventricular (RV) SL were measured using 2D-STE. Logistic regression analysis was performed to assess the relationship between CHF and echocardiographic variables, including 2D-STE. Results comparing the healthy cats and CM vs. CHF groups showed that increased left atrial to aortic diameter ratio and decreased LV apical SC were significantly associated with the existence of CHF (odds ratio [95% confidence interval]: 1.40 [1.16-1.78] and 1.59 [1.06-2.36], respectively). Results comparing the CM vs. CHF group showed that increased end-diastolic RV internal dimension and decreased RV SL were significantly associated with the existence of CHF (odds ratio: 1.07 [1.00-1.13] and 1.34 [1.07-1.68], respectively). Left atrial enlargement and depressed LV apical myocardial function may be useful tools for predicting the progression to CHF in cats. Furthermore, RV enlargement and dysfunction may lead to the onset of CHF in asymptomatic cats with cardiomyopathy.
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Affiliation(s)
- Ryohei Suzuki
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takahiro Saito
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Yunosuke Yuchi
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Haruka Kanno
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Takahiro Teshima
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hirotaka Matsumoto
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
| | - Hidekazu Koyama
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino, Japan
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Morita T, Nakamura K, Osuga T, Takiguchi M. Incremental predictive value of echocardiographic indices of right ventricular function in the assessment of long-term prognosis in dogs with myxomatous mitral valve disease. J Vet Cardiol 2021; 39:51-62. [PMID: 34979482 DOI: 10.1016/j.jvc.2021.12.002] [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: 04/16/2021] [Revised: 11/18/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Few studies have evaluated the utility of echocardiographic indices of right ventricular (RV) function in predicting prognosis in dogs with myxomatous mitral valve disease (MMVD). ANIMALS Sixty-seven client-owned dogs were diagnosed with MMVD. MATERIALS AND METHODS clinical cohort study. Dogs diagnosed with American college of veterinary internal medicine (ACVIM) stage B2, C or D between April 2014 and March 2017 were enrolled. Long-term outcomes were assessed by telephone or from the medical record. The primary end-point was defined as cardiac-related death. Echocardiographic indices of RV function, including the RV Tei index, free wall and septal RV longitudinal strain, were obtained. Univariable and multivariable Cox proportional hazard analyses were used to identify variables predictive of cardiac-related death. RESULTS Twenty-four dogs died during the follow-up period. The median follow-up time was 482 days, and the median survival time for dogs with cardiac-related death was 230 days. For cardiac-related death, peak early diastolic mitral inflow velocity, ACVIM stage C or D, tricuspid regurgitation velocity, RV Tei index and RV end-diastolic area were predictors in univariable Cox proportional hazard analysis. In multivariable Cox proportional analysis adjusted for the left atrial to aorta ratio, peak early diastolic mitral inflow velocity and ACVIM stage, an increase in the Tei index by 0.1 increased the hazard ratio of cardiac-related death by 33% (95% confidence interval, 16-70%; P = 0.002). CONCLUSIONS In dogs with MMVD, RV dysfunction assessed by the Tei index is an independent predictor of cardiac-related death.
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Affiliation(s)
- T Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, 060-0818, Japan
| | - K Nakamura
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, 060-0818, Japan.
| | - T Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuenkibanadai-nishi, Miyazaki, 889-2192, Japan
| | - M Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido, 060-0818, Japan
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Gicana KRB, Lertwanakarn T, Tachampa K. Novel Approach to Assess Cardiac Function Using Systolic Performance and Myocardial Performance Indices From Simultaneous Electrocardiography and Phonocardiography Recordings in Dogs With Various Stages of Myxomatous Mitral Valve Disease. Front Vet Sci 2021; 8:741115. [PMID: 34746282 PMCID: PMC8566337 DOI: 10.3389/fvets.2021.741115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: Myxomatous mitral valve disease (MMVD) progression entails changes in the structural and functional properties of the heart affecting cardiac timings and intervals within the cardiac cycle. Conventionally, echocardiography is used to determine the cardiac time intervals (CTIs) including systolic and myocardial performance indices (SPI and MPI) in evaluating cardiac function. Alternatively, these CTIs can also be measured using simultaneous recordings of electrocardiography (ECG) and phonocardiography (PCG), but their values in different MMVD stages remain to be established. This study aimed to establish and prove the use of derived SPI and MPI from a dedicated device as a novel approach to assess cardiac function in different stages of MMVD dogs. Materials and Methods: A prospective study in 52 dogs with different MMVD stages measured the CTIs using a novel device. These were compared and correlated with standard echocardiographic parameters. The predictive value of SPI and three new proposed formulas to estimate MPI (i.e., F1, F2, and F3) in association with asymptomatic from symptomatic MMVD dogs were investigated. Results: Our findings revealed that CTI parameters measured from a novel device including QS1, QS2, S1S2, MPI-F1, and MPI-F2 were altered at different stages of MMVD. The SPI and all proposed MPI formulas were comparable with the systolic time interval and Tei index from echocardiography. In addition, the SPI, MPI-F1, and MPI-F2 were significantly correlated with the Tei index. However, the SPI was not able to differentiate the various stages of MMVD. Conversely, only the MPI-F1 (i.e., (QS1 + S2)/S1S2) demonstrated good predictive accuracy when compared between asymptomatic and symptomatic MMVD dogs similar to the Tei index. Moreover, this formula was able to differentiate stages B1 and C with remarkable predictive accuracy, higher sensitivity, and high specificity when compared with the Tei index. Conclusion: We have successfully described the CTI parameters in different MMVD stages using simultaneous ECG and PCG recordings in dogs. Furthermore, we have proven that the concept of using the newly proposed parameters from a novel device is equivalent to the Tei index. Thus, we established a novel approach to evaluate cardiac function and its supportive use in the diagnosis of MMVD patients.
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Affiliation(s)
- Karlo Romano B Gicana
- The International Graduate Program of Veterinary Science and Technology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, Los Baños, Philippines
| | - Tuchakorn Lertwanakarn
- Department of Physiology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Kittipong Tachampa
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Yuchi Y, Suzuki R, Teshima T, Matsumoto H, Koyama H. Right ventricular systolic and diastolic function assessed by two-dimensional speckle tracking echocardiography in dogs with myxomatous mitral valve disease. J Vet Med Sci 2021; 83:1918-1927. [PMID: 34732606 PMCID: PMC8762426 DOI: 10.1292/jvms.21-0195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pulmonary hypertension (PH) is a common comorbidity in dogs with myxomatous mitral valve
disease (MMVD), and can induce various changes in the right heart, such as right
ventricular (RV) hypertrophy, dilatation, and dysfunction. We hypothesized that RV
function, not only systolic function but also diastolic function, could be worsened with
PH progression. We aimed to compare RV systolic and diastolic function in dogs with MMVD.
Twenty healthy dogs and sixty-eight dogs with MMVD were enrolled. Dogs with MMVD were
classified into the probability of PH. Two-dimensional and Doppler echocardiographic
indices for right heart and two-dimensional speckle tracking echocardiography indices were
measured. The morphological indicators of the right heart were significantly higher only
in the high probability of PH group. The RV strain, early-diastolic and systolic strain
rates were significantly lower in the high probability of PH group than those in the low
and intermediate probability of PH groups. Multivariate analysis showed that increased RV
internal dimension normalized by body weight and RV myocardial performance index were
significantly associated with the presence of right-sided congestive heart failure.
Speckle tracking echocardiography-derived RV systolic and diastolic function were
activated in the low and intermediate probability of PH groups. However, dogs with high
probability of PH showed RV myocardial dysfunction and dilatation. Increased RV myocardial
performance index and end-diastolic RV internal dimension normalized by body weight were
significantly associated with the presence of right-sided congestive heart failure in dogs
with MMVD.
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Affiliation(s)
- Yunosuke Yuchi
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Ryohei Suzuki
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Takahiro Teshima
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Hirotaka Matsumoto
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Hidekazu Koyama
- Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
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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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Fujioka T, Nakamura K, Minamoto T, Tsuzuki N, Yamaguchi J, Hidaka Y. Ultrasonographic evaluation of the caudal vena cava in dogs with right-sided heart disease. J Vet Cardiol 2021; 34:80-92. [PMID: 33626419 DOI: 10.1016/j.jvc.2021.01.005] [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: 07/16/2018] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION/OBJECTIVES In humans with impaired right-sided cardiac function, the caudal vena cava (CVC) diameter serves as a marker of venous congestion. This study aimed to investigate whether ultrasonographic CVC variables could identify the presence of right-sided congestive heart failure (R-CHF) in dogs with right-sided heart disease (RHD). ANIMALS Fifty client-owned control dogs and 67 dogs with RHD were enrolled. The dogs with RHD were subdivided into the non-R-CHF (n = 43) and R-CHF (n = 24) groups. MATERIALS AND METHODS We measured and compared the ultrasonographic CVC variables and echocardiographic variables among the groups. Receiver operating characteristic (ROC) curve analysis was performed to calculate the sensitivity and specificity of the variables at optimal cutoff values. RESULTS We obtained the highest accuracies of the ratio of the shortest diameter (SD) of the minimal CVC area to the aorta diameter (Ao) during inspiration [SD(min)/Ao] and of the ratio of SD(min) to the longest diameter of the minimal CVC area during inspiration [LD(min),SD/LD(min)], with high sensitivities, specificities, and an area under the ROC curve greater than 0.925. CONCLUSIONS In addition to the echocardiographic assessment of right-sided cardiac function, the CVC variables in this study, especially SD(min)/Ao and SD/LD(min), would be useful diagnostic indices for identifying R-CHF in dogs with RHD.
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Affiliation(s)
- T Fujioka
- Asap Animal Clinic, 3597-1 Ganda, Nogata, Fukuoka 822-0001, Japan; Laboratory of Veterinary Surgery, Department of Veterinary Medicine, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan
| | - K Nakamura
- Organization for Promotion of Tenure Track, University of Miyazaki, 1-1 Gakuen, Kibanadai-nishi, Miyazaki 889-2192, Japan
| | - T Minamoto
- Evergreen Vet Research & Publication, 2-10-2 Hanaike, Ichinomiya, Aichi 491-0914, Japan
| | - N Tsuzuki
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Inada, Obihiro, Hokkaido 080-8555, Japan
| | - J Yamaguchi
- Asap Animal Clinic, 3597-1 Ganda, Nogata, Fukuoka 822-0001, Japan
| | - Y Hidaka
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki 889-2192, Japan.
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Saetang K, Surachetpong SD. Short-term effects of sildenafil in the treatment of dogs with pulmonary hypertension secondary to degenerative mitral valve disease. Vet World 2020; 13:2260-2268. [PMID: 33281365 PMCID: PMC7704324 DOI: 10.14202/vetworld.2020.2260-2268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/25/2020] [Indexed: 11/21/2022] Open
Abstract
Background and Aim: Pulmonary hypertension (PH) is a common complication of degenerative mitral valve disease (DMVD). Sildenafil, a phosphodiesterase-5 inhibitor, has effects in reducing pulmonary arterial pressure by selectively dilating pulmonary vessels. The study aimed to evaluate the effects of sildenafil in combination with conventional therapy in dogs with PH caused by DMVD. Materials and Methods: Fourteen dogs diagnosed with PH secondary to DMVD Stage C on conventional therapy were randomly assigned to placebo (n=7) and sildenafil (n=7) groups. On day 0, the recruited dogs underwent physical examinations, clinical score assessments, electrocardiography, systolic blood pressure measurements, blood collection, thoracic radiography, and echocardiography for baseline. The dogs then received a combination of conventional therapy with sildenafil or placebo every 8 h for 1 week. On day 7, all dogs underwent the baseline evaluations again. Results: The sildenafil group experienced a significant decrease in estimated systolic pulmonary artery pressure (sPAP) (p=0.043) from day 0 to day 7. Moreover, the total clinical scores were decreased in dogs treated with sildenafil relative to those who received the placebo (p=0.007); however, the lung scores were not different between before and after treatment with sildenafil. Conclusion: Sildenafil had a synergistic effect with conventional therapy in reducing the estimated sPAP and clinical scores in dogs with PH secondary to DMVD.
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Affiliation(s)
- Karun Saetang
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Caivano D, Rishniw M, Birettoni F, Petrescu VF, Porciello F. Transverse Right Ventricle Strain and Strain Rate Assessed by 2-Dimensional Speckle Tracking Echocardiography in Dogs with Pulmonary Hypertension. Vet Sci 2020; 7:E19. [PMID: 32046130 PMCID: PMC7157588 DOI: 10.3390/vetsci7010019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 11/23/2022] Open
Abstract
Right ventricular (RV) strain analysis using 2-dimensional speckle tracking echocardiography (2D STE) permits practitioners to assess regional and global deformation of the myocardium. Recently, assessment of the longitudinal right ventricle (RV) strain and strain rate using 2D STE has been reported in dogs. Although longitudinal deformation is the dominant component of the RV systole, RV myocardial fibers of the superficial layer are oriented circumferentially and these contribute to the RV pump function (radial deformation). Because this strain component has not been investigated in dogs, we have assessed radial RV strain and strain rate using 2D STE in healthy dogs and dogs with pulmonary hypertension (PH). We have recruited 74 dogs (40 healthy dogs and 34 dogs with PH) in which we have analyzed radial RV free wall strain and strain rate using XstrainTM software. We have used the left apical 4-chamber view optimized for the RV for analysis of the radial strain and strain rate variables (XstrainTM software denoted radial strain as "transverse"). Seven dogs were excluded during the analysis for low quality images. Transverse strain and strain rate obtained in healthy dogs showed no relationship with heart rate, body weight or age (r2 < 0.09 and p > 0.05 for all variables). Moreover, no relationship between transverse strain/strain rate variables and left atrial-to-aortic ratios was observed (r2 < 0.06 and p = 0.2, for both). Transverse strain and strain rate obtained in dogs with PH, showed weak negative relationships with tricuspid regurgitation velocity (r2 < 0.25 and p = 0.006, for both). Transverse RV strain and strain rate using 2D STE is feasible in most dogs and decrease with worsening of the PH, but these advanced echocardiographic indices do not help in identifying dogs with PH.
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Affiliation(s)
- Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
| | - Mark Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA;
| | - Francesco Birettoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
| | - Vasilica-Flory Petrescu
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
| | - Francesco Porciello
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (V.-F.P.); (F.P.)
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Effect of temperature variation on hospital admissions and outcomes in dogs with myxomatous mitral valve disease and new onset pulmonary edema. PLoS One 2020; 15:e0227807. [PMID: 31935277 PMCID: PMC6959981 DOI: 10.1371/journal.pone.0227807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 12/31/2019] [Indexed: 01/26/2023] Open
Abstract
The effect of seasonal variation on hospital admissions and outcomes in humans with cardiovascular disease and congestive heart failure (CHF) has been described. This study evaluates the effect of temperature variation on admissions and outcomes in dogs with myxomatous mitral valve disease (MMVD) and first onset CHF. Ninety-three client-owned dogs with MMVD and a first occurrence of pulmonary edema were included in this retrospective clinical cohort study. Recorded clinical and echocardiographic variables were accumulated and analyzed with dogs allocated into groups in a temperature-wise manner that considered the mean of the average (Tave) and maximum ambient temperature (Tmax) of the 14 days preceding hospital admission. A survival analysis was also performed. No difference was found in the percentage of dogs decompensating in three different temperature periods (i.e., cold, intermediate, and hot temperature) according to both Tave and Tmax. Dogs developing CHF during the intermediate temperatures according to Tmax died earlier from cardiac-related causes (median survival time 280 days, 95% CI = 147–486 days) compared to those decompensating during hot temperatures (median survival time 518 days, 95% CI = 344–819 days, P = 0.039). However, an effect of the ambient temperature on survival was not confirmed by Cox proportional hazard analysis. In conclusion, this study failed to show that ambient temperature has an effect on the first occurrence of CHF and outcomes in dogs with MMVD.
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Chan IP, Weng MC, Hsueh T, Lin YC, Lin SL. Prognostic value of right pulmonary artery distensibility in dogs with pulmonary hypertension. J Vet Sci 2019; 20:e34. [PMID: 31364319 PMCID: PMC6669208 DOI: 10.4142/jvs.2019.20.e34] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/19/2019] [Accepted: 05/20/2019] [Indexed: 11/20/2022] Open
Abstract
The right pulmonary artery distensibility (RPAD) index has been used in dogs with pulmonary hypertension (PH) caused by heartworm infection, myxomatous mitral valve disease, or patent ductus arteriosus. We hypothesized that this index correlates with the tricuspid regurgitation pressure gradient (TRPG) assessed by echocardiography and could predict survival in dogs with PH secondary to various causes. To assess this hypothesis, the medical records of 200 client-owned dogs at a referral institution were retrospectively reviewed. The RPAD index and the ratios of acceleration time to peak pulmonary artery flow (AT) and to the ejection time of pulmonary artery flow (ET) were recorded for each dog. The owners were contacted for follow-up assessments. The findings indicated that the RPAD index was correlated with the TRPG (R² = 0. 362, p < 0.001). The survival time was significantly shorter in dogs with an RPAD index ≤ 21% that were followed up for 3 months and in dogs with an RPAD index ≤ 24% that were followed up for 1 year. Thus, the RPAD index was correlated with the TRPG and could predict the clinical outcome in dogs with PH caused by various diseases. This index could be used to evaluate the severity of PH in dogs without tricuspid regurgitation.
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Affiliation(s)
- I Ping Chan
- Veterinary Medical Teaching Hospital, National Chung Hsing University, Taichung 40227, Taiwan.,Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Min Chieh Weng
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Tung Hsueh
- Veterinary Medical Teaching Hospital, National Chung Hsing University, Taichung 40227, Taiwan.,Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Yun Chang Lin
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Shiun Long Lin
- Veterinary Medical Teaching Hospital, National Chung Hsing University, Taichung 40227, Taiwan.,Department of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan.
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Guglielmini C, Berlanda M, Fracassi F, Poser H, Koren S, Baron Toaldo M. Electrocardiographic and echocardiographic evaluation in dogs with hypothyroidism before and after levothyroxine supplementation: A prospective controlled study. J Vet Intern Med 2019; 33:1935-1942. [PMID: 31468615 PMCID: PMC6766517 DOI: 10.1111/jvim.15600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/07/2019] [Indexed: 12/25/2022] Open
Abstract
Background Improvement in cardiac function has been demonstrated after thyroxine treatment in humans with hypothyroidism using the myocardial performance index (MPI). Cardiac changes after thyroxine supplementation are poorly documented in dogs with spontaneous hypothyroidism and comparison with clinically healthy dogs is lacking. Objectives To evaluate the electrical activity and mechanical function of the heart in dogs with primary hypothyroidism at baseline (T0) and after thyroxine supplementation (T60). Animals Forty client‐owned dogs with hypothyroidism and 20 clinically healthy dogs. Methods Prospective cohort study. Selected electrocardiographic and echocardiographic variables, including the MPI, were measured in all dogs at T0 and in 30 hypothyroid dogs at T60. Results Hypothyroid dogs had significantly decreased median or mean heart rate (HR), P wave amplitude, and R wave amplitude (P = .04, P = .002, and P = .003, respectively) and E‐point‐to‐septal separation normalized to body weight (EPSSn) and trans‐mitral E wave velocity (E max; P < .001 and P = .025, respectively) at T0 compared to control dogs. At T60, significantly increased median or mean HR, P wave amplitude, fractional shortening, and E max (P < .001, P = .004, P = .002, and P = .009, respectively) and significantly decreased left ventricular end‐diastolic volume index, and normalized systolic diameter and EPSSn (P = .03, P = .03, and P = .001, respectively) were found. Conclusions and Clinical Importance Hypothyroidism in dogs induces mild and reversible changes of electromechanical cardiac function. The MPI does not have clinical importance in identifying cardiac dysfunction in affected dogs.
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Affiliation(s)
- Carlo Guglielmini
- The Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Michele Berlanda
- The Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Federico Fracassi
- The Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Helen Poser
- The Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy
| | - Shani Koren
- The Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Marco Baron Toaldo
- The Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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Jaffey JA, Leach SB, Kong LR, Wiggen KE, Bender SB, Reinero CR. Clinical efficacy of tadalafil compared to sildenafil in treatment of moderate to severe canine pulmonary hypertension: a pilot study. J Vet Cardiol 2019; 24:7-19. [PMID: 31405557 DOI: 10.1016/j.jvc.2019.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/29/2019] [Accepted: 05/03/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Canine pulmonary hypertension (PH) is associated with high morbidity and mortality. Tadalafil, a phosphodiesterase-5 inhibitor used commonly in humans with PH, has not been evaluated in a clinical trial in dogs with naturally occurring PH. Our objectives were to compare the efficacy of tadalafil and sildenafil on PH assessed by peak tricuspid regurgitant flow velocity, estimated systolic pulmonary arterial pressure gradient, voluntary activity, quality of life, and safety profiles in dogs with moderate to severe PH. ANIMALS Twenty-three dogs with echocardiographic evidence of moderate to severe PH were enrolled. METHODS A prospective short-term, randomized, double-blinded pilot study was carried out. Dogs with PH were randomly allocated to receive sildenafil or tadalafil for 2 weeks and assessed via echocardiography, activity monitors, and owner-reported outcomes. RESULTS Collectively, phosphodiesterase-5 inhibition significantly decreased (improved) quality of life scores (p = 0.003) and visual analog score (p = 0.024) without significant between-treatment difference of these variables. Phosphodiesterase-5 inhibition did not significantly affect peak tricuspid regurgitant flow velocity (p = 0.056) or voluntary activity (p = 0.27). A total of 33% (7/21) of dogs experienced at least one adverse event during the study (tadalafil, n = 5; sildenafil, n = 2) with no significant difference between treatment type and incidence of adverse events (p = 0.36). DISCUSSION In this pilot study, phosphodiesterase-5 inhibition led to apparent improvement in quality of life scores without documenting superiority of tadalafil over sildenafil. CONCLUSION Tadalafil at a dose of 2 mg/kg once daily appears to be a viable alternative to sildenafil in dogs with moderate to severe PH.
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Affiliation(s)
- J A Jaffey
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA
| | - S B Leach
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA
| | - L R Kong
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA
| | - K E Wiggen
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA
| | - S B Bender
- Department of Biomedical Sciences, University of Missouri, 1600 E Rollins, Columbia, MO, 65211, USA; Dalton Cardiovascular Research Center, University of Missouri, 134 Research Park Drive, Columbia, MO, 65211, USA; Research Service, Harry S Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia, MO, 65201, USA
| | - C R Reinero
- Department of Veterinary Medicine and Surgery, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO, 65211, USA.
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Right ventricular function and dyssynchrony measured by echocardiography in dogs with precapillary pulmonary hypertension. J Vet Cardiol 2019; 23:1-14. [PMID: 31174719 DOI: 10.1016/j.jvc.2018.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 11/27/2018] [Accepted: 12/21/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Assessment of the right ventricular (RV) function by echocardiography is important in dogs with pulmonary hypertension (PH). Few reports are available on RV function and dyssynchrony in dogs, especially in the context of precapillary PH. ANIMALS The study included 79 client-owned dogs: 25 dogs with precapillary PH and 54 control dogs. METHODS Dogs with precapillary PH were prospectively enrolled between December 2013 and February 2017. The echocardiographic indices of RV function, including RV strain and the dyssynchrony index by speckle-tracking echocardiography, were measured. Multivariate analysis was used to determine independent predictors of the RV dyssynchrony index. RESULTS Dogs with precapillary PH showed RV dilation, hypertrophy and right atrial dilation. Impaired echocardiographic indices of RV function, including RV strain, were observed. In addition, RV dyssynchrony occurred in dogs with precapillary PH. Multivariate analysis revealed that tricuspid regurgitation velocity and RV dilation were independent predictors of the RV dyssynchrony index. CONCLUSIONS Echocardiographic RV function indices are impaired in dogs with precapillary PH. In addition, RV dilation and elevated systolic pulmonary arterial pressure estimated by echocardiography are associated with RV dyssynchrony.
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Morita T, Nakamura K, Osuga T, Yokoyama N, Morishita K, Sasaki N, Ohta H, Takiguchi M. Effect of acute volume overload on echocardiographic indices of right ventricular function and dyssynchrony assessed by use of speckle tracking echocardiography in healthy dogs. Am J Vet Res 2019; 80:51-60. [DOI: 10.2460/ajvr.80.1.51] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cunningham S, Aona B, Antoon K, Rush J, Barton B. Echocardiographic assessment of right ventricular systolic function in Boxers with arrhythmogenic right ventricular cardiomyopathy. J Vet Cardiol 2018; 20:343-353. [DOI: 10.1016/j.jvc.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 07/10/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
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Caivano D, Rishniw M, Birettoni F, Patata V, Giorgi M, Dei K, Porciello F. Right ventricular outflow tract fractional shortening: an echocardiographic index of right ventricular systolic function in dogs with pulmonary hypertension. J Vet Cardiol 2018; 20:354-363. [DOI: 10.1016/j.jvc.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Evaluation of tricuspid annular plane systolic excursion measured by two-dimensional echocardiography in healthy dogs: repeatability, reference intervals, and comparison with M-mode assessment. J Vet Cardiol 2018; 20:165-174. [DOI: 10.1016/j.jvc.2018.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 11/20/2022]
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Chapel EH, Scansen BA, Schober KE, Bonagura JD. Echocardiographic Estimates of Right Ventricular Systolic Function in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med 2017; 32:64-71. [PMID: 29224256 PMCID: PMC5787149 DOI: 10.1111/jvim.14884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/01/2017] [Accepted: 10/19/2017] [Indexed: 01/01/2023] Open
Abstract
Background Right ventricular (RV) dysfunction independently predicts outcomes in human myxomatous mitral valve disease (MMVD). There is limited information regarding RV systolic function in dogs with MMVD. Hypothesis Right ventricular systolic function differs among stages of disease, decreasing in decompensated MMVD. Animals Thirty‐sixclient‐owned dogs with MMVD not receiving oral cardiovascular medications. Methods Prospective clinical study. Dogs were categorized according to disease severity as ACVIM Stage B1, B2, or C. Seven echocardiographic indices of RV systolic function were measured. Groups were compared by 1‐way ANOVA and Tukey's HSD test. Frequencies of cases with cardiac remodeling falling outside previously established reference intervals were compared using Fisher's exact test. Intra‐ and interobserver measurement variability was calculated for each RV function index. Results The indices TAPSE (P = 0.029), RV StL (P = 0.012), and RV StRL (P = 0.041) were significantly different between groups. A greater proportion of B2 dogs (7 of 12) had TAPSE values above reference intervals compared with B1 (2 of 12) or C (2 of 12) dogs (P = 0.027). Measurement variability of TAPSE, RV S', and RV StG was clinically acceptable. Conclusions and Clinical Importance Right ventricular systolic function differs between stages of MMVD, increasing in stage B2, and declining in stage C. The prognostic importance of RV function indices, particularly TAPSE, might be worth evaluating in dogs with MMVD.
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Affiliation(s)
- E H Chapel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - B A Scansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - K E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - J D Bonagura
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
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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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Visser LC, Sloan CQ, Stern JA. Echocardiographic Assessment of Right Ventricular Size and Function in Cats With Hypertrophic Cardiomyopathy. J Vet Intern Med 2017; 31:668-677. [PMID: 28295648 PMCID: PMC5435046 DOI: 10.1111/jvim.14688] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/09/2017] [Accepted: 02/09/2017] [Indexed: 11/28/2022] Open
Abstract
Background Studies evaluating right ventricular (RV) structural and functional abnormalities in feline hypertrophic cardiomyopathy (HCM) are limited. Hypothesis Right ventricular structural and functional abnormalities are present in cats with HCM and are associated with clinical severity. Animals Eighty‐one client‐owned cats. Methods Retrospective 2‐dimensional (2D) echocardiographic study. Right atrial diameter (RAD), RV free wall thickness (RVFWd), RV internal dimension (RVIDd), RV fractional area change (FAC), and tricuspid annular plane systolic excursion (TAPSE) were measured in control cats (n = 26), cats with subclinical HCM (subclinical HCM; n = 31), and cats with HCM and congestive heart failure (HCM + CHF; n = 24). Results Right heart size (RAD, RVFWd, and RVIDd) and RV function (FAC and TAPSE) significantly (all P < .05) increased and decreased, respectively, in the HCM + CHF group compared with controls. In the subclinical HCM group, only RVFWd was significantly (P < .05) higher than in controls. Compared with reference intervals derived from controls, 29% of cats with HCM had increased RVFWd. Increased left ventricular free wall thickness, increased RVIDd and decreased TAPSE independently correlated with increased left atrial size. Cats with HCM and pleural effusion were significantly more likely to have increased RVFWd and had increased RAD and decreased TAPSE compared with cats without pleural effusion. Conclusions and Clinical Importance Right ventricular remodeling and dysfunction occur in some cats with HCM and may be associated with clinical severity. Our results support involvement of RV in the pathophysiology of HCM in some cats and support echocardiographic assessment of the RV in cats with HCM.
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Affiliation(s)
- L C Visser
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - C Q Sloan
- 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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Gentile-Solomon J, Abbott J. Conventional echocardiographic assessment of the canine right heart: reference intervals and repeatability. J Vet Cardiol 2016; 18:234-247. [DOI: 10.1016/j.jvc.2016.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/26/2016] [Accepted: 05/24/2016] [Indexed: 11/24/2022]
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