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Ivasovic F, Poletti G, Baron Toaldo M. Echocardiographic findings in apparently healthy Czechoslovakian wolfdogs. J Vet Cardiol 2024; 53:60-71. [PMID: 38705085 DOI: 10.1016/j.jvc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION To echocardiographically evaluate a large number of apparently healthy Czechoslovakian wolfdogs (CWDs) to identify possible subclinical cardiac abnormalities and to generate reference intervals. ANIMALS One-hundred and seventeen apparently healthy client-owned CWDs. MATERIALS AND METHODS Standard two-dimensional, M-mode, and Doppler echocardiographic measurements were obtained on non-sedated, manually restrained standing dogs. Animals with no relevant echocardiographic abnormalities were used to generate reference intervals. Echocardiographic variables were compared between males and females and between dogs with and without mitral regurgitation (MR). RESULTS AND DISCUSSION Among the 117 CWDs, 103 dogs were used to generate reference intervals. The 14 dogs with abnormalities had more than trivial MR (12 dogs), subaortic stenosis (one dog), and equivocal subaortic stenosis (one dog). The 44 males were heavier than 59 females (P<0.001) and had a larger maximum left atrial dimension (P=0.015), left ventricular internal dimension at end-diastole (P<0.001) and systole (P<0.001), and thicker interventricular septum thickness at end-diastole (P=0.016). A positive linear correlation was identified between bodyweight and aortic root and left atrial diameters and left ventricular dimensions and between age and aortic root and left atrial diameter and peak late transmitral flow velocity. A negative linear correlation was identified between age and peak early transmitral flow velocity and the ratio between peak early and late transmitral flow velocities. No differences in echocardiographic-derived cardiac dimensions were detected between healthy dogs and dogs with more than trivial MR. CONCLUSIONS In this population of CWDs, subclinical cardiac abnormalities were uncommon, and they were mainly classified as MR.
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Affiliation(s)
- F Ivasovic
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland
| | - G Poletti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano Emilia, Italy
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano Emilia, Italy.
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Czech AA, Glaus TM, Testa F, Romito G, Baron Toaldo M. Clinical presentation, echocardiographic findings, treatment strategies, and prognosis of dogs with myxomatous mitral valve disease presented with pericardial effusion due to suspected left atrial tear: a retrospective case-control study. J Vet Cardiol 2023; 51:105-115. [PMID: 38128416 DOI: 10.1016/j.jvc.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION/OBJECTIVES Left atrial tear (LAT) is a life-threatening complication in dogs with myxomatous mitral valve disease (MMVD). The study objective was to describe clinical presentation, echocardiographic findings, treatment strategies, and survival in dogs with LAT compared to a control group of dogs with a similar stage of MMVD but no LAT. ANIMALS AND MATERIALS AND METHODS: two-center retrospective case-controlled study including 15 dogs with and 15 dogs without LAT was conducted. Clinical and echocardiographic data were reviewed, and survival information were collected. RESULTS Nine dogs in each group were in stage C of MMVD, while the remaining were in stage B2. No differences between groups were found regarding age, body weight, sex, kidney values, and echocardiography-derived cardiac dimensions. Most reported clinical signs associated with LAT included weakness, respiratory signs, and syncope. Treatment varied and was mainly focused on the management of congestive heart failure. Three dogs with LAT received a pericardiocentesis. All 15 dogs with LAT had died of cardiac causes, 5 dogs during the first 7 days after admission. The median survival time for all 15 dogs with LAT was 52 days compared to 336 days in the control group (P=0.103). When excluding 5 dogs with LAT that died during the first 7 days, the median survival increased to 407 days, not different compared to the control group (P=0.549). CONCLUSIONS Dogs with MMVD and LAT have a high short-term mortality; however, when surviving the acute phase, the long-term prognosis may not differ from dogs with a similarly advanced degree of MMVD but without LAT.
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Affiliation(s)
- A A Czech
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - F Testa
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy.
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Sidler M, Santarelli G, Kovacevic A, Novo Matos J, Schreiber N, Baron Toaldo M. Ventricular pre-excitation in cats: 17 cases. J Vet Cardiol 2023; 47:70-82. [PMID: 37267820 DOI: 10.1016/j.jvc.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Atrioventricular accessory pathways are abnormal electrical connections between the atria and ventricles that predispose to ventricular pre-excitation (VPE) and tachycardias. ANIMALS Seventeen cats with VPE and 15 healthy matched-control cats. MATERIAL AND METHODS Multicenter case-control retrospective study. Clinical records were searched for cats with VPE, defined as preserved atrioventricular synchrony, reduced PQ interval, and increased QRS complex duration with a delta wave. Clinical, electrocardiography, echocardiographic, and outcome data were collated. RESULTS Most cats with VPE were male (16/17 cats), non-pedigree cats (11/17 cats). Median age and mean body weight were 5.4 years (0.3-11.9 years) and 4.6 ± 0.8 kg, respectively. Clinical signs at presentation included lethargy (10/17 cats), tachypnea (6/17 cats), and/or syncope (3/17 cats). In two cats, VPE was an incidental finding. Congestive heart failure was uncommon (3/17 cats). Nine (9/17) cats had tachyarrhythmias: 7/9 cats had narrow QRS complex tachycardia and 2/9 cats had wide QRS complex tachycardia. Four cats had ventricular arrhythmias. Cats with VPE had larger left (P < 0.001) and right (P < 0.001) atria and thicker interventricular septum (P = 0.019) and left ventricular free wall (P = 0.028) than controls. Three cats had hypertrophic cardiomyopathy. Treatment included different combinations of sotalol (5/17 cats), diltiazem (5/17 cats), atenolol (4/17 cats), furosemide (4/17 cats), and platelet inhibitors (4/17 cats). Five cats died, all from cardiac death (median survival time 1882 days [2-1882 days]). CONCLUSIONS Cats with VPE had a relatively long survival, albeit showing larger atria and thicker left ventricular walls than healthy cats.
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Affiliation(s)
- M Sidler
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - G Santarelli
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Utrecht, the Netherlands
| | - A Kovacevic
- Division of Small Animal Cardiology, Department of Veterinary Clinical Medicine, Vetsuisse Faculty, University of Bern, Switzerland
| | - J Novo Matos
- Queen's Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, UK
| | - N Schreiber
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland.
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Schreiber N, Willis R, Glaus T, Baron Toaldo M. Comparison of the diagnostic value of a small, single channel, electrocardiogram monitoring patch with a standard 3-lead Holter system over 24 h in dogs. J Vet Cardiol 2023; 47:47-54. [PMID: 37196397 DOI: 10.1016/j.jvc.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION/OBJECTIVES The aim of this study was to compare a novel small event recorder device, the Carnation Ambulatory Monitor (CAM), with a standard Holter. ANIMALS Nineteen adult dogs. MATERIAL AND METHODS Comparative and explorative study. The two devices were simultaneously applied for approximately 24 h. RESULTS analysis time (p=0.013) and percentage of artefacts (p<0.001) were greater for the CAM (110 min [40-264]; and 9% [0-34], respectively) compared to a standard Holter (30 min [18-270]; and 0.3% [0-9], respectively). The total number of beats (p=0.017) and maximum (p=0.02) and mean (p=0.037) heart rates were lower for the CAM (113,806 ± 23,619 beats; 227 ± 35 bpm; and 88 ± 22 bpm, respectively) compared to the standard Holter (131,640 ± 40,037 beats; 260 ± 64 bpm; and 92 ± 26 bpm, respectively). The minimal heart rate (p=0.725), number of pauses (p=0.078), duration of the longest pause (p=0.087), number of ventricular ectopic beats (p=0.55), ventricular couplets (p=0.186), ventricular triplets (p=0.203), ventricular tachycardia (p=0.05), Lown grade (p=0.233), presence or absence of ventricular bigeminy, trigeminy, supraventricular tachycardia, and atrial fibrillation (p=0.98) did not differ. The CAM missed some relevant events, like complex ventricular arrhythmias, and the Lown grade did not match in 5/19 dogs when comparing the devices. CONCLUSIONS CAM can be used to record ECG traces in dogs over a prolonged period, allowing to detect arrhythmias. Due to some clinically relevant limitations, including a higher percentage of artefacts, a longer reading time (which precludes quantitative counts of >300VPCs), and underestimation of complex ventricular arrhythmias, the CAM appears not suitable for quantitative arrhythmia analysis in dogs.
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Affiliation(s)
- N Schreiber
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland
| | - R Willis
- Sarah Smith Cardiology, Ivy Court, Willington Road, Etwall, Derby, DE65 6JG, UK
| | - T Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland.
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Romito G, Summerfield N, Baron Toaldo M. Corrigendum to ‘Presumptive vagally-mediated atrial flutter in a dog’ [J Vet Cardiol (2022) 39, 46–50]. J Vet Cardiol 2022; 42:14. [DOI: 10.1016/j.jvc.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Romito G, Summerfield N, Baron Toaldo M. Presumptive vagally-mediated atrial flutter in a dog. J Vet Cardiol 2021; 39:46-50. [PMID: 34973471 DOI: 10.1016/j.jvc.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
An asymptomatic nine-year-old Dobermann Pinscher underwent a screening for dilated cardiomyopathy. Echocardiography revealed left ventricular eccentric hypertrophy and systolic dysfunction; the rest of the echocardiographic parameters were within normal limits. Holter monitoring demonstrated sinus rhythm as the dominant cardiac rhythm during the first hours of the recording. Then, during a period of physiologically enhanced vagal tone (sleep), spontaneous development of atrial flutter (AFL) associated with variable ventricular response was documented. Alternation between AFL and paroxysmal atrial fibrillation was also observed. Subsequently, during a period of physiological increase of sympathetic tone (physical activity/excitement), spontaneous conversion of AFL to sinus rhythm occurred. In light of these findings, a presumptive diagnosis of vagal AFL was made. The images here described allow us to study the onset, behavior and termination of this intriguing electrocardiographic entity.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell'Emilia, Italy.
| | | | - M Baron Toaldo
- Division of Cardiology, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
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Kost LV, Glaus TM, Diana A, Baron Toaldo M. Effect of a single dose of pimobendan on right ventricular and right atrial function in 11 healthy cats. J Vet Cardiol 2021; 37:52-61. [PMID: 34560344 DOI: 10.1016/j.jvc.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/30/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the effect of pimobendan on echocardiographic parameters of right ventricular and atrial function in healthy cats. ANIMALS Eleven privately owned, healthy adult cats. MATERIAL AND METHODS Each cat underwent five echocardiographic examinations: the first and second examinations were performed 1 h apart on day 0. On day 1, the third examination served as baseline, whereas the fourth and fifth examinations were performed one and 6 h after administration of a single oral dose of pimobendan (1.25 mg/cat), respectively. Parameters of right ventricular and atrial morphology and function were collected and compared among time points. RESULTS Pimobendan administration produced a change in some echocardiographic variables. Specifically, heart rate, right ventricular fractional shortening and peak velocity of systolic lateral tricuspid annular motion increased (P = 0.032, P = 0.002 and P < 0.001, respectively), whereas right ventricular end-systolic internal diameter and right atrial maximum and minimum internal diameters decreased (P = 0.004, P = 0.025 and P = 0.01, respectively). Right ventricular fractional area change and tricuspid annular plane systolic excursion did not change. CONCLUSIONS This novel study showed that pimobendan had positive effects on right ventricular and right atrial function in healthy cats. Further studies are needed to determine whether pimobendan has similar effects in cats with cardiac diseases.
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Affiliation(s)
- L V Kost
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy.
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Borgarelli M, Ferasin L, Lamb K, Chiavegato D, Bussadori C, D'Agnolo G, Migliorini F, Poggi M, Santilli RA, Guillot E, Garelli-Paar C, Toschi Corneliani R, Farina F, Zani A, Dirven M, Smets P, Guglielmini C, Oliveira P, Di Marcello M, Porciello F, Crosara S, Ciaramella P, Piantedosi D, Smith S, Vannini S, Dall'Aglio E, Savarino P, Quintavalla C, Patteson M, Silva J, Locatelli C, Baron Toaldo M. The predictive value of clinical, radiographic, echocardiographic variables and cardiac biomarkers for assessing risk of the onset of heart failure or cardiac death in dogs with preclinical myxomatous mitral valve disease enrolled in the DELAY study. J Vet Cardiol 2021; 36:77-88. [PMID: 34118562 DOI: 10.1016/j.jvc.2021.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify the predictive value on time to onset of heart failure (HF) or cardiac death of clinical, radiographic, and echocardiographic variables, as well as cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I in dogs with preclinical myxomatous mitral valve disease (MMVD). ANIMALS One hundred sixty-eight dogs with preclinical MMVD and left atrium to aortic root ratio ≥1.6 (LA:Ao) and normalized left ventricular end-diastolic diameter ≥1.7 were included. METHODS Prospective, randomized, multicenter, single-blinded, placebo-controlled study. Clinical, radiographic, echocardiographic variables and plasma cardiac biomarkers concentrations were compared at different time points. Using receiving operating curves analysis, best cutoff for selected variables was identified and the risk to develop the study endpoint at six-month intervals was calculated. RESULTS Left atrial to aortic root ratio >2.1 (hazard ratio [HR] 3.2, 95% confidence interval [95% CI] 1.9-5.6), normalized left ventricular end-diastolic diameter > 1.9 (HR: 6.3; 95% CI: 3.3-11.8), early transmitral peak velocity (E peak) > 1 m/sec (HR: 3.9; 95% CI: 2.3-6.7), and NT-proBNP > 1500 ρmol/L (HR: 5.7; 95% CI: 3.3-9.5) were associated with increased risk of HF or cardiac death. The best fit model to predict the risk to reach the endpoint was represented by the plasma NT-proBNP concentrations adjusted for LA:Ao and E peak. CONCLUSIONS Logistic and survival models including echocardiographic variables and NT-proBNP can be used to identify dogs with preclinical MMVD at higher risk to develop HF or cardiac death.
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Affiliation(s)
- M Borgarelli
- Department Small Animal Clinical Science, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA.
| | - L Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd, Alton, Hampshire, UK
| | - K Lamb
- Lamb Statiscal Consulting and Scientific Writing LLC, West St. Paul, MN, USA
| | | | - C Bussadori
- Clinica Veterinaria Gran Sasso, Milan, Italy
| | | | | | - M Poggi
- Centro Veterinario Imperiese, Imperia, Italy
| | - R A Santilli
- Clinica Veterinaria Malpensa, Samarate Varese, Italy
| | - E Guillot
- Ceva Santé Animale, Libourne, France
| | | | | | - F Farina
- Ambulatorio Veterinario del Parco Margherita, Naples, Italy
| | - A Zani
- Clinica Cardiovet, Livorno, Italy
| | - M Dirven
- Dierenkliniek Rijen, Rijen, the Netherlands
| | - P Smets
- Dierenkliniek Rijen, Rijen, the Netherlands
| | - C Guglielmini
- Dipartimento di Medicina Animale, Produzione e Salute, Università di Padova, Legnaro, Padova, Italy
| | - P Oliveira
- Davies Veterinary Specialists Ltd, Higham Gobion, Hertfordshire, UK
| | - M Di Marcello
- Centro Veterinario Cellatica, Cellatica, Brescia, Italy
| | - F Porciello
- Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Perugia, Italy
| | - S Crosara
- Clinica Veterinaria CMV, Varese, Italy
| | - P Ciaramella
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - D Piantedosi
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - S Smith
- Sarah Smith Cardiology Ivy Court, Willington, UK
| | - S Vannini
- Clinica Veterinaria Gran Sasso, Milan, Italy
| | - E Dall'Aglio
- Clinica Veterinaria Milano Sud, Peschiera Borromeo, Milano, Italy
| | - P Savarino
- Facoltà di Medicina Veterinaria di Torino, Ospedale Didattico Veterinario della Facoltà, Sezione Clinica Medica, Grugliasco, Turin, Italy
| | - C Quintavalla
- Dipartimento di Scienze Mediche Veterinarie, Università di Parma, Parma, Italy
| | - M Patteson
- Heartvets, The Animal Hospital Stinchcombe, Dursley, UK
| | - J Silva
- Clinica Veterinaria Gran Sasso, Milan, Italy
| | - C Locatelli
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - M Baron Toaldo
- Dipartimento di Scienze Mediche Veterinarie, Alma Mayor Studiorum, Università di Bologna, Ozzano Emilia, Italy
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Baron Toaldo M, Glaus T, Campagna I, Novo Matos J, Dennler M. Echocardiographic assessment of right ventricular systolic function in healthy Beagle dogs compared to high field cardiac magnetic resonance imaging. Vet J 2021; 271:105653. [PMID: 33840484 DOI: 10.1016/j.tvjl.2021.105653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/25/2022]
Abstract
Ten healthy Beagle dogs were used to compare selected echocardiographic parameters of right ventricular (RV) systolic function with high field cardiac magnetic resonance imaging (MRI). All dogs underwent complete transthoracic echocardiography before and during anesthesia, as well as cardiac MRI with determination of morphology-based ejection fraction, and phase contrast angiography-derived stroke volume. A correlation analysis was carried out between echocardiographic and MRI parameters. The values of fractional area change, tricuspid annular plane systolic excursion, tissue Doppler imaging derived peak velocity of the isovolumic contraction wave and systolic wave of the lateral tricuspid valve annulus showed lower values under general anesthesia. Of all echocardiographic parameters of RV systolic function, only fractional area change (r = 0.671, P = 0.034) and tissue Doppler imaging derived peak velocity of the systolic wave of the lateral tricuspid valve annulus (r = 0.768; P = 0.01), showed a significant correlation with MRI derived stroke volume. None of the echocardiographic parameters correlated with MRI derived ejection fraction. When evaluating the RV echocardiographically, fractional area change and peak velocity of the systolic wave of the lateral tricuspid valve annulus appear to be the most reliable predictors of RV systolic function when compared to MRI under anesthesia.
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Affiliation(s)
- M Baron Toaldo
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - T Glaus
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - I Campagna
- Department of Clinical Diagnostics and Services, Section of Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - J Novo Matos
- Department for Small Animals, Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - M Dennler
- Department of Clinical Diagnostics and Services, Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Schreiber N, Baron Toaldo M, Romero-Palomo F, Sydler T, Glaus T. Endocardial fibroelastosis in a dog with congestive heart failure. J Vet Cardiol 2020; 32:33-39. [PMID: 33091799 DOI: 10.1016/j.jvc.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/21/2020] [Accepted: 09/02/2020] [Indexed: 11/25/2022]
Abstract
In a 6-month-old, intact female, Japanese spitz presenting with severe dyspnea, lung ultrasonography revealed confluent B lines associated with severe echocardiographic left sided volume overload and systolic dysfunction. A congenital shunt or valvular dysplasia was not demonstrable. On electrocardiogram, there was a constant sinus rhythm, respectively sinus tachycardia. Cardiac troponin I was normal. Within 2 days of admission, the dog died of heart failure. On macroscopic postmortem examination, the left ventricle and atrium were markedly dilated, and the left ventricular endocardium had a mild diffuse whitish appearance. Histopathology revealed moderate to severe thickening of the left ventricular endocardium, composed mostly of abundant elastic fibers and fewer collagen fibers, diagnostic for endocardial fibroelastosis. In addition, there were mild degenerative changes of the atrioventricular valves. Endocardial fibroelastosis is a rare congenital disease and should be considered in a young dog if more common causes of echocardiographic dilated cardiomyopathy phenotype are ruled out.
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Affiliation(s)
- N Schreiber
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland
| | - F Romero-Palomo
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 268, CH-8057, Zurich, Switzerland
| | - T Sydler
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 268, CH-8057, Zurich, Switzerland
| | - T Glaus
- Division of Cardiology, Clinic for Small Animal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057, Zurich, Switzerland.
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Patata V, Scalise F, Sorropago G, Marchesotti F, Nicoli S, Auriemma E, Rondelli V, Pesaresi M, Glaus TM, Baron Toaldo M, Vezzosi T, Domenech O. Closure of an unusual morphology patent ductus arteriosus with a covered stent in a dog. J Vet Cardiol 2020; 32:7-15. [PMID: 33039928 DOI: 10.1016/j.jvc.2020.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 07/01/2020] [Accepted: 09/02/2020] [Indexed: 02/02/2023]
Abstract
Patent ductus arteriosus (PDA) with unusual morphology was diagnosed in a 3-year-old German shepherd presented for exercise intolerance. Two interventional PDA closure procedures with various Amplatzer devices and one surgical ligation were attempted to close the PDA. However, PDA closure failed with both methods due to the unusual morphology and the severe enlarged ductus ampulla. Therefore, the patient underwent an aortic covered stent placement, and successful closure of the PDA was achieved. Eight months after the procedure, the dog was free of clinical signs and no residual flow was identified through the PDA on transthoracic echocardiography. Moreover, computed tomography angiography demonstrated correct stent positioning, with no evidence of thrombus formation, damage to the stent, nor any aortic wall abnormalities. Aortic covered stent placement is a viable option in dogs with unusual PDA morphology.
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Affiliation(s)
- V Patata
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy.
| | - F Scalise
- Department of Interventional Cardiology, Policlinico di Monza, via Carlo Amati, 111, 20900, Monza, Italy
| | - G Sorropago
- Department of Interventional Cardiology, Policlinico di Monza, via Carlo Amati, 111, 20900, Monza, Italy
| | - F Marchesotti
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - S Nicoli
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - E Auriemma
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - V Rondelli
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - M Pesaresi
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057, Zürich, Switzerland
| | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, 40064, Ozzano Emilia, Italy
| | - T Vezzosi
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy; Department of Veterinary Medicine, University of Pisa, Viale delle Piagge, 1, 56124, Pisa, Italy
| | - O Domenech
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
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12
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Baron Toaldo M, Pollesel M, Diana A. Effect of pimobendan on left atrial function: an echocardiographic pilot study in 11 healthy cats. J Vet Cardiol 2020; 28:37-47. [PMID: 32244178 DOI: 10.1016/j.jvc.2020.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES - To evaluate the effect of a single dose of pimobendan on left atrial (LA) function in healthy cats. ANIMALS - Eleven client owned healthy cats. MATERIAL AND METHODS - Standardized and repeated echocardiographic examinations were performed on healthy and conscious cats before and after a single dose of orally administered pimobendan (1.25 mg/cat). Left atrial systolic functional parameters were assessed. RESULTS - Some of the tested parameters of LA function showed significant improvement after pimobendan administration, whereas no significant effect on left ventricular function was observed. In particular, LA minimal diameters obtained from M-mode images in short (p=0.018) and long (p=0.009) axis reduced after pimobendan administration, whereas LA fractional shortening from short (p=0.027) and long (p=0.042) axis and LA appendage emptying velocity (p<0.001) significantly increased. A mild increase in heart rate (p=0.001), and a transient increase on the peak systolic wave pulmonary vein velocity (p=0.008) were also recorded as a possible effect. CONCLUSIONS - A single dose of pimobendan appears to impact LA function in healthy cats. However, because of the small number of cats included, and the absence of a placebo group, these results cannot be definitively separated from the effect of time. Additional studies are needed to understand if similar effects are observed in cats with cardiomyopathy and LA dilatation.
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Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy.
| | - M Pollesel
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
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13
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De Silva M, Mihailovic A, Baron Toaldo M. Two-dimensional, M-mode, and Doppler echocardiography in 22 conscious and apparently healthy pet guinea pigs. J Vet Cardiol 2020; 27:54-61. [PMID: 32070937 DOI: 10.1016/j.jvc.2020.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study was to report normal echocardiographic values in healthy guinea pigs. ANIMALS, MATERIALS, AND METHODS Twenty-two privately owned, apparently healthy, conscious guinea pigs underwent complete transthoracic echocardiography. Left ventricular (LV), right ventricular, left atrial, and aortic root dimensions were measured, as were forward flow velocities across the mitral, aortic, and pulmonic valves. The effects of age, body weight, sex, and heart rate on these variables were also investigated. RESULTS The median age (interquartile range) was 3.0 (1.8-4.0) years with a body weight of 902 (822-998) grams. Echocardiography was feasible in all conscious animals. Early and late diastolic transmitral flow waves were summated in 17 of 22 individuals. In the remaining five animals, the two waves were reversed (E wave-to-A wave velocity less than 1.0). A positive correlation was detected between body weight and LV internal diameter at end-diastole and end-systole and left atrial diameter (P < 0.05). Heart rate was negatively correlated with LV internal diameter at end-systole (r = -0.463, P = 0.035). Age was positively correlated with LV posterior wall thickness at end-diastole and aortic diameter (P < 0.05). LV internal diameter at end-systole was larger in males than in females (P = 0.012), while fractional shortening was lower (P = 0.008). CONCLUSIONS Descriptive echocardiography ranges in apparently healthy awake guinea pigs have been provided and can be used for cardiac assessment in these pet animals.
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Affiliation(s)
- M De Silva
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy.
| | | | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Italy
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14
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Borgarelli M, Ferasin L, Lamb K, Bussadori C, Chiavegato D, D'Agnolo G, Migliorini F, Poggi M, Santilli RA, Guillot E, Garelli-Paar C, Toschi Corneliani R, Farina F, Zani A, Dirven M, Smets P, Guglielmini C, Oliveira P, Di Marcello M, Porciello F, Crosara S, Ciaramella P, Piantedosi D, Smith S, Vannini S, Dall'Aglio E, Savarino P, Quintavalla C, Patteson M, Silva J, Locatelli C, Baron Toaldo M. DELay of Appearance of sYmptoms of Canine Degenerative Mitral Valve Disease Treated with Spironolactone and Benazepril: the DELAY Study. J Vet Cardiol 2020; 27:34-53. [PMID: 32032923 DOI: 10.1016/j.jvc.2019.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Efficacy of renin-angiotensin-aldosterone system (RAAS) blockade using angiotensin-converting enzyme inhibitors (ACEi) in dogs with preclinical myxomatous mitral valve disease (MMVD) is controversial. HYPOTHESIS Administration of spironolactone (2-4 mg q 24 h) and benazepril (0.25-0.5 mg q 24 h) in dogs with preclinical MMVD, not receiving any other cardiac medications, delays the onset of heart failure (HF) and cardiac-related death. Moreover, it reduces the progression of the disease as indicated by echocardiographic parameters and level of cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). ANIMALS 184 dogs with pre-clinical MMVD and left atrium-to-aortic root ratio (LA:Ao) ≥1.6 and normalized left ventricular end-diastolic diameter (LVEDDn) ≥1.7. METHODS This is a prospective, randomized, multicenter, single-blinded, placebo-controlled study. Primary outcome variable was time-to-onset of first occurrence of HF or cardiac death. Secondary end points included effect of treatment on progression of the disease based on echocardiographic and radiographic parameters, as well as variations of NT-proBNP and cTnI concentrations. RESULTS The median time to primary end point was 902 days (95% confidence interval (CI) 682-not available) for the treatment group and 1139 days (95% CI 732-NA) for the control group (p = 0.45). Vertebral heart score (p = 0.05), LA:Ao (p < 0.001), LVEDDn (p < 0.001), trans-mitral E peak velocity (p = 0.011), and NT-proBNP (p = 0.037) were lower at the end of study in the treatment group. CONCLUSIONS This study failed in demonstrating that combined administration of spironolactone and benazepril delays onset of HF in dogs with preclinical MMVD. However, such treatment induces beneficial effects on cardiac remodeling and these results could be of clinical relevance.
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Affiliation(s)
- M Borgarelli
- Department Small Animal Clinical Science, Virginia Maryland College of Veterinary Medicine, Blacksburg, VA, USA.
| | - L Ferasin
- Lumbry Park Veterinary Specialists, Alton, Hampshire, UK
| | - K Lamb
- Lamb Statiscal Consulting and Scientific Writing LLC, West St. Paul, MN, USA
| | - C Bussadori
- Clinica Veterinaria Gran Sasso, Milan, Italy
| | | | | | | | - M Poggi
- Centro Veterinario Imperiese, Imperia, Italy
| | - R A Santilli
- Clinica Veterinaria Malpensa, Samarate Varese, Italy
| | - E Guillot
- Ceva Santé Animale, Libourne, France
| | | | | | - F Farina
- Ambulatorio Veterinario Del Parco Margherita, Naples, Italy
| | - A Zani
- Clinica Cardiovet, Livorno, Italy
| | - M Dirven
- Dierenkliniek Rijen, Rijen the Netherlands
| | - P Smets
- Dierenkliniek Rijen, Rijen the Netherlands
| | - C Guglielmini
- Dipartimento di Medicina Animale, Produzione e Salute, Università di Padova, Legnaro Padova, Italy
| | - P Oliveira
- Davies Veterinary Specialists Ltd, Higham Gobion, Hertfordshire, UK
| | - M Di Marcello
- Centro Veterinario Cellatica, Cellatica, Brescia, Italy
| | - F Porciello
- Dipartimento di Medicina Veterinaria, Università Degli Studi di Perugia, Perugia, Italy
| | - S Crosara
- Clinica Veterinaria CMV, Varese, Italy
| | - P Ciaramella
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - D Piantedosi
- Dipartimento di Medicina Veterinaria e Produzioni Animali, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - S Smith
- Sarah Smith Cardiology Ivy Court, Willington, UK
| | - S Vannini
- Clinica Veterinaria Gran Sasso, Milan, Italy
| | - E Dall'Aglio
- Clinica Veterinaria Milano Sud, Peschiera Borromeo, Milano, Italy
| | - P Savarino
- Facoltà di Medicina Veterinaria di Torino, Ospedale Didattico Veterinario Della Facoltà, Sezione Clinica Medica, Grugliasco, Turin, Italy
| | - C Quintavalla
- Dipartimento di Scienze Mediche Veterinarie, Università di Parma, Parma, Italy
| | - M Patteson
- Heartvets, The Animal Hospital Stinchcombe, Dursley, UK
| | - J Silva
- Clinica Veterinaria Gran Sasso, Milan, Italy
| | - C Locatelli
- Dipartimento di Medicina Veterinaria, Università Degli Studi di Milano, Milan, Italy
| | - M Baron Toaldo
- Dipartimento di Scienze Mediche Veterinarie, Alma Mayor Studiorum, Università di Bologna, Ozzano Emilia, Italy
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Glaus T, Ivasovic F, Jörger F, Schreiber N, Baron Toaldo M. [Extraction invasive minimale de Dirofilaria immitis chez un chien souffrant d'un syndrome cave supérieur]. SCHWEIZ ARCH TIERH 2019; 161:749-754. [PMID: 31685448 DOI: 10.17236/sat00234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Caval syndrome due to infection with Dirofilaria (D.) immitis is a life-threatening situation, needing immediate therapeutic intervention. Severe pulmonary hypertension due to dirofilariosis was diagnosed echocardiographically in a 3.6 kg dog with heart failure and moderate hemolytic anemia. A ball of adult worms was visualized in the tricuspid valve area. Using a modified pigtail catheter, these worms were removed under fluoroscopic guidance by a transvenous approach. Already intraoperatively the hemodynamic condition improved. Subsequently, additional routine adulticide treatment was performed without complications. Over the following weeks the severe pulmonary hypertension normalized slowly but steadily. Manual extraction of adult D. immitis can be achieved with relatively simple tools and allows rapid stabilization of a critically sick patient.
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Affiliation(s)
- T Glaus
- Abteilung für Kardiologie, Klinik für Kleintiermedizin, Departement für Kleintiere, Vetsuisse Fakultät Universität Zürich
| | - F Ivasovic
- Abteilung für Kardiologie, Klinik für Kleintiermedizin, Departement für Kleintiere, Vetsuisse Fakultät Universität Zürich
| | - F Jörger
- Abteilung für Anästhesiologie, Departement für klinische Diagnostik und Service, Vetsuisse-Fakultät, Universität Zürich
| | - N Schreiber
- Abteilung für Kardiologie, Klinik für Kleintiermedizin, Departement für Kleintiere, Vetsuisse Fakultät Universität Zürich
| | - M Baron Toaldo
- Abteilung für Kardiologie, Klinik für Kleintiermedizin, Departement für Kleintiere, Vetsuisse Fakultät Universität Zürich
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16
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Abstract
This report describes the transthoracic and transesophageal echocardiographic features of cor triatriatum sinister in an asymptomatic 6-year-old male French bulldog. Although cor triatriatum sinister represents a well-known and widely described cardiac malformation in humans, its description in the canine population is rare. In this clinical case, non-invasive echocardiographic techniques were helpful in visualizing and characterizing the lesion, allowing a valuable assessment of the malformation, and its hemodynamic consequences.
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Affiliation(s)
- P Castagna
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy.
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17
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Abstract
Preexcitation alternans and orthodromic atrioventricular reciprocating tachycardia were diagnosed in a 3-month-old Boxer. The images described here show how conventional electrocardiographic techniques (12-lead surface electrocardiography, 24-hour Holter monitoring, and ladder diagram) can be interpreted to gain detailed information on presence of canine atrioventricular accessory pathways and their conduction properties.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | | | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy.
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18
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Bartoszuk U, Keene BW, Baron Toaldo M, Pereira N, Summerfield N, Novo Matos J, Glaus TM. Holter monitoring demonstrates that ventricular arrhythmias are common in cats with decompensated and compensated hypertrophic cardiomyopathy. Vet J 2018; 243:21-25. [PMID: 30606435 DOI: 10.1016/j.tvjl.2018.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/25/2022]
Abstract
Arrhythmias can complicate cardiac disease in cats and are a potential cause of sudden death. The aim of this study was to evaluate the presence and nature of cardiac arrhythmias, and the potential correlation between plasma serum troponin I (cTnI) concentrations and the presence or severity of arrhythmias in cats with decompensated (dHCM) and compensated hypertrophic cardiomyopathy (cHCM). Forty one client-owned cats were studied: 16 with cHCM, 15 with dHCM and 10 healthy control cats. Physical examination, echocardiography, cTnI and 24-h Holter recordings were obtained in all cats and thoracic radiographs in cats with dHCM. Cats in both HCM groups were followed for 1 year after their initial Holter examination. The median (range) number of ventricular premature complexes (VPCs) over 24h was 867 (1-35,160) in cats with dHCM, 431 (0-18,919) in cats with cHCM and 2 (0-13) in healthy control cats. The median number of episodes of ventricular tachycardia (VTach) was 0 (0-1497) in dHCM and 0.5 (0-91) in cats with cHCM. The number of VPCs, VTach episodes and heart rate was not different between the HCM groups. Plasma serum troponin I was highest in the cats with dHCM, but there was no correlation between cTnI concentration and the number of arrhythmias. Thirteen of 31 cats with HCM died, but an association with the presence and complexity of ventricular arrhythmias was not observed. Compared to healthy cats, ventricular arrhythmias were common in cats with cHCM and dHCM, but neither presence nor complexity of arrhythmias could be linked to prognosis.
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Affiliation(s)
- U Bartoszuk
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland
| | - B W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Dr. Raleigh, NC 27607, USA
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano Emilia, Italy
| | - N Pereira
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Vet Zentrum, Riedäckerstrasse 7, 8422 Pfungen, Switzerland
| | - N Summerfield
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Virtual Veterinary Specialists, P.O. Box 1301, RH10 0NT, UK
| | - J Novo Matos
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland; Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057 Zürich, Switzerland.
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19
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Romito G, Guglielmini C, Mazzarella MO, Cipone M, Diana A, Contiero B, Baron Toaldo M. Diagnostic and prognostic utility of surface electrocardiography in cats with left ventricular hypertrophy. J Vet Cardiol 2018; 20:364-375. [PMID: 30082249 DOI: 10.1016/j.jvc.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 07/06/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To assess the ability of electrocardiography (ECG) to predict left ventricular hypertrophy (LVH) in the cat and to investigate the prognostic value of selected ECG variables in cats with LVH. ANIMALS Fifty-seven privately owned cats: 22 clinically healthy cats and 35 cats with LVH. MATERIAL AND METHODS This is a clinical cohort study. Echocardiographic diagnosis and surface ECG were available. Electrocardiography analysis included rhythm diagnosis and specific electrocardiographic measurements. In cats with LVH, cause of death and outcome data were recorded and analyzed using Kaplan-Meier curves. RESULTS The presence of arrhythmia had sensitivity and specificity of 31% and 100%, respectively, for identifying LVH. Among ECG measurements, duration of QT interval (QT) and QT interval corrected for heart rate (QTc) was statistically different between healthy cats and cats with LVH (p = 0.007). Overall, the most accurate cutoffs to identify LVH were QT > 170 ms (sensitivity and specificity 48.3% and 91%, respectively) and QTc > 188 ms (sensitivity and specificity 62% and 77%, respectively). In healthy cats, the highest QT and QTc values were 180 ms and 200 ms, respectively. Mean survival time was 58 days and indeterminable for cats with QT > 180 ms and QT ≤ 180 ms, respectively (p = 0.042) and 125 days and indeterminable for cats with QTc > 200 ms and QTc ≤ 200 ms, respectively (p = 0.017). CONCLUSIONS Arrhythmias as well as prolonged QT and QTc are useful ECG parameters in identifying LVH and predicting survival in affected cats.
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Affiliation(s)
- G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padua, Italy
| | - M O Mazzarella
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Italy
| | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy.
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20
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Pfammatter N, Campagna I, Baron Toaldo M, Bruellmann E, Richter H, Kircher P, Dennler M. Whole-heart 4D flow cardiac magnetic resonance in healthy dogs. SCHWEIZ ARCH TIERH 2018; 160:295-303. [DOI: 10.17236/sat00159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Baron Toaldo M, Poser H, Menciotti G, Battaia S, Contiero B, Cipone M, Diana A, Mazzotta E, Guglielmini C. Utility of Tissue Doppler Imaging in the Echocardiographic Evaluation of Left and Right Ventricular Function in Dogs with Myxomatous Mitral Valve Disease with or without Pulmonary Hypertension. J Vet Intern Med 2018; 30:697-705. [PMID: 27177623 PMCID: PMC4913565 DOI: 10.1111/jvim.13940] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 02/02/2016] [Accepted: 03/07/2016] [Indexed: 11/29/2022] Open
Abstract
Background In human medicine, right ventricular (RV) functional parameters represent a tool for risk stratification in patients with congestive heart failure caused by left heart disease. Little is known about RV alterations in dogs with left‐sided cardiac disorders. Objectives To assess RV and left ventricular (LV) function in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH). Animals One‐hundred and fourteen dogs: 28 healthy controls and 86 dogs with MMVD at different stages. Methods Prospective observational study. Animals were classified as healthy or having MMVD at different stages of severity and according to presence or absence of PH. Twenty‐eight morphological, echo‐Doppler, and tissue Doppler imaging (TDI) variables were measured and comparison among groups and correlations between LV and RV parameters were studied. Results No differences were found among groups regarding RV echo‐Doppler and TDI variables. Sixteen significant correlations were found between RV TDI and left heart echocardiographic variables. Dogs with PH had significantly higher transmitral E wave peak velocity and higher E/eʹ ratio of septal (sMV) and lateral (pMV) mitral annulus. These 2 variables were found to predict presence of PH with a sensitivity of 84 and 72%, and a specificity of 71 and 80% at cut‐off values of 10 and 9.33 for sMV E/eʹ and pMV E/eʹ, respectively. Conclusions and clinical importance No association between variables of RV function and different MMVD stage and severity of PH could be detected. Some relationships were found between echocardiographic variables of right and left ventricular function.
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Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - H Poser
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - G Menciotti
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - S Battaia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - E Mazzotta
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
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Baron Toaldo M, Romito G, Cipone M, Diana A, Tursi M. Electrocardiographic, echocardiographic, and left atrial strain imaging features of a dog with atrial flutter and third-degree atrioventricular block. J Vet Cardiol 2017; 19:462-468. [DOI: 10.1016/j.jvc.2017.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 07/29/2017] [Accepted: 08/08/2017] [Indexed: 11/29/2022]
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Pereira N, Novo Matos J, Baron Toaldo M, Bartoszuk U, Summerfield N, Riederer A, Reusch C, Glaus T. Cats with diabetes mellitus have diastolic dysfunction in the absence of structural heart disease. Vet J 2017; 225:50-55. [DOI: 10.1016/j.tvjl.2017.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/15/2022]
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Linta N, Baron Toaldo M, Bettini G, Cordella A, Quinci M, Pey P, Galli V, Cipone M, Diana A. The feasibility of contrast enhanced ultrasonography (CEUS) in the diagnosis of non-cardiac thoracic disorders of dogs and cats. BMC Vet Res 2017; 13:141. [PMID: 28545570 PMCID: PMC5445396 DOI: 10.1186/s12917-017-1061-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 05/17/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND This study describes the feasibility of Contrast Enhanced Ultrasonography (CEUS) in the diagnostic work-up of non-cardiac thoracic disorders of small animals. The second aim is to assess the usefulness of CEUS as a direct guide for sample procedures. RESULTS Forty animals, 28 dogs and 12 cats, were included in the study. Thoracic disorders included 23 pulmonary lesions [primary carcinoma (14), lymphoma (1), sarcoma (1), histiocytic sarcoma (1), abscess (1) and pneumonia (5)] and 17 mediastinal lesions [lymphoma (8), thymoma (3), mesothelioma (1), melanoma (1), carcinomatous lymphadenopathy (1), mixsosarcoma (1), lipoma (1), and abscess (1)]. The majority of neoplastic pulmonary lesions showed an inhomogeneous distribution of contrast medium, whereas inflammatory lesions had a homogenous distribution with typical pulmonary vessels ramification. The majority of mediastinal malignant lesions showed an inhomogeneous distribution pattern. The lung and mediastinal abscesses had peripheral enhancement of the wall with an avascular center. All cytological and biopsy samples obtained after CEUS were diagnostic. Quantitative analysis, performed in 19/23 pulmonary lesions, showed a statistically significant difference (P < 0.0001) between the arrival time of the malignant (7.27 s - range 4.46-13.52 s) and benign (4.52 s - range 2.87-6.06 s) pulmonary lesions. CONCLUSIONS CEUS may be a useful tool for the evaluation of non-cardiac thoracic lesions. The contrast medium allows for the precise definition of lesion edges, the presence of necrotic areas, and the distribution of pulmonary vessels. Based on our preliminary results, the use of ultrasonographic contrast medium can be recommended for improving the diagnostic usefulness of cytology and biopsy sampling, because CEUS may help to define necrotic areas from viable tissue.
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Affiliation(s)
- N. Linta
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
| | - M. Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
| | - G. Bettini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
| | - A. Cordella
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
| | - M. Quinci
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
| | - P. Pey
- ANTECH Imaging Services, 17672-B Cowan Avenue, Irvine, CA 92614 USA
| | - V. Galli
- Freelance sonographer, Rome, Italy
| | - M. Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
| | - A. Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, Via Tolara di Sopra 50, I-40064 Ozzano Emilia, Bologna Italy
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Baron Toaldo M, Romito G, Guglielmini C, Diana A, Pelle NG, Contiero B, Cipone M. Assessment of Left Atrial Deformation and Function by 2-Dimensional Speckle Tracking Echocardiography in Healthy Dogs and Dogs With Myxomatous Mitral Valve Disease. J Vet Intern Med 2017; 31:641-649. [PMID: 28455877 PMCID: PMC5435061 DOI: 10.1111/jvim.14722] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 02/02/2017] [Accepted: 03/27/2017] [Indexed: 02/02/2023] Open
Abstract
Background The assessment of left atrial (LA) function by 2‐dimensional speckle tracking echocardiography (STE) holds important clinical implications in human medicine. Few similar data are available in dogs. Objectives To assess LA function by STE in dogs with and without myxomatous mitral valve disease (MMVD), analyzing LA areas, systolic function, and strain. Animals One hundred and fifty dogs were divided according to the American College of Veterinary Internal Medicine classification of heart failure: 23 dogs in class A, 52 in class B1, 36 in class B2, and 39 in class C + D. Methods Prospective observational study. Conventional morphologic and Doppler variables, LA areas, and STE‐based LA strain analysis were performed in all dogs and results were compared among groups. Correlation analysis was carried out between LA STE variables and other echocardiographic variables. Results Variability study showed good reproducibility for all the tested variables (coefficient of variation <16%). Left atrial areas, fractional area change, peak atrial longitudinal strain (PALS), peak atrial contraction strain, and contraction strain index (CSI) differed significantly between groups B2 and C + D and all the other groups (overall P < .001), whereas only PALS differed between groups B1 and A (P = .01). Left atrial areas increased with progression of the disease, whereas LA functional parameters decreased. Only CSI increased nonsignificantly from group A to group B1 and then progressively decreased. Thirty‐one significant correlations (P < .001, r > .3) were found between conventional left heart echocardiographic variables and LA areas and strain variables. Conclusions and Clinical Importance Left atrial STE analysis provides useful information on atrial function in the dog, highlighting a progressive decline in atrial function with worsening of MMVD.
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Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - N G Pelle
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
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Mazzotta E, Guglielmini C, Menciotti G, Contiero B, Baron Toaldo M, Berlanda M, Poser H. Red Blood Cell Distribution Width, Hematology, and Serum Biochemistry in Dogs with Echocardiographically Estimated Precapillary and Postcapillary Pulmonary Arterial Hypertension. J Vet Intern Med 2016; 30:1806-1815. [PMID: 27747929 PMCID: PMC5115192 DOI: 10.1111/jvim.14596] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 08/29/2016] [Accepted: 09/13/2016] [Indexed: 11/17/2022] Open
Abstract
Background Red blood cell distribution width (RDW) is a quantitative measurement of anisocytosis. RDW has prognostic value in humans with different cardiovascular and systemic disorders, but few studies have investigated this biomarker in dogs. Objectives To compare the RDW in dogs with precapillary and postcapillary pulmonary hypertension (PH) and a control population of dogs and to correlate RDW with demographic, echocardiographic, and laboratory variables. Animals One hundred and twenty‐seven client‐owned dogs including 19 healthy dogs, 82 dogs with myxomatous mitral valve disease (50 dogs without PH and 32 dogs with postcapillary PH), and 26 dogs with precapillary PH. Methods Prospective study. Dogs were allocated to groups according to clinical and echocardiographic evaluation. RDW and selected laboratory and echocardiographic variables were compared among dog groups. Associations between RDW and demographic, laboratory, and echocardiographic variables were analyzed using correlation and multiple regression analysis. Results Median RDW in dogs with precapillary PH (13.8%, interquartile range 13.2–14.9%) and postcapillary PH (13.7, 13.2–14.7%) was significantly increased compared to healthy dogs (13.3, 12.3–13.7%; P < .05 for both comparisons), but only dogs with severe PH had significantly increased RDW compared to dogs without PH (P < .05). Peak tricuspid regurgitation pressure gradient was significantly associated with increased RDW (rho = 0.263, P = .007). Serum urea concentration, hematocrit, age, and white blood cell number were significantly associated with RDW in the multivariate analysis. Conclusions and Clinical Importance Underlying pathophysiologic processes associated with PH instead of severity of PH are likely responsible for increased RDW in dogs with PH.
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Affiliation(s)
- E Mazzotta
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - G Menciotti
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - M Berlanda
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - H Poser
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
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Hammes K, Novo Matos J, Baron Toaldo M, Glaus T. Hypovolemia induced systolic anterior motion of the mitral valve in two dogs. J Vet Cardiol 2016; 18:367-371. [PMID: 27639515 DOI: 10.1016/j.jvc.2016.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 06/07/2016] [Accepted: 06/13/2016] [Indexed: 11/20/2022]
Abstract
Systolic anterior (septal) motion of the mitral valve (SAM) is a common secondary phenomenon in hypertrophic cardiomyopathy (HCM) in people and cats. In humans, it is increasingly recognized that SAM may be found in other cardiac and non-cardiac disease states. In small animal cardiology, SAM unassociated with HCM has been described in dogs with mitral valve dysplasia and right ventricular pressure overload. In this report, we describe two cases of dogs where transient SAM was caused by hypovolemia. When SAM was present both dogs showed pseudohypertrophy and tachycardia. Important factors in the genesis of SAM in this scenario are probably hypovolemia induced changes in left ventricular geometry affecting the orientation of the mitral valve apparatus combined with elevated catecholamine levels. SAM associated with increased wall thickness is not pathognomonic of HCM; this observation is of particular clinical importance when extrapolated to species where HCM is highly prevalent, e.g., cats. An echocardiographic diagnosis should always be evaluated together with full clinical assessment of history and physical examination.
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Affiliation(s)
- K Hammes
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zürich, Switzerland
| | - J Novo Matos
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zürich, Switzerland
| | - M Baron Toaldo
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zürich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, via Tolara di Sopra 50, 40064 Ozzano Emilia (BO), Italy
| | - T Glaus
- Division of Cardiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zürich, Switzerland.
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Salvatore V, Baron Toaldo M, Marinelli S, Milazzo M, Palamà C, Venerandi L, Cipone M, Bolondi L, Piscaglia F. Early prediction of treatment response to sorafenib with elastosonography in a mice xenograft model of hepatocellular carcinoma: a proof-of-concept study. Ultraschall Med 2013; 34:541-549. [PMID: 24132648 DOI: 10.1055/s-0033-1355834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Sorafenib is the reference therapy for advanced hepatocellular carcinoma (HCC). There is no method for predicting in the early period subsequent individual response. Starting from the clinical experience in humans that subcutaneous metastases may rapidly change consistency under sorafenib and that elastosonography allows assessment of tissue elasticity, we investigated the role of this ultrasound-based technique in the early prediction of tumor response to sorafenib in a HCC mice model. MATERIALS AND METHODS HCC subcutaneous xenografting in mice was utilized. Mice were randomized to vehicle (17 mice) or treatment with sorafenib (19 mice). Strain elastosonography (Esaote, Italy) of the tumor mass was performed at different time points (day 0, + 2 and + 14 from treatment start) until the mice were sacrificed (day + 14). At the same time points, the volume was calculated with ultrasonography. RESULTS Sorafenib-treated mice showed a smaller increase in tumor size on day + 14 in comparison to vehicle-treated mice (tumor volume increase + 175 % vs. + 382 %, p = 0.009). The median tumor elasticity increased in both groups on day + 2 (+ 5.65 % and + 3.86 %, respectively) and decreased on day + 14 (-3.86 % and -3.63 %, respectively). However, among Sorafenib-treated tumors, 13 mice with a growth percentage delta < 200 % (considered as good treatment response) showed an increase in elasticity on day + 2 (+ 8.9 %, range -12.6 - + 64) while the other 6 with a growth percentage delta > 300 % (considered as poor treatment response) showed a decrease in elasticity (-17 %, range -30.2 - + 15.3) (p = 0.044). CONCLUSION Elastosonography appears to be a promising noninvasive new technique for the early treatment prediction of HCC tumor response to sorafenib. Specifically, an early increase in tumor elasticity (corresponding to tumors becoming softer) is associated with a good response.
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Affiliation(s)
- V Salvatore
- Dept. of Medical and Surgical Sciences, University of Bologna, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna
| | - M Baron Toaldo
- Dept. of Veterinary Medical Sciences, University of Bologna
| | - S Marinelli
- Dept. of Medical and Surgical Sciences, University of Bologna, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna
| | - M Milazzo
- CRBA, Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna
| | - C Palamà
- Dept. of Medical and Surgical Sciences, University of Bologna, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna
| | - L Venerandi
- Dept. of Medical and Surgical Sciences, University of Bologna, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna
| | - M Cipone
- Dept. of Veterinary Medical Sciences, University of Bologna
| | - L Bolondi
- Dept. of Medical and Surgical Sciences, University of Bologna, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna
| | - F Piscaglia
- Dept. of Medical and Surgical Sciences, University of Bologna, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi, Bologna
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Abstract
A 13-year-old, neutered female domestic shorthair cat was presented for sudden respiratory distress following palliative radiotherapy and the combined administration of a single dose of carboplatin for the treatment of recurrent fibrosarcoma. Clinical and radiographic findings were suggestive of pleural effusion. Echocardiography revealed marked right-sided cardiac enlargement associated with tricuspid regurgitation and Doppler evidence of pulmonary hypertension. After 25 days of treatment for congestive heart failure and suspected pulmonary thromboembolism, clinical signs and echocardiographic and Doppler evidence of right-sided cardiac enlargement and pulmonary hypertension had completely resolved. To the best of the authors' knowledge, this is the first report of reversible pulmonary hypertension, likely secondary to pulmonary thromboembolism, in a cat.
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Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Science, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
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