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Tidholm A, Menciotti G, Borgarelli M. Current use of real-time three-dimensional transthoracic echocardiography in animals. J Vet Cardiol 2023; 51:97-104. [PMID: 38118235 DOI: 10.1016/j.jvc.2023.11.009] [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: 11/10/2022] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/22/2023]
Abstract
This review includes 36 studies of transthoracic real-time three-dimensional echocardiography (RT3DE) in animals. Most of these studies concern cardiac chamber quantification of the left atrium and left ventricle, in dogs. Comparisons of RT3DE and different two-dimensional echocardiographic (2DE) methods have been reported in dogs with myxomatous mitral valve disease (MMVD), dilated cardiomyopathy, and in healthy control dogs. Comparisons of RT3DE and standard reference methods have been reported in healthy control dogs. In dogs with MMVD, volumetric RT3DE measurements of left atrium do not appear to provide superior prognostic value compared with 2DE methods using Simpson's method of discs in dogs with MMVD. The major advantages of RT3DE compared to 2DE include improvements in visualization of the complex morphology of the mitral valve, the estimation of mitral valve regurgitation, and improved visualization of complex congenital cardiac abnormalities.
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Affiliation(s)
- A Tidholm
- Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden; Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, USA
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Crosara S, Allodi G, Guazzetti S, Oricco S, Borgarelli M, Corsini A, Quintavalla C. Aorto-septal angle, isolated basal septal hypertrophy, and systolic murmur in 122 cats. J Vet Cardiol 2023; 46:30-39. [PMID: 37037177 DOI: 10.1016/j.jvc.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023]
Abstract
INTRODUCTION/OBJECTIVES Systolic murmurs in the absence of cardiac structural abnormalities are common in cats. Narrow aorto-septal angle (AoSA) and septal remodeling can be a cause of a systolic murmur in elderly human beings. The aim of this study was to measure the AoSA in cats and to investigate the association between the AoSA and the presence of a murmur and isolated basal septal hypertrophy (IBSH). ANIMALS The study population comprised 122 cats. MATERIALS AND METHODS A physical exam, blood pressure measurement, chest radiographs, and echocardiography were performed. RESULTS A systolic murmur was audible in 39/122 cats. A difference between cats with and without a murmur was found for age (P=0.0001), interventricular basal septal thickness (BIVSd) (P=0.004), AoSA (P=0.003), aortic (P<0.0001), and pulmonic (P=0.021) flow velocity, the presence of IBSH (P<0.0001), and systolic anterior motion of the mitral valve (P=0.0002). More than 50% of cats with a murmur had an AoSA ≤122°. Less than 25% of the cats with an AoSA ≥137° had a murmur. The AoSA narrowed 0.55°/year of age (P<0.001), whereas the BIVSd increased 0.11 mm/year of age (P<0.0001); the BIVSd increased as the AoSA narrowed. In all cats with AoSA < 120°, IBSH was present. CONCLUSIONS This study demonstrates that the probability of having a systolic murmur in cats is increased by the presence of a narrow AoSA. Aging was associated with a narrower AoSA and a thicker basal septum; these findings might represent an age-related heart remodeling.
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Franchini A, Borgarelli M, Abbott JA, Menciotti G, Crosara S, Häggström J, Lahmers S, Rosenthal S, Tyrrell W. The Longitudinal Outcome Of Canine (K9) myxomatous mitral valve disease (LOOK-Mitral) registry: baseline treatment characteristics. J Vet Cardiol 2022; 41:99-120. [DOI: 10.1016/j.jvc.2022.02.001] [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] [Received: 06/03/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
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Santilli R, Saponaro V, Carlucci L, Perego M, Battaia S, Borgarelli M. Heart rhythm characterization during sudden cardiac death in dogs. J Vet Cardiol 2021; 38:18-30. [PMID: 34710652 DOI: 10.1016/j.jvc.2021.09.005] [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: 04/17/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION/OBJECTIVES Inherited or acquired arrhythmic disorders and cardiac disease have been associated with sudden cardiac death (SCD) in dogs. The electrical mechanism related to death in most of these cases is unknown. This retrospective study aimed to describe arrhythmic events in dogs that experienced SCD during Holter monitoring. ANIMALS, MATERIALS AND METHODS Nineteen client-owned dogs that experienced SCD during Holter examination were included. Clinical records from a Holter service database were reviewed, and both the rhythm preceding death and the dominant rhythm causing SCD were analysed. Clinical data, Holter diaries and echocardiographic diagnosis were also evaluated. RESULTS Structural heart disease was identified in 12/19 dogs (dilated cardiomyopathy in five dogs, arrhythmogenic right ventricular cardiomyopathy in four dogs, myxomatous mitral valve disease in two dogs, and suspected myocarditis in one dog), five of which had concurrent congestive heart failure. Sudden cardiac death was related to ventricular premature complexes or monomorphic ventricular tachycardia degenerating into ventricular fibrillation in 42% of dogs, polymorphic ventricular tachycardia, or torsade de pointes-like inducing ventricular fibrillation in 21%, and asystole or presumptive agonal pulseless electrical activity triggered by malignant bradyarrhythmias in 37%. CONCLUSIONS The most common rhythm associated with SCD in our population of dogs was ventricular tachycardia leading to ventricular fibrillation, although bradyarrhythmia-related SCD, possibly related to inappropriate vagal reflexes, was also a notable cause.
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Affiliation(s)
- R Santilli
- Clinica Veterinaria Malpensa, AniCura, Via G. Marconi 27, Samarate, Varese, 21017, Italy; Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, NY, 14853, USA.
| | - V Saponaro
- Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), Ecole Nationale Vétérinaire d'Alfort, 7 avenue du Général de Gaulle, Maisons-Alfort, F-94700, France
| | - L Carlucci
- Scuola Superiore Sant'Anna, Istituto Scienze della Vita, Via Martiri della Libertà, 33, Pisa, 56100, Italy
| | - M Perego
- Clinica Veterinaria Malpensa, AniCura, Via G. Marconi 27, Samarate, Varese, 21017, Italy; Ospedale Veterinario I Portoni Rossi, Via Roma 57, Zola Predosa, Bologna, 40069, Italy
| | - S Battaia
- Clinica Veterinaria Malpensa, AniCura, Via G. Marconi 27, Samarate, Varese, 21017, Italy; Ospedale Veterinario I Portoni Rossi, Via Roma 57, Zola Predosa, Bologna, 40069, Italy
| | - M Borgarelli
- Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA, 24060, USA
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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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Franchini A, Borgarelli M, Abbott JA, Menciotti G, Crosara S, Häggström J, Lahmers S, Rosenthal S, Tyrrell W. The Longitudinal Outcome Of Canine (K9) myxomatous mitral valve disease (LOOK-Mitral registry): Baseline characteristics. J Vet Cardiol 2021; 36:32-47. [PMID: 34062479 DOI: 10.1016/j.jvc.2021.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The Longitudinal Outcome Of Canine (K9) myxomatous mitral valve disease (MMVD) registry (LOOK-Mitral registry) was established to describe the natural history and predictors of outcome in dogs affected by MMVD. This study was intended to describe the baseline characteristics of dogs in the LOOK-mitral registry. ANIMALS Dogs with echocardiographic evidence of MMVD were prospectively enrolled by thirteen referral centers. RESULTS A total of 6102 dogs with MMVD were included. The median age was 10 years (1-19 years), and mixed breed was the most common breed (n = 1,360, 22%). Concomitant diseases were reported in 2459 dogs with chronic respiratory diseases occurring most frequently (14%), followed by the presence of azotemia (6%) and orthopedic diseases (5%). Regarding disease severity, 65% of dogs were in ACVIM Stage-B1, 15% in Stage-B2, and 20% in Stage-C. Dogs in Stage-B1 were younger (p<0.001) than dogs in other stages. Murmur intensity, heart rate during physical examination, and radiographic vertebral heart score were positively associated with the stage. Dogs in Stage-C were more likely to have tachypnea (p<0.001), dyspnea (p<0.001), cough (p<0.001), syncopal episodes (p<0.001), and tachyarrhythmias (p<0.001) compared to dogs in Stage-B1 and B2. Echocardiographic indices of left atrial and ventricular size were positively correlated with the ACVIM stage. Interestingly, 4% of dogs that weighed <20 kg had an increased normalized end-systolic left ventricle internal diameter (>1.26). CONCLUSIONS This study contributes to a better understanding of the clinical characteristics of dogs affected by MMVD and provides new findings that may be of clinical relevance.
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Affiliation(s)
- A Franchini
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA.
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
| | - J A Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN, 37996, USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
| | - S Crosara
- Department of Veterinary Sciences, University of Parma, Strada Del Taglio 10, 43126, PR, Italy
| | - J Häggström
- Department of Clinical Science, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Science, Box 7054, Uppsala, Sweden
| | - S Lahmers
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
| | - S Rosenthal
- CVCA Cardiac Care for Pets, 1209 Cromwell Bridge Road, Towson, MD, 21286, USA
| | - W Tyrrell
- CVCA Cardiac Care for Pets, 165 Fort Evans Road NE, Leesburg, VA, 20176, USA
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Menciotti G, Abbott JA, Aherne M, Lahmers SM, Borgarelli M. Accuracy of echocardiographically estimated pulmonary artery pressure in dogs with myxomatous mitral valve disease. J Vet Cardiol 2021; 35:90-100. [PMID: 33895627 DOI: 10.1016/j.jvc.2021.03.003] [Citation(s) in RCA: 3] [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: 11/06/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Echocardiographically identified pulmonary hypertension is an independent predictor of poor outcome in dogs affected by myxomatous valvular degeneration (MMVD). Systolic pulmonary arterial pressure is routinely estimated based on its relationship with the Doppler-determined velocity of tricuspid regurgitation as defined by the simplified Bernoulli equation (sPAP_D). Experimental studies suggest that the method is imperfect, but its accuracy in dogs with MMVD is not known. ANIMALS Twenty dogs affected by MMVD that had cardiac remodeling and measurable tricuspid regurgitation. METHODS A flow-directed thermodilution monitoring catheter was percutaneously placed in the right external jugular vein and advanced to the main pulmonary artery. Pulmonary arterial systolic pressure was recorded (systolic pulmonary arterial pressure obtained by right heart catheterization [sPAP_C]). A second operator contemporaneously acquired tricuspid regurgitant velocity spectra to calculate sPAP_D. Each operator was blinded to the result of the other techniques. RESULTS Technical difficulties prevented the analysis of catheterization data in two dogs. Eighteen measurement pairs were therefore used for comparison of sPAP_C and sPAP_D through correlation and Bland-Altman analysis. A statistically significant bias between sPAP_C and sPAP_D (mean difference = 0.5 mmHg; confidence interval = -6.5 mmHg, +7.5 mmHg) was not detected. The interval of agreement between the techniques was wide (-27.3 mmHg, +28.2 mmHg). A significant linear association between the two techniques was not identified (r = 0.11, p=0.17). CONCLUSION Echocardiographically estimated pulmonary artery pressure poorly agrees with sPAP_C measurement in dogs affected by MMVD and cardiac remodeling with or without previously diagnosed congestive heart failure. In these dogs, sPAP_D could under- or over-estimate sPAP_C by more than 20 mmHg, and therefore caution should be used when interpreting sPAP_D.
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Affiliation(s)
- G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061, USA.
| | - J A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061, USA
| | - M Aherne
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061, USA
| | - S M Lahmers
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061, USA
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061, USA
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Franchini A, Abbott JA, Tyrrell W, Rosenthal S, Lahmers S, Menciotti G, Crosara S, Häggström J, Borgarelli M. Predictors of reoccurrence of congestive signs within 180 days after successful treatment of the first episode of congestive heart failure in dogs with myxomatous mitral valve disease. J Vet Cardiol 2021; 34:112-119. [PMID: 33706221 DOI: 10.1016/j.jvc.2020.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/24/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Myxomatous mitral valve disease (MMVD) is the most common cause of left-sided congestive heart failure in dogs. We sought to identify predictors of first reoccurrence of congestive signs (CS) within 180 days in dogs with MMVD and clinically stable heart failure. ANIMALS A total of 445 dogs affected by stable American College of Veterinary Internal Medicine (ACVIM)-Stage-C MMVD were included, 106 in the reoccurrence group (RG) and 339 in no reoccurrence group (NRG). Patients were considered "stable" if medical treatment had been unchanged for at least 4 weeks since the first identification of CS. METHODS Medical records of dogs with stable ACVIM-Stage-C MMVD included in a registry of dogs affected by MMVD were reviewed. Follow-up was required for inclusion in this investigation. Logistic regression was used to identify clinical and echocardiographic variables that independently predict first reoccurrence of CS. RESULTS Baseline left atrial-aortic ratio (p=0.022, OR: 1.89, 90% CI: 1.20-2.98), left ventricular internal diameter at end-diastole (LVIDd_N) (p=0.014, OR: 2.84, 90% CI: 1.41-5.77), peak velocity of early diastolic transmitral flow (p=0.049, OR: 1.81, 90% CI: 1.10-3.00) and furosemide daily dosage (p=0.039, OR: 1.19, 90% CI: 1.04-1.37) were associated with reoccurrence of CS in univariable analyses. The LVIDd_N (p=0.014) remained significant in the multivariable analysis, but the area under the receiver operator characteristic curve was 0.57. CONCLUSION This study failed to identify accurate predictors of reoccurrence of CS. However, dogs with larger value of LVIDd_N are more likely to have reoccurrence of CS within 180 days.
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Affiliation(s)
- A Franchini
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytech Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA.
| | - J A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytech Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
| | - W Tyrrell
- CVCA Cardiac Care for Pets, 165 Fort Evans Road NE, Leesburg, VA, 20176, USA
| | - S Rosenthal
- CVCA Cardiac Care for Pets, 1209 Cromwell Bridge Road, Towson, MD, 21286, USA
| | - S Lahmers
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytech Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytech Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
| | - S Crosara
- Department of Veterinary Sciences, University of Parma, Strada Del Taglio 10, 43126, PR, Italy
| | - J Häggström
- Department of Clinical Science, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Science, Box 7054, Uppsala, Sweden
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytech Institute and State University, 204 Duck Pond Drive, Blacksburg, VA, 24061-0442, USA
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Rivera PA, Borgarelli M. Cardiovascular images: constrictive pericarditis and tricavitary effusion in a dog with pericardial mesothelioma. J Vet Cardiol 2020; 32:55-59. [PMID: 33137660 DOI: 10.1016/j.jvc.2020.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/19/2019] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 11/19/2022]
Abstract
This report describes the transthoracic echocardiographic findings and computed tomography features of a 12-year-old West Highland white terrier with constrictive pericarditis (CP) secondary to pericardial mesothelioma. Although pericardial mesothelioma is well described in dogs, its association with CP in the canine population is not as widely reported. In this clinical case, a multidisciplinary imaging approach was helpful to identify anatomical and hemodynamic abnormalities that allowed for a diagnosis of CP.
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Affiliation(s)
- P A Rivera
- Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA, 24060, USA.
| | - M Borgarelli
- Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr, Blacksburg, VA, 24060, USA
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Reinero C, Visser LC, Kellihan HB, Masseau I, Rozanski E, Clercx C, Williams K, Abbott J, Borgarelli M, Scansen BA. ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. J Vet Intern Med 2020; 34:549-573. [PMID: 32065428 PMCID: PMC7097566 DOI: 10.1111/jvim.15725] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/30/2020] [Indexed: 01/01/2023] Open
Abstract
Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.
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Affiliation(s)
- Carol Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Heidi B Kellihan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin
| | - Isabelle Masseau
- Department of Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, Medford, Massachusetts
| | - Cécile Clercx
- Department of Clinical Sciences of Companion Animals and Equine, University of Liège, Liège, Belgium
| | - Kurt Williams
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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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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Fox PR, Keene BW, Lamb K, Schober KE, Chetboul V, Luis Fuentes V, Payne JR, Wess G, Hogan DF, Abbott JA, Häggström J, Culshaw G, Fine-Ferreira D, Cote E, Trehiou-Sechi E, Motsinger-Reif AA, Nakamura RK, Singh M, Ware WA, Riesen SC, Borgarelli M, Rush JE, Vollmar A, Lesser MB, Van Israel N, Lee PMS, Bulmer B, Santilli R, Bossbaly MJ, Quick N, Bussadori C, Bright J, Estrada AH, Ohad DG, Del Palacio MJF, Brayley JL, Schwartz DS, Gordon SG, Jung S, Bove CM, Brambilla PG, Moïse NS, Stauthammer C, Quintavalla C, Manczur F, Stepien RL, Mooney C, Hung YW, Lobetti R, Tamborini A, Oyama MA, Komolov A, Fujii Y, Pariaut R, Uechi M, Yukie Tachika Ohara V. Long-term incidence and risk of noncardiovascular and all-cause mortality in apparently healthy cats and cats with preclinical hypertrophic cardiomyopathy. J Vet Intern Med 2019; 33:2572-2586. [PMID: 31605422 PMCID: PMC6872868 DOI: 10.1111/jvim.15609] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 08/20/2019] [Indexed: 01/08/2023] Open
Abstract
Background Epidemiologic knowledge regarding noncardiovascular and all‐cause mortality in apparently healthy cats (AH) and cats with preclinical hypertrophic cardiomyopathy (pHCM) is limited, hindering development of evidence‐based healthcare guidelines. Objectives To characterize/compare incidence rates, risk, and survival associated with noncardiovascular and all‐cause mortality in AH and pHCM cats. Animals A total of 1730 client‐owned cats (722 AH, 1008 pHCM) from 21 countries. Methods Retrospective, multicenter, longitudinal, cohort study. Long‐term health data were extracted by medical record review and owner/referring veterinarian interviews. Results Noncardiovascular death occurred in 534 (30.9%) of 1730 cats observed up to 15.2 years. Proportion of noncardiovascular death did not differ significantly between cats that at study enrollment were AH or had pHCM (P = .48). Cancer, chronic kidney disease, and conditions characterized by chronic weight‐loss‐vomiting‐diarrhea‐anorexia were the most frequently recorded noncardiovascular causes of death. Incidence rates/risk of noncardiac death increased with age in AH and pHCM. All‐cause death proportions were greater in pHCM than AH (65% versus 40%, respectively; P < .001) because of higher cardiovascular mortality in pHCM cats. Comparing AH with pHCM, median survival (study entry to noncardiovascular death) did not differ (AH, 9.8 years; pHCM, 8.6 years; P = .10), but all‐cause survival was significantly shorter in pHCM (P = .0001). Conclusions and Clinical Importance All‐cause mortality was significantly greater in pHCM cats due to disease burden contributed by increased cardiovascular death superimposed upon noncardiovascular death.
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Affiliation(s)
- Philip R Fox
- Animal Medical Center, New York, New York, U.S.A
| | - Bruce W Keene
- College of Veterinary Medicine, North Carolina State University, Department of Clinical Sciences, Raleigh, North Carolina, U.S.A
| | | | - Karsten E Schober
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, U.S.A
| | - Valérie Chetboul
- Alfort Cardiology Unit, École Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Virginia Luis Fuentes
- Department of Veterinary Clinical Sciences and Services, Royal Veterinary College, Hatfield, United Kingdom
| | | | - Gerhard Wess
- Clinic of Small Animal Medicine, Ludwig-Maximillians University, Munich, Germany
| | - Daniel F Hogan
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Jonathan A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, U.S.A
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Geoffrey Culshaw
- Division of Veterinary Clinical Sciences, R(D)SVS Hospital for Small Animals Easter Bush Veterinary Centre, The University of Edinburgh, Midlothian, United Kingdom
| | | | - Etienne Cote
- Atlantic Veterinary College, Univertisy of PEI-Department of Companion Animals, Charlottetown, Prince Edward Island, Canada
| | - Emilie Trehiou-Sechi
- École Nationale Vétérinaire d'Alfort, Cardiology Unit of Alfort-Université Paris-Est, Maisons-Alfort, France
| | | | - Reid K Nakamura
- Advanced Veterinary Care Center-Cardiology, Lawndale, California, U.S.A
| | - Manreet Singh
- Veterinary Cardiac Referrals-Cardiology, Sydney, New South Wales, Australia
| | - Wendy A Ware
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, U.S.A
| | | | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, U.S.A
| | - John E Rush
- Department of Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts, U.S.A
| | | | | | | | - Pamela Ming-Show Lee
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington, U.S.A
| | - Barret Bulmer
- Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, U.S.A
| | - Roberto Santilli
- Department of Cardiology, Clinica Veterinaria Malpensa, Varese, Italy
| | | | - Nadine Quick
- Ludwig-Maximilians-University Munich, Clinic of Small Animal Medicine, Munich, Germany
| | - Claudio Bussadori
- Department of Cardiology, Clinica Veterinaria Gran Sasso, Milano, Italy
| | - Janice Bright
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, U.S.A
| | - Amara H Estrada
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, U.S.A
| | - Dan G Ohad
- The Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | | | | | - Denise S Schwartz
- School of Veterinary Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, U.S.A
| | - SeungWoo Jung
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, U.S.A
| | - Christina M Bove
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, U.S.A
| | - Paola G Brambilla
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - N Sydney Moïse
- Department of Clinical Sciences, Cornell University, Ithaca, New York, U.S.A
| | - Christopher Stauthammer
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, U.S.A
| | | | - Ferenc Manczur
- Department of Internal Medicine, University of Veterinary Medicine, Budapest, Hungary
| | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin Madison School of Veterinary Medicine, Madison, Wisconsin, U.S.A
| | - Carmel Mooney
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | | | - Remo Lobetti
- Bryanston Veterinary Hospital, Bryanston, South Africa
| | - Alice Tamborini
- Department of Small Animal Medicine, University College Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Mark A Oyama
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | | | - Yoko Fujii
- Laboratory of Surgery 1, Azabu University, Sagamihara, Japan
| | - Romain Pariaut
- Department of Veterinary Clinical Sciences, Cornell University, Ithaca, New York, U.S.A
| | - Masami Uechi
- Jasmine Animal Cardiovascular Center, Yokohama, Japan
| | - Victoria Yukie Tachika Ohara
- Department of Medicine, Surgery and Zootechnics for Small Species, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Menciotti G, Borgarelli M, Aherne M, Camacho P, Häggström J, Ljungvall I, Lahmers SM, Abbott JA. Comparison of the mitral valve morphologies of Cavalier King Charles Spaniels and dogs of other breeds using 3D transthoracic echocardiography. J Vet Intern Med 2018; 32:1564-1569. [PMID: 30238697 PMCID: PMC6189382 DOI: 10.1111/jvim.15252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/25/2018] [Accepted: 05/31/2018] [Indexed: 11/30/2022] Open
Abstract
Background Myxomatous mitral valve disease (MMVD) is more prevalent in Cavalier King Charles Spaniels (CKCSs) compared to dogs of other breeds at a given age. Abnormal valvular stress is thought to contribute to the development and progression of MMVD, and a relationship exists between mitral valve (MV) morphology and stress acting on the valve. Objectives To determine whether the MV morphology of healthy adult CKCSs differs from the morphology of healthy adult dogs of other breeds determined by RT‐3DTTE. Animals Thirty‐five healthy CKCSs and 41 healthy dogs of other breeds. Methods Prospective cross‐sectional study. Dogs underwent physical examination, conventional echocardiography, and RT‐3DTTE. RT–3DTTE datasets were analyzed using dedicated software for MV morphologic analysis. Morphologic variables were compared between CKCSs and dogs of other breeds. Results The MV of healthy CKCSs had a smaller annulus height (0.46 ± 0.11 vs. 0.56 ± 0.17; P = .0021), tenting height (0.26 ± 0.12 vs. 0.42 ± 0.18; P < .001), tenting area (0.42 ± 0.15 vs. 0.79 ± 0.34; P < .001), normalized tenting volume (0.09 [0.05–0.13] vs. 0.14 [0.10–0.20]; P < .001), and normalized area of the posterior leaflet (0.57 ± 0.15 vs. 0.66 ± 0.18; P = .016) compared to healthy dogs of other breeds; this results in CKCSs having a flatter MV with reduced tenting, compared to the MV of other breeds. Conclusions and Clinical Importance These morphologic features could confer a mechanical disadvantage and play a role in the predisposition of CKCSs to the early development of MMVD.
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Affiliation(s)
- Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Michael Aherne
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Paula Camacho
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Sunshine M Lahmers
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Jonathan A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia
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Fox PR, Keene BW, Lamb K, Schober KA, Chetboul V, Luis Fuentes V, Wess G, Payne JR, Hogan DF, Motsinger-Reif A, Häggström J, Trehiou-Sechi E, Fine-Ferreira DM, Nakamura RK, Lee PM, Singh MK, Ware WA, Abbott JA, Culshaw G, Riesen S, Borgarelli M, Lesser MB, Van Israël N, Côté E, Rush JE, Bulmer B, Santilli RA, Vollmar AC, Bossbaly MJ, Quick N, Bussadori C, Bright JM, Estrada AH, Ohad DG, Fernández-Del Palacio MJ, Lunney Brayley J, Schwartz DS, Bové CM, Gordon SG, Jung SW, Brambilla P, Moïse NS, Stauthammer CD, Stepien RL, Quintavalla C, Amberger C, Manczur F, Hung YW, Lobetti R, De Swarte M, Tamborini A, Mooney CT, Oyama MA, Komolov A, Fujii Y, Pariaut R, Uechi M, Tachika Ohara VY. International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study. J Vet Intern Med 2018; 32:930-943. [PMID: 29660848 PMCID: PMC5980443 DOI: 10.1111/jvim.15122] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/04/2018] [Accepted: 02/24/2018] [Indexed: 12/31/2022] Open
Abstract
Background Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved. Hypothesis/Objectives Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH). Animals One thousand seven hundred and thirty client‐owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH). Methods Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long‐term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death. Results During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean ± standard deviation, 1.3 ± 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9‐15 years. Conclusions and Clinical Importance Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality.
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Affiliation(s)
- Philip R Fox
- Department of Cardiology and Caspary Research Institute, The Animal Medical Center, New York, New York, U.S.A
| | - Bruce W Keene
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, U.S.A
| | | | - Karsten A Schober
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, U.S.A
| | - Valerie Chetboul
- Alfort Cardiology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Virginia Luis Fuentes
- Department of Veterinary Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Gerhard Wess
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Jessie Rose Payne
- Department of Veterinary Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Daniel F Hogan
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Alison Motsinger-Reif
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, U.S.A
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Emilie Trehiou-Sechi
- Alfort Cardiology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France
| | - Deborah M Fine-Ferreira
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, U.S.A
| | - Reid K Nakamura
- Advanced Veterinary Care Center, Lawndale, California, U.S.A
| | - Pamela M Lee
- Department of Cardiology and Caspary Research Institute, The Animal Medical Center, New York, New York, U.S.A
| | - Manreet K Singh
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, U.S.A
| | - Wendy A Ware
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, U.S.A
| | - Jonathan A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, U.S.A
| | - Geoffrey Culshaw
- Royal (Dick) SVS Hospital for Small Animals, The University of Edinburgh, Roslin, Midlothian, United Kingdom
| | - Sabine Riesen
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Michele Borgarelli
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, U.S.A
| | | | | | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - John E Rush
- Department of Clinical Sciences, Tufts University, Cummings School of Veterinary Medicine, North Grafton, Massachusetts, U.S.A
| | - Barret Bulmer
- Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, U.S.A
| | | | | | | | - Nadine Quick
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Claudio Bussadori
- Department of Cardiology, Clinica Veterinaria Gran Sasso, Milan, Italy
| | - Janice M Bright
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, U.S.A
| | - Amara H Estrada
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida
| | - Dan G Ohad
- Department of Clinical Sciences, The Koret School of Veterinary Medicine, Rehovot, Israel
| | | | | | - Denise S Schwartz
- Department of Internal Medicine, University of São Paulo, São Paulo, Brazil
| | - Christina M Bové
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, U.S.A
| | - Seung Woo Jung
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, U.S.A
| | - Paola Brambilla
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - N Sydney Moïse
- Department of Clinical Sciences, Cornell University, Ithaca, New York, U.S.A
| | | | - Rebecca L Stepien
- Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin, U.S.A
| | | | | | - Ferenc Manczur
- Department of Internal Medicine, University of Veterinary Medicine, Budapest, Hungary
| | | | - Remo Lobetti
- Bryanston Veterinary Hospital, Bryanston, South Africa
| | - Marie De Swarte
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Alice Tamborini
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Carmel T Mooney
- University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland
| | - Mark A Oyama
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | | | - Yoko Fujii
- Azabu University, Sagamihara, Kanagawa, Japan
| | - Romain Pariaut
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, U.S.A
| | - Masami Uechi
- Jasmine Animal Cardiovascular Center, Yokohama, Kanagawa, Japan
| | - Victoria Yukie Tachika Ohara
- Department of Medicine, Surgery and Zootechnics for Small Species, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Müller S, Menciotti G, Borgarelli M. Anatomic regurgitant orifice area obtained using 3D-echocardiography as an indicator of severity of mitral regurgitation in dogs with myxomatous mitral valve disease. J Vet Cardiol 2017; 19:433-440. [PMID: 28964709 DOI: 10.1016/j.jvc.2017.07.001] [Citation(s) in RCA: 5] [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: 12/01/2016] [Revised: 07/21/2017] [Accepted: 07/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine feasibility and repeatability of measuring the anatomic regurgitant orifice area (AROA) using real-time three-dimensional transthoracic echocardiography (RT3DE) in dogs with myxomatous mitral valve disease (MMVD), and to investigate differences in the AROA of dogs with different disease severity and in different American College of Veterinary Internal Medicine (ACVIM) stages. ANIMALS Sixty privately-owned dogs diagnosed with MMVD. METHODS The echocardiographic database of our institution was retrospectively searched for dogs diagnosed with MMVD and RT3DE data set acquisition. Dogs were classified into mild, moderate, or severe MMVD according to a Mitral Regurgitation Severity Score (MRSS), and into stage B1, B2 or C according to ACVIM staging. The RT3DE data sets were imported into dedicated software and a short axis plane crossing the regurgitant orifice was used to measure the AROA. Feasibility, inter- and intra-observer variability of measuring the AROA was calculated. Differences in the AROA between dogs in different MRSS and ACVIM stages were investigated. RESULTS The AROA was measurable in 60 data sets of 81 selected to be included in the study (74%). The inter- and intra-observer coefficients of variation were 26% and 21%, respectively. The AROA was significantly greater in dogs with a severe MRSS compared with dogs with mild MRSS (p=0.045). There was no difference between the AROA of dogs in different ACVIM clinical stages. CONCLUSIONS Obtaining the AROA using RT3DE is feasible and might provide additional information to stratify mitral regurgitation severity in dogs with MMVD. Diagnostic and prognostic utility of the AROA deserves further investigation.
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Affiliation(s)
- S Müller
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA.
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA
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Menciotti G, Borgarelli M. Review of Diagnostic and Therapeutic Approach to Canine Myxomatous Mitral Valve Disease. Vet Sci 2017; 4:vetsci4040047. [PMID: 29056705 PMCID: PMC5753627 DOI: 10.3390/vetsci4040047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/09/2017] [Accepted: 09/20/2017] [Indexed: 01/11/2023] Open
Abstract
The most common heart disease that affects dogs is myxomatous mitral valve disease. In this article, we review the current diagnostic and therapeutic approaches to this disease, and we also present some of the latest technological advancements in this field.
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Affiliation(s)
- Giulio Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, 205 Duck Pond Dr., Blacksburg, VA 24061, USA.
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Borgarelli M, Lanz O, Pavlisko N, Abbott JA, Menciotti G, Aherne M, Lahmers SM, Lahmers KK, Gammie JS. Mitral valve repair in dogs using an ePTFE chordal implantation device: a pilot study. J Vet Cardiol 2017; 19:256-267. [PMID: 28576476 DOI: 10.1016/j.jvc.2017.03.002] [Citation(s) in RCA: 9] [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: 07/06/2016] [Revised: 02/07/2017] [Accepted: 03/28/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mitral valve (MV) regurgitation due to degenerative MV disease is the leading cause of cardiac death in dogs. We carried out preliminary experiments to determine the feasibility and short-term effects of beating-heart MV repair using an expanded polytetrafluorethylene (ePTFE) chordal implantation device (Harpoon TSD-5) in dogs. ANIMALS This study involved six healthy purpose-bred Beagles (weight range 8.9-11.4 kg). MATERIAL AND METHODS Following a mini-thoracotomy performed under general anesthesia, the TSD-5 was used to place 1 or 2 artificial ePTFE cords on the anterior MV leaflet or the posterior MV leaflet via a left-ventricular transapical approach. The procedure was guided and monitored by transesophageal echocardiography. Postoperative antithrombotic treatment consisted of clopidogrel or a combination of clopidogrel and apixaban. Dogs were serially evaluated by transthoracic echocardiography at day 1, 7, 14, 21, and 30. The hearts were then examined for evaluation of tissues reactions and to detect signs of endothelialization. RESULTS One or two chords were successfully implanted in five dogs. Four dogs completed the 30 days follow-up. One dog died intra-operatively because of aortic perforation. One dog died early post-operatively from a hemorrhagic pleural effusion attributed to overly aggressive antithrombotic treatment. One dog developed a thrombus surrounding both the knot and the synthetic cord. Postmortem exam confirmed secure placement of ePTFE knots in the mitral leaflets in all dogs and the presence of endothelialization of the knots and chords. CONCLUSIONS These preliminary results demonstrate the feasibility of artificial chordal placement using an ePTFE cordal implantation device in dogs.
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Affiliation(s)
- M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA.
| | - O Lanz
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - N Pavlisko
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - J A Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - M Aherne
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - S M Lahmers
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Phase II, Duck Pond Dr., VA 24061, USA
| | - K K Lahmers
- Department of Biomedical Sciences & Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, 205 Duck Pond Dr., VA 24061, USA
| | - J S Gammie
- Division of Cardiac Surgery, University of Maryland School of Medicine, 110 S. Paca St., MD 21201, USA
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Menciotti G, Borgarelli M, Aherne M, Wesselowski S, Häggström J, Ljungvall I, Lahmers S, Abbott J. Mitral valve morphology assessed by three-dimensional transthoracic echocardiography in healthy dogs and dogs with myxomatous mitral valve disease. J Vet Cardiol 2017; 19:113-123. [DOI: 10.1016/j.jvc.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 12/12/2016] [Accepted: 01/02/2017] [Indexed: 01/15/2023]
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Apple SM, Menciotti G, Braz-Ruivo L, Crosara S, Häggström J, Borgarelli M. Effects of pimobendan on myocardial perfusion and pulmonary transit time in dogs with myxomatous mitral valve disease: a pilot study. Aust Vet J 2016; 94:324-8. [DOI: 10.1111/avj.12480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/23/2015] [Accepted: 12/11/2015] [Indexed: 11/27/2022]
Affiliation(s)
- SM Apple
- Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24060 USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24060 USA
| | - L Braz-Ruivo
- Dogs and Cats Veterinary Referral & ER; Bowie MD USA
| | - S Crosara
- Department of Veterinary Science; University of Parma; Parma Italy
| | - J Häggström
- Department of Clinical Sciences; Swedish University of Agricultural Science; Uppsala Sweden
| | - M Borgarelli
- Department of Small Animal Clinical Sciences; Virginia-Maryland College of Veterinary Medicine; Blacksburg VA 24060 USA
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Menciotti G, Borgarelli M, Aherne M, Häggström J, Ljungvall I, Lahmers S, Abbott J. Assessment of mitral valve morphology using three-dimensional echocardiography. Feasibility and reference values. J Vet Cardiol 2016; 18:156-67. [DOI: 10.1016/j.jvc.2015.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/23/2015] [Accepted: 11/23/2015] [Indexed: 01/04/2023]
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Borgarelli M, Abbott J, Braz-Ruivo L, Chiavegato D, Crosara S, Lamb K, Ljungvall I, Poggi M, Santilli RA, Haggstrom J. Prevalence and prognostic importance of pulmonary hypertension in dogs with myxomatous mitral valve disease. J Vet Intern Med 2015; 29:569-74. [PMID: 25818210 PMCID: PMC4895522 DOI: 10.1111/jvim.12564] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/08/2014] [Accepted: 01/28/2015] [Indexed: 12/31/2022] Open
Abstract
Background Pulmonary hypertension (PH) is common in dogs with myxomatous mitral valve disease (MMVD) but its effect on clinical outcome has not been investigated. Hypothesis/objectives The presence of PH worsens the outcome in dogs with MMVD. To compare survival times of dogs with MMVD and PH to those without PH. Animals Two hundred and twelve client‐owned dogs. Methods Case review study. Medical records of dogs diagnosed with ACVIM stage B2 and C MMVD between January 2010 and December 2011 were retrospectively reviewed. Long‐term outcome was determined by telephone interview or from the medical record. End of the observation period was March 2013. PH was identified if tricuspid regurgitation peak velocity was >3 m/s. Results Two hundred and twelve were identified. Eighty‐three dogs (39%) had PH. PH was more commonly identified in stage C compared to B2 (P < .0001). One hundred and five (49.5%) dogs died during the observation period. Median survival time for the entire study population was 567 days (95% CI 512–743). Stage C (P = .003), the presence of PH (P = .009), left atrial to aortic root ratio (LA/Ao) >1.7 (P = .0002), normalized left‐ventricular end‐diastolic diameter (LVEDn) >1.73 (P = .048), and tricuspid regurgitation pressure gradient (TRPG) >55 mmHg (P = .009) were associated with worse outcomes in the univariate analyses. The presence of TRPG >55 mmHg (HR 1.8 95% CI 1–2.9; P = .05) and LA/Ao > 1.7 (HR 2 95% CI 1.2–3.4; P = .01) remained significant predictors of worse outcome in the multivariate analysis. Conclusions and Clinical Importance In dogs with MMVD, moderate to severe PH worsens outcome.
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Affiliation(s)
- M Borgarelli
- Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA
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Wesselowski S, Borgarelli M, Menciotti G, Abbott J. Echocardiographic anatomy of the mitral valve in healthy dogs and dogs with myxomatous mitral valve disease. J Vet Cardiol 2015; 17:97-106. [PMID: 26003902 DOI: 10.1016/j.jvc.2015.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 01/08/2015] [Accepted: 01/16/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To further characterize the echocardiographic anatomy of the canine mitral valve apparatus in normal dogs and in dogs affected by myxomatous mitral valve disease (MMVD). ANIMALS Twenty-two normal dogs and 60 dogs with MMVD were prospectively studied. METHODS The length (AMVL), width (AMVW) and area (AMVA) of the anterior mitral valve leaflet were measured in the control group and the affected group, as were the diameters of the mitral valve annulus in diastole (MVAd) and systole (MVAs). The dogs with MMVD were staged based on American College of Veterinary Internal Medicine (ACVIM) guidelines and separated into groups B1 and B2/C. All measurements were indexed to body weight based on empirically defined allometric relationships. RESULTS There was a statistically significant relationship between all log10 transformed mitral valve dimensions and body weight. The AMVL, AMVW, AMVA, MVAd and MVAs were all significantly greater in the B2/C group compared to the B1 and control groups. The AMVW was also significantly greater in the B1 group compared to the control group. Interobserver % coefficient of variation (% CV) was <10% for AMVL, AMVA, MVAd and MVAs, but was 29.6% for AMVW. Intraobserver % CV was <10.4% for all measurements. CONCLUSIONS Measurements of the anterior mitral valve leaflet and the mitral valve annulus in the dog can be indexed to body weight based on allometric relationships. Preliminary reference intervals have been proposed over a range of body sizes. Relative to normal dogs, AMVL, AMVW, AMVA, MVAd and MVAs are greater in patients with advanced MMVD.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA.
| | - M Borgarelli
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - G Menciotti
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA
| | - J Abbott
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA
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Wesselowski S, Borgarelli M, Bello NM, Abbott J. Discrepancies in identification of left atrial enlargement using left atrial volume versus left atrial-to-aortic root ratio in dogs. J Vet Intern Med 2014; 28:1527-33. [PMID: 25056960 PMCID: PMC4895582 DOI: 10.1111/jvim.12410] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/31/2014] [Accepted: 06/11/2014] [Indexed: 12/25/2022] Open
Abstract
Background Left atrial size is prognostically important in dogs with myxomatous mitral valve disease (MMVD). Hypothesis/Objectives To compare the level of agreement in identification of left atrial enlargement (LAE) between the left atrial‐to‐aortic root ratio (LA : Ao) and left atrial volume using the biplane area‐length method indexed to body weight (LA Vol/BW). Animals Sixty dogs with MMVD and 22 normal dogs were prospectively studied with 2‐dimensional echocardiography. Methods The upper limit of normal for LA Vol/BW was defined as 1.1 mL/kg. LA : Ao was deemed normal if ≤1.5. To define overall disease severity, each dog was assigned a mitral regurgitation severity score (MRSS) based on echocardiographic parameters that did not include left atrial size. ACVIM staging also was utilized. Results Of 60 affected dogs, 20 were ACVIM Stage B1, 25 were Stage B2, and 15 were Stage C. LA Vol/BW identified LAE in 12 cases in which LA : Ao was normal; 7 of these were Stage B1 and 5 were Stage B2. This diagnostic disagreement was significant (P = .00012). Of the 12 cases in which diagnostic discrepancies were identified, 5/5 of the B2 dogs and 3/7 B1 dogs had a moderate MRSS, whereas 4/7 B1 dogs had a mild MRSS. No diagnostic discrepancies between LA : Ao and LA Vol/BW were apparent in dogs with a severe MRSS. Conclusions and Clinical Importance This study shows evidence of diagnostic disagreement between LA : Ao and LA Vol/BW for assessment of LAE. LA Vol/BW may be superior to LA : Ao for identification of mild LAE.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA
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Häggström J, Boswood A, O'Grady M, Jöns O, Smith S, Swift S, Borgarelli M, Gavaghan B, Kresken JG, Patteson M, Åblad B, Bussadori CM, Glaus T, Kovačević A, Rapp M, Santilli RA, Tidholm A, Eriksson A, Belanger MC, Deinert M, Little CJL, Kvart C, French A, Rønn-Landbo M, Wess G, Eggertsdottir A, Lynne O'Sullivan M, Schneider M, Lombard CW, Dukes-McEwan J, Willis R, Louvet A, DiFruscia R. Longitudinal analysis of quality of life, clinical, radiographic, echocardiographic, and laboratory variables in dogs with myxomatous mitral valve disease receiving pimobendan or benazepril: the QUEST study. J Vet Intern Med 2013; 27:1441-51. [PMID: 24010489 DOI: 10.1111/jvim.12181] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 05/03/2013] [Accepted: 07/31/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Myxomatous mitral valve disease (MMVD) is an important cause of morbidity and mortality in dogs. OBJECTIVES To compare, throughout the period of follow-up of dogs that had not yet reached the primary endpoint, the longitudinal effects of pimobendan versus benazepril hydrochloride treatment on quality-of-life (QoL) variables, concomitant congestive heart failure (CHF) treatment, and other outcome variables in dogs suffering from CHF secondary to MMVD. ANIMALS A total of 260 dogs in CHF because of MMVD. METHODS A prospective single-blinded study with dogs randomized to receive pimobendan (0.4-0.6 mg/kg/day) or benazepril hydrochloride (0.25-1.0 mg/kg/day). Differences in outcome variables and time to intensification of CHF treatment were compared. RESULTS A total of 124 dogs were randomized to pimobendan and 128 to benazepril. No difference was found between groups in QoL variables during the trial. Time from inclusion to 1st intensification of CHF treatment was longer in the pimobendan group (pimobendan 98 days, IQR 30-276 days versus benazepril 59 days, IQR 11-121 days; P = .0005). Postinclusion, dogs in the pimobendan group had smaller heart size based on VHS score (P = .013) and left ventricular diastolic (P = .035) and systolic (P = .0044) dimensions, higher body temperature (P = .030), serum sodium (P = .0027), and total protein (P = .0003) concentrations, and packed cell volume (P = .030). Incidence of arrhythmias was similar in treatment groups. CONCLUSIONS AND CLINICAL IMPORTANCE Pimobendan versus benazepril resulted in similar QoL during the study, but conferred increased time before intensification of CHF treatment. Pimobendan treatment resulted in smaller heart size, higher body temperature, and less retention of free water.
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Affiliation(s)
- J Häggström
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
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López Y, Lutjemeier B, Seshareddy K, Trevino EM, Hageman KS, Musch TI, Borgarelli M, Weiss ML. Wharton's jelly or bone marrow mesenchymal stromal cells improve cardiac function following myocardial infarction for more than 32 weeks in a rat model: a preliminary report. Curr Stem Cell Res Ther 2013; 8:46-59. [PMID: 23270633 DOI: 10.2174/1574888x11308010007] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 11/28/2012] [Accepted: 12/21/2012] [Indexed: 11/22/2022]
Abstract
The therapeutic effect of mesenchymal stromal cells (MSCs) following myocardial infarction (MI) is small. This may be due to differences in cellular sources and donor age, route of administration, in vitro cellular manipulations and the short time course of follow up in many animal studies. Here, we compared MSCs from two different sources (adult bone marrow or Wharton's jelly from umbilical cord) for their long-term therapeutic effect following MI in a rat model to evaluate the effect of donor age. MSCs (or control infusions) were given intravenously 24-48 hr after myocardial ischemia (MI) induced by coronary artery ligation. Cardiac function was assessed by ultrasound at time points starting from before MSC infusion through 68 weeks after MI. A significant improvement in ejection fraction was seen in animals that received MSCs in time points 25 to 31 wks after treatment (p < 0.01). These results support previous work that show that MSCs can cause improvement in cardiac function and extend that work by showing that the beneficial effects are durable. To investigate MSCs' cardiac differentiation potential, Wharton's jelly MSCs were co-cultured with fetal or adult bone-derived marrow MSCs. When Wharton's jelly MSCs were co-cultured with fetal MSCs, and not with adult MSCs, myotube structures were observed in two-three days and spontaneous contractions (beating) cells were observed in fiveseven days. The beating structures formed a functional syncytium indicated by coordinated contractions (beating) of independent nodes. Taken together, these results suggest that MSCs given 24-48 hr after MI have a significant and durable beneficial effect more than 25 weeks after MI and that MSC treatment can home to damaged tissue and improve heart function after intravenous infusion 24-48 hrs after MI, and that WJCs may be a useful source for off-the-shelf cellular therapy for MI.
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Affiliation(s)
- Yelica López
- Department of Anatomy and Physiology, Kansas State University, Coles Hall, room 105, Manhattan, KS 66506, USA
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Ferasin L, Crews L, Biller D, Lamb K, Borgarelli M. Risk Factors for Coughing in Dogs with Naturally Acquired Myxomatous Mitral Valve Disease. J Vet Intern Med 2013; 27:286-92. [DOI: 10.1111/jvim.12039] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 10/21/2012] [Accepted: 12/06/2012] [Indexed: 12/01/2022] Open
Affiliation(s)
- L. Ferasin
- Specialist Veterinary Cardiology Consultancy Ltd; Biggin Hill Kent UK
| | - L. Crews
- College of Veterinary Medicine; University of Minnesota; St Paul MN
| | - D.S. Biller
- College of Veterinary Medicine; Kansas State University; Manhattan KS
| | - K.E. Lamb
- Lamb Biostatistical and Scientific Writing Consulting; St Paul MN
| | - M. Borgarelli
- College of Veterinary Medicine; Kansas State University; Manhattan KS
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Crosara S, Ljungvall I, Margiocco ML, Häggström J, Tarducci A, Borgarelli M. Use of contrast echocardiography for quantitative and qualitative evaluation of myocardial perfusion and pulmonary transit time in healthy dogs. Am J Vet Res 2012; 73:194-201. [PMID: 22280378 DOI: 10.2460/ajvr.73.2.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate reproducibility of ejection fraction (EF), myocardial perfusion (MP), and pulmonary transit time (PTT) measured in a group of dogs by use of contrast echocardiography and to examine safety of this method by evaluating cardiac troponin I concentrations. ANIMALS 6 healthy dogs. PROCEDURES 2 bolus injections and a constant rate infusion of contrast agent were administered IV. Echocardiographic EF was determined by use of the area-length method and was calculated without and with contrast agent. The PTT and normalized PTT (PTT/mean R-R interval) were measured for each bolus. Constant rate infusion was used for global MP evaluation, and regional MP was calculated by use of a real-time method in 4 regions of interest of the left ventricle. Cardiac troponin I concentration was analyzed before and after contrast agent administration. Intraoberserver and interobserver variability was calculated. RESULTS EF was easier to determine with the ultrasonographic contrast agent. For the first and second bolus, mean ± SD PTT was 1.8 ± 0.2 seconds and 2.1 ± 0.3 seconds and normalized PTT was 3.4 ± 0.3 seconds and 3.5 ± 0.3 seconds, respectively. A coefficient of variation < 15% was obtained for global MP but not for the regional MPs. No differences were detected between precontrast and postcontrast cardiac troponin I concentrations. CONCLUSIONS AND CLINICAL RELEVANCE Contrast echocardiography appeared to be a repeat-able and safe technique for use in the evaluation of global MP and PTT in healthy dogs, and it improved delineation of the endocardial border in dogs.
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Affiliation(s)
- Serena Crosara
- Department of Animal Pathology, University of Torino, Grugliasco, Italy.
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Savarino P, Borgarelli M, Tarducci A, Crosara S, Bello NM, Margiocco ML. Diagnostic performance of P wave duration in the identification of left atrial enlargement in dogs. J Small Anim Pract 2012; 53:267-72. [DOI: 10.1111/j.1748-5827.2012.01200.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Borgarelli M, Crosara S, Lamb K, Savarino P, La Rosa G, Tarducci A, Haggstrom J. Survival characteristics and prognostic variables of dogs with preclinical chronic degenerative mitral valve disease attributable to myxomatous degeneration. J Vet Intern Med 2011; 26:69-75. [PMID: 22211523 DOI: 10.1111/j.1939-1676.2011.00860.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 10/19/2011] [Accepted: 11/21/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Preclinical myxomatous mitral valve degeneration (MMVD) includes a heterogeneous group of dogs. Therefore, identifying risk factors for progression of the disease is of clinical importance. OBJECTIVES To investigate survival time and risk factors for clinical and echocardiographic variables taken at initial examination for clinical progression in preclinical MMVD dogs. ANIMALS A total of 256 dogs with stage B1 or B2 MMVD. MATERIALS AND METHODS Medical records of 256 dogs with preclinical MMVD were reviewed retrospectively. Long-term outcome was assessed by telephone interview. Dogs alive at the time of phone interview were asked to return to the hospital for re-evaluation of their cardiac status. RESULTS Seventy of 256 (27.3%) dogs died during the observation period. The median survival time, regardless of cause of death, was 588 (range 75-1,668) days. The presence of a murmur was associated with an increased risk of death (AHR 2.14; 95% CI 1.12, 4.11; P = 0.022). Thirty (12%) deaths were considered cardiac related. LA/Ao > 1.4 was the only negative predictor (AHR 2.64; 1.13, 6.13; P = 0.024) for cardiac-related deaths. Eighty-three dogs were re-examined, of which 34 progressed to a more advanced stage of MMVD. The presence of Emax > 1.2 (AHR 2.75; 95% CI 1.01, 7.48; P = 0.047) and cough (AHR 7.89; 95% CI 3.18, 20.07; P < 0.001) were significant in the multivariate analysis. CONCLUSIONS AND CLINICAL IMPORTANCE Preclinical MMVD represents a relatively benign condition in dogs. Clinicians might find stratification of this dog population according to risk factors based on clinical and echocardiographic findings helpful in determining treatment.
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Affiliation(s)
- M Borgarelli
- Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA.
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Borgarelli M, Tursi M, Rosa GL, Savarino P, Galloni M. Anatomic, histologic, and two-dimensional–echocardiographic evaluation of mitral valve anatomy in dogs. Am J Vet Res 2011; 72:1186-92. [DOI: 10.2460/ajvr.72.9.1186] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ljungvall I, Rajamäki MM, Crosara S, Olsen LH, Kvart C, Borgarelli M, Höglund K, Häggström J. Evaluation of plasma activity of matrix metalloproteinase-2 and -9 in dogs with myxomatous mitral valve disease. Am J Vet Res 2011; 72:1022-8. [DOI: 10.2460/ajvr.72.8.1022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Borgarelli M, Haggstrom J. Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy. Vet Clin North Am Small Anim Pract 2010; 40:651-63. [PMID: 20610017 DOI: 10.1016/j.cvsm.2010.03.008] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Myxomatous mitral valve disease is a common condition in geriatric dogs. Most dogs affected are clinically asymptomatic for a long time. However, about 30% of these animals present a progression to heart failure and eventually die as a consequence of the disease. Left atrial enlargement, and particularly a change in left atrial size, seems to be the most reliable predictor of progression in some studies, however further studies are needed to clarify how to recognize asymptomatic patients at higher risk of developing heart failure. According to the published data on the natural history of the disease and the results of published studies evaluating the effect of early therapy on delaying the progression of the disease, it seems that no currently available treatment delays the onset of clinical signs of congestive heart failure (CHF). Although the ideal treatment of more severely affected dogs is probably surgical mitral valve repair or mitral valve replacement, this is not a currently available option. The results of several clinical trials together with clinical experience suggest that dogs with overt CHF can be managed with acceptable quality of life for a relatively long time period with medical treatment including furosemide, an angiotensin-converting enzyme inhibitor, pimobendan, and spironolactone.
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Affiliation(s)
- Michele Borgarelli
- Department of Clinical Sciences, Kansas State University, Manhattan, KS 66505, USA.
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Crosara S, Borgarelli M, Perego M, Häggström J, La Rosa G, Tarducci A, Santilli RA. Holter monitoring in 36 dogs with myxomatous mitral valve disease. Aust Vet J 2010; 88:386-92. [DOI: 10.1111/j.1751-0813.2010.00628.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Crosara
- Dipartimento di Patologia Animale, Facolta' di Medicina Veterinaria, Universita' di Torino, Grugliasco, Torino, Italy
| | - M Borgarelli
- Department of Clinical Science, Kansas State University, 1800 Denison Ave, Manhattan, KS, USA
| | - M Perego
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Uppsala, Sweden
| | - G La Rosa
- Dipartimento di Patologia Animale, Facolta' di Medicina Veterinaria, Universita' di Torino, Grugliasco, Torino, Italy
| | - A Tarducci
- Dipartimento di Patologia Animale, Facolta' di Medicina Veterinaria, Universita' di Torino, Grugliasco, Torino, Italy
| | - RA Santilli
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
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Margiocco ML, Borgarelli M, Musch TI, Hirai DM, Hageman KS, Fels RJ, Garcia AA, Kenney MJ. Effects of combined aging and heart failure on visceral sympathetic nerve and cardiovascular responses to progressive hyperthermia in F344 rats. Am J Physiol Regul Integr Comp Physiol 2010; 299:R1555-63. [PMID: 20844265 DOI: 10.1152/ajpregu.00434.2010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Sympathetic nerve discharge (SND) responses to hyperthermia are attenuated in aged rats without heart failure (HF) and in young HF (Y(HF)) rats, demonstrating that individually aging and HF alter SND regulation. However, the combined effects of aging and HF on SND regulation to heat stress are unknown, despite the high prevalence of HF in aged individuals. We hypothesized that SND responses to heating would be additive when aging and HF are combined, demonstrated by marked reductions in SND and mean arterial pressure (MAP) responses to heating in aged HF (A(HF)) compared with aged sham HF (A(SHAM)) rats, and in A(HF) compared with Y(HF) rats. Renal and splenic SND responses to hyperthermia (colonic temperature increased to 41.5°C) were determined in anesthetized Y(HF), young sham (Y(SHAM)), A(HF), and A(SHAM) Fischer rats. HF was induced by myocardial infarction and documented using echocardiographic, invasive, and postmortem measures. The severity of HF was similar in Y(HF) and A(HF) rats. SND responses to heating were attenuated in Y(HF) compared with Y(SHAM) rats, demonstrating an effect of HF on SND regulation in young rats. In contrast, A(HF) and A(SHAM) rats demonstrated similar SND responses to heating, suggesting a prominent influence of age on SND regulation in A(HF) rats. Splenic SND and MAP responses to heating were similar in Y(HF), A(HF), and A(SHAM) rats, indicating that the imposition of HF in young rats changes the regulatory status of these variables to one consistent with aged rats. These data suggest that the effect of HF on SND regulation to hyperthermia is age dependent.
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Affiliation(s)
- M L Margiocco
- Dept. of Anatomy and Physiology, Kansas State Univ., Manhattan, KS 66506, USA
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Ljungvall I, Höglund K, Tidholm A, Olsen L, Borgarelli M, Venge P, Häggström J. Cardiac Troponin I Is Associated with Severity of Myxomatous Mitral Valve Disease, Age, and C-Reactive Protein in Dogs. J Vet Intern Med 2010; 24:153-9. [DOI: 10.1111/j.1939-1676.2009.0428.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Häggström J, Höglund K, Borgarelli M. An update on treatment and prognostic indicators in canine myxomatous mitral valve disease. J Small Anim Pract 2009; 50 Suppl 1:25-33. [DOI: 10.1111/j.1748-5827.2009.00800.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tursi M, Garofalo L, Muscio M, Galloni M, Zanatta R, Borgarelli M, Pucci A. Verrucoid lesions of mitral valve in a dog with features of inflammatory myofibroblastic tumor. Cardiovasc Pathol 2009; 18:315-6. [DOI: 10.1016/j.carpath.2007.12.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 12/21/2007] [Accepted: 12/28/2007] [Indexed: 11/29/2022] Open
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Bussadori C, Pradelli D, Borgarelli M, Chiavegato D, D’Agnolo G, Menegazzo L, Migliorini F, Santilli R, Zani A, Quintavalla C. Congenital heart disease in boxer dogs: Results of 6years of breed screening. Vet J 2009; 181:187-92. [DOI: 10.1016/j.tvjl.2008.02.008] [Citation(s) in RCA: 16] [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: 06/29/2007] [Revised: 01/31/2008] [Accepted: 02/12/2008] [Indexed: 10/22/2022]
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Margiocco ML, Warren J, Borgarelli M, Kukanich B. Analysis of weight uniformity, content uniformity and 30-day stability in halves and quarters of routinely prescribed cardiovascular medications. J Vet Cardiol 2009; 11:31-9. [DOI: 10.1016/j.jvc.2009.04.003] [Citation(s) in RCA: 9] [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: 10/22/2008] [Revised: 12/08/2008] [Accepted: 04/27/2009] [Indexed: 10/20/2022]
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Ljungvall I, Ahlstrom C, Höglund K, Hult P, Kvart C, Borgarelli M, Ask P, Häggström J. Use of signal analysis of heart sounds and murmurs to assess severity of mitral valve regurgitation attributable to myxomatous mitral valve disease in dogs. Am J Vet Res 2009; 70:604-13. [DOI: 10.2460/ajvr.70.5.604] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zini E, Glaus TM, Bussadori C, Borgarelli M, Santilli RA, Tarducci A, Margiocco ML, Rampazzo A, Meli ML, Maisch B, Pankuweit S. Evaluation of the presence of selected viral and bacterial nucleic acids in pericardial samples from dogs with or without idiopathic pericardial effusion. Vet J 2009; 179:225-9. [DOI: 10.1016/j.tvjl.2007.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 09/06/2007] [Accepted: 09/11/2007] [Indexed: 10/22/2022]
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Häggström J, Boswood A, O'Grady M, Jöns O, Smith S, Swift S, Borgarelli M, Gavaghan B, Kresken JG, Patteson M, Ablad B, Bussadori CM, Glaus T, Kovacević A, Rapp M, Santilli RA, Tidholm A, Eriksson A, Belanger MC, Deinert M, Little CJL, Kvart C, French A, Rønn-Landbo M, Wess G, Eggertsdottir AV, O'Sullivan ML, Schneider M, Lombard CW, Dukes-McEwan J, Willis R, Louvet A, DiFruscia R. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. J Vet Intern Med 2008; 22:1124-35. [PMID: 18638016 DOI: 10.1111/j.1939-1676.2008.0150.x] [Citation(s) in RCA: 181] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Myxomatous mitral valve disease (MMVD) continues to be an important cause of morbidity and mortality in geriatric dogs despite conventional therapy. HYPOTHESIS Pimobendan in addition to conventional therapy will extend time to sudden cardiac death, euthanasia for cardiac reasons, or treatment failure when compared with conventional therapy plus benazepril in dogs with congestive heart failure (CHF) attributable to MMVD. ANIMALS Two hundred and sixty client-owned dogs in CHF caused by MMVD were recruited from 28 centers in Europe, Canada, and Australia. METHODS A prospective single-blinded study with dogs randomized to PO receive pimobendan (0.4-0.6 mg/kg/d) or benazepril hydrochloride (0.25-1.0 mg/kg/d). The primary endpoint was a composite of cardiac death, euthanized for heart failure, or treatment failure. RESULTS Eight dogs were excluded from analysis. One hundred and twenty-four dogs were randomized to pimobendan and 128 to benazepril. One hundred and ninety dogs reached the primary endpoint; the median time was 188 days (267 days for pimobendan, 140 days for benazepril hazard ratio = 0.688, 95% confidence limits [CL]=0.516-0.916, P= .0099). The benefit of pimobendan persisted after adjusting for all baseline variables. A longer time to reach the endpoint was also associated with being a Cavalier King Charles Spaniel, requiring a lower furosemide dose, and having a higher creatinine concentration. Increases in several indicators of cardiac enlargement (left atrial to aortic root ratio, vertebral heart scale, and percentage increase in left ventricular internal diameter in systole) were associated with a shorter time to endpoint, as was a worse tolerance for exercise. CONCLUSIONS AND CLINICAL IMPORTANCE Pimobendan plus conventional therapy prolongs time to sudden death, euthanasia for cardiac reasons, or treatment failure in dogs with CHF caused by MMVD compared with benazepril plus conventional therapy.
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Affiliation(s)
- J Häggström
- Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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Abstract
A 12-year-old, male Yorkshire terrier was presented for acute pulmonary oedema. Thoracic radiographs showed a linear metallic foreign body within the cardiac silhouette. Echocardiogram showed a hyperechoic line extending through the left ventricle, the mitral valve, leading into the left atrium. A 4 cm long Kirschner wire was surgically removed by left fourth thoracotomy. The dog died two days after surgery for acute pulmonary oedema. Necropsy showed thrombi on the mitral leaflets that impeded their movement.
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Affiliation(s)
- S Crosara
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Torino, 10095 Grugliasco, Torino, Italy
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Borgarelli M, Savarino P, Crosara S, Santilli RA, Chiavegato D, Poggi M, Bellino C, La Rosa G, Zanatta R, Haggstrom J, Tarducci A. Survival Characteristics and Prognostic Variables of Dogs with Mitral Regurgitation Attributable to Myxomatous Valve Disease. J Vet Intern Med 2008; 22:120-8. [DOI: 10.1111/j.1939-1676.2007.0008.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Borgarelli M, Tarducci A, Zanatta R, Haggstrom J. Decreased systolic function and inadequate hypertrophy in large and small breed dogs with chronic mitral valve insufficiency. J Vet Intern Med 2007; 21:61-7. [PMID: 17338151 DOI: 10.1892/0891-6640(2007)21[61:dsfaih]2.0.co;2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Systolic dysfunction associated with chronic mitral valve insufficiency (CMVI) has been demonstrated in experimental animal models and large breed (LB) dogs but has been reported as an uncommon finding in small breed (SB) dogs with naturally occurring disease. It has been suggested the myocardial failure could be, in part, because of an insufficient increase in left ventricular mass. HYPOTHESIS To test if SB and LB dogs with CMVI and moderate heart failure have systolic dysfunction and if they have adequate eccentric hypertrophy. ANIMALS Data from 38 SB and 18 LB dogs affected with CMVI were compared retrospectively with results from 2 groups of normal dogs (17 SB and 32 LB). METHODS Systolic function was investigated echocardiographically by using percentage fractional shortening (FS), the ratio between observed and expected end-systolic diameter (ESD/ESDe), and end-systolic volume index (ESVI). Left ventricular hypertrophy was estimated by using the ratio between the thickness of the left ventricular free wall and the radius in diastole (h/R). RESULTS Both affected SB and LB dogs had a significantly increased FS and ESVI (FS% SB 45.6 + 8.04 versus 40.06 + 8.9, P < .05; FS% LB 33.64 + 8.61 versus 27.3 + 7.3 P < .05; ESVI SB 30.0 +/- 2.3 mL/m2 versus 21.18 +/- 13.9 mL/m2, P < .05; ESVI LB 83.22 +/- 43.84 mL/m2 versus 36.43 +/- 13.30 mL/m2 versus P < .001). The h/R in affected animals was decreased (0.53 +/- 0.11 versus 0.41 +/- 0.12, P < .05 SB; 0.47 +/- 0.11 versus 0.38 +/- 0.09, P < .05, LB). CONCLUSIONS AND CLINICAL IMPORTANCE Data from this study indicate that dogs with moderate heart failure caused by CMVI have systolic dysfunction. Inadequate hypertrophy of the left ventricle may be, in part, responsible for this finding.
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Affiliation(s)
- Michele Borgarelli
- Department Patologia Animale, Faculty Veterinary Medicine, Via L. da Vinci 44, Grugliasco, Italy.
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Borgarelli M, Tarducci A, Zanatta R, Haggstrom J. Decreased Systolic Function and Inadequate Hypertrophy in Large and Small Breed Dogs with Chronic Mitral Valve Insufficiency. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb02929.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Borgarelli M, Santilli RA, Chiavegato D, D'Agnolo G, Zanatta R, Mannelli A, Tarducci A. Prognostic indicators for dogs with dilated cardiomyopathy. J Vet Intern Med 2006; 20:104-10. [PMID: 16496929 DOI: 10.1892/0891-6640(2006)20[104:pifdwd]2.0.co;2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to investigate the prognostic value of various clinical, ECG, echocardiographic, and Doppler echocardiographic variables in dogs with dilated cardiomyopathy. The relationship to survival of 11 variables was evaluated in 63 dogs. Studied variables were age at time of diagnosis, class of heart failure (HF), dyspnea, ascites, atrial fibrillation (AF), ejection fraction (EF), E-point septal separation, end-diastolic volume index, end-systolic volume index (ESV-I), and restrictive or nonrestrictive transmitral flow (TMF) pattern. Median survival time was 671 days (lower 95% confidence limit, 350 days). Survival curves showed that severity of HF, ascites, ESV-I greater than 140 mL/m2, EF less than 25%, and restrictive TMF pattern had a significant negative relation to survival time. Thirty-nine dogs with both sinus rhythm and AF presented adequate TMF recordings; in these dogs, after stratification by TMF pattern, the restrictive TMF pattern was the most important negative prognostic indicator. We conclude that in dogs with dilated cardiomyopathy the restrictive TMF pattern appears to represent a useful prognostic indicator. Class of HF, ascites, ESV-I, and EF are also useful indexes if an adequate TMF pattern is not recorded.
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Affiliation(s)
- Michele Borgarelli
- Department Patologia Animale, Faculty Veterinary Medicine, Grugliasco, Italy.
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Borgarelli M, Santilli RA, Chiavegato D, D'Agnolo G, Zanatta R, Mannelli A, Tarducci A. Prognostic Indicators for Dogs with Dilated Cardiomyopathy. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb02829.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Affiliation(s)
- A Tarducci
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Torino, Grugliasco (To), Italy.
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Borgarelli M, Zini E, D'Agnolo G, Tarducci A, Santilli RA, Chiavegato D, Tursi M, Prunotto M, Häggström J. Comparison of primary mitral valve disease in German Shepherd dogs and in small breeds. J Vet Cardiol 2004; 6:27-34. [DOI: 10.1016/s1760-2734(06)70055-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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