RESUMEN
A heart-convolutional neural network (heart-CNN) was designed and tested for the automatic classification of chest radiographs in dogs affected by myxomatous mitral valve disease (MMVD) at different stages of disease severity. A retrospective and multicenter study was conducted. Lateral radiographs of dogs with concomitant X-ray and echocardiographic examination were selected from the internal databases of two institutions. Dogs were classified as healthy, B1, B2, C and D, based on American College of Veterinary Internal Medicine (ACVIM) guidelines, and as healthy, mild, moderate, severe and late stage, based on Mitral INsufficiency Echocardiographic (MINE) score. Heart-CNN performance was evaluated using confusion matrices, receiver operating characteristic curves, and t-SNE and UMAP analysis. The area under the curve (AUC) was 0.88, 0.88, 0.79, 0.89 and 0.84 for healthy and ACVIM stage B1, B2, C and D, respectively. According to the MINE score, the AUC was 0.90, 0.86, 0.71, 0.82 and 0.82 for healthy, mild, moderate, severe and late stage, respectively. The developed algorithm showed good accuracy in predicting MMVD stages based on both classification systems, proving a potentially useful tool in the early diagnosis of canine MMVD.
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Algoritmos , Inteligencia Artificial , Enfermedades de los Perros , Radiografía Torácica , Animales , Perros , Enfermedades de los Perros/diagnóstico por imagen , Estudios Retrospectivos , Radiografía Torácica/veterinaria , Femenino , Insuficiencia de la Válvula Mitral/veterinaria , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Masculino , Ecocardiografía/veterinaria , Ecocardiografía/métodos , Índice de Severidad de la Enfermedad , Redes Neurales de la ComputaciónRESUMEN
INTRODUCTION/OBJECTIVES: In clinical practice, dogs are screened for subaortic stenosis (SAS) using two-dimensional (2DE) and Doppler echocardiography. There is no accepted antemortem diagnostic criterion to distinguish between mild SAS and unaffected, therefore additional means of evaluating the left ventricular outflow tract (LVOT) and aorta may be desirable. This study sought to determine and compare LVOT and aortic orifice areas using 2DE and three-dimensional echocardiography (3DE) in apparently healthy dogs of various breeds and somatotypes. ANIMALS, MATERIALS, AND METHODS: Sixty-nine healthy, privately-owned dogs. The LVOT and aortic orifice areas were determined using 2DE aortic valve (AV) diameter-derived area; the continuity equation (CE); and 3DE planimetry of the LVOT, AV, sinus of Valsalva, and sinotubular junction. Orifice areas were indexed to body surface area (BSA). RESULTS: Obtaining 3DE images and performing planimetry were feasible in all dogs. The mean indexed area measured using the 2DE AV diameter (2.85 cm2/m2) was significantly lower than that derived from 3DE AV planimetry (3.85 cm2/m2; mean difference, 1.00 cm2/m2; P<0.001). There was poor agreement between the effective area calculated using the CE and the anatomic areas calculated using 2DE AV diameter and 3DE planimetry. The area calculated using the CE was less than all other calculations of area. Interobserver and intraobserver repeatability and reproducibility for 3DE planimetry were excellent. CONCLUSIONS: Methods for determining aortic orifice areas in dogs are not interchangeable, and this must be taken into account if these methods are investigated in the evaluation of dogs with SAS in the future.
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Ecocardiografía Tridimensional , Perros/anatomía & histología , Animales , Ecocardiografía Tridimensional/veterinaria , Ecocardiografía Tridimensional/métodos , Masculino , Femenino , Enfermedades de los Perros/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Ecocardiografía/veterinaria , Válvula Aórtica/diagnóstico por imagen , Aorta/diagnóstico por imagenRESUMEN
OBJECTIVES: The aim of this study was to evaluate the efficacy of a single dose of oral pregabalin (PGB) for sedation and its impact on physiological and echocardiographic variables in healthy cats. METHODS: This study was a randomised, blinded, crossover trial. Eight cats were randomly assigned to receive PGB or placebo, with a 1-week washout period between each administration. Cats in the treatment group received oral PGB at varying doses (low dose: 2.5 mg/kg, medium dose: 5 mg/kg, high dose: 10 mg/kg). Systolic blood pressure (SBP), pulse rate (PR), respiratory rate (RR) and sedation score were measured at intervals of 30 mins after administration. Echocardiography was performed 120 mins after administration. RESULTS: Oral administration of PGB 2.5 mg/kg and 5 mg/kg significantly increased sedation scores starting at 150 mins, while 10 mg/kg PGB showed a significant increase in sedation scores starting at 120 mins compared with placebo. PGB 5 mg/kg and 10 mg/kg resulted in a significant reduction in SBP compared with placebo, with minimal impact on PR and RR. In addition, PGB 10 mg/kg resulted in significant changes in the peak velocity of late diastolic transmitral flow (A) and the ratio of peak velocity of early diastolic transmitral flow and A; however, these changes were of marginal clinical significance. CONCLUSIONS AND RELEVANCE: A single dose of oral PGB could cause mild to moderate sedation. Hypotension was more prevalent in the PGB 5 mg/kg and 10 mg/kg groups among the majority of cats, but it was less frequently observed in the PGB 2.5 mg/kg group.
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Estudios Cruzados , Ecocardiografía , Pregabalina , Animales , Gatos , Pregabalina/administración & dosificación , Pregabalina/farmacología , Administración Oral , Ecocardiografía/veterinaria , Masculino , Femenino , Presión Sanguínea/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Respiratoria/efectos de los fármacos , Analgésicos/administración & dosificación , Analgésicos/farmacología , Relación Dosis-Respuesta a Droga , Distribución AleatoriaRESUMEN
Three cats were presented for unusual collapsing episodes. Echocardiography revealed a hypertrophic cardiomyopathy (HCM) phenotype in each cat. Continuous electrocardiographic monitoring showed that the clinical signs coincided with periods of severe ST-segment elevation in each cat. The first cat was treated with amlodipine and diltiazem but did not improve and was euthanized due to poor quality of life. Postmortem examination revealed cardiac lymphoma without obstructive coronary disease. The second cat was thought to have cardiac lymphoma, based on pericardial effusion cytology, and was euthanized before starting therapy. The third cat was diagnosed with HCM and left ventricular outflow tract obstruction and was treated with atenolol and diltiazem. This treatment reduced the frequency of episodic clinical signs, but the cat subsequently developed congestive heart failure and was euthanized. This case series describes clinical signs associated with severe ST elevation in cats with an HCM phenotype, and their outcomes. Continuous electrocardiographic monitoring was necessary to detect transient ST elevation in each case.
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Cardiomiopatía Hipertrófica , Enfermedades de los Gatos , Electrocardiografía , Animales , Gatos , Cardiomiopatía Hipertrófica/veterinaria , Cardiomiopatía Hipertrófica/tratamiento farmacológico , Cardiomiopatía Hipertrófica/diagnóstico , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/tratamiento farmacológico , Enfermedades de los Gatos/patología , Electrocardiografía/veterinaria , Masculino , Femenino , Ecocardiografía/veterinaria , Diltiazem/uso terapéuticoRESUMEN
INTRODUCTION: Right ventricular (RV) dysfunction is a significant negative prognostic indicator in human dilated cardiomyopathy (DCM). Many RV indices are weight-dependent, and there is a lack of reference values for the right heart in giant breed dogs (over 50 kg), including Great Danes (GDs). This study aimed to compare indices of RV function in echocardiographically normal GDs, those with preclinical DCM (PC-DCM), and those with DCM and congestive heart failure (DCM-CHF). ANIMALS: A total of 116 client-owned adult GDs: 74 normal, 31 with PC-DCM, and 11 with DCM-CHF. METHODS: A retrospective, single-center cohort study assessed RV function using free-wall RV longitudinal strain (RVLS), strain rate, fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and pulsed-wave tissue Doppler imaging-derived systolic myocardial velocity of the lateral tricuspid annulus (TDI S'). Relationships between DCM status and RV function indices were analyzed. RESULTS: RV function, measured by TAPSE (P=0.001), FAC (P<0.001), and TDI S' (P<0.001), decreased in dogs with PC-DCM and DCM-CHF compared to healthy dogs, with FAC being lower in DCM-CHF compared to PC-DCM (P=0.048). RVLS impairment was more significant in the DCM-CHF group than in the PC-DCM group (P=0.048). RVLS had the highest area under the curve (0.899) for differentiating between normal and DCM-CHF dogs. CONCLUSION: As DCM progresses, echocardiographic variables of RV function, including TAPSE, FAC, TDI S', RVLS, and strain rate, worsen, indicating impaired RV systolic function in GDs affected by DCM.
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Cardiomiopatía Dilatada , Enfermedades de los Perros , Función Ventricular Derecha , Perros , Animales , Cardiomiopatía Dilatada/veterinaria , Cardiomiopatía Dilatada/fisiopatología , Cardiomiopatía Dilatada/diagnóstico por imagen , Enfermedades de los Perros/fisiopatología , Enfermedades de los Perros/diagnóstico por imagen , Estudios Retrospectivos , Masculino , Femenino , Ecocardiografía/veterinaria , Disfunción Ventricular Derecha/veterinaria , Disfunción Ventricular Derecha/fisiopatología , Disfunción Ventricular Derecha/diagnóstico por imagen , Estudios de Cohortes , Insuficiencia Cardíaca/veterinaria , Insuficiencia Cardíaca/fisiopatología , Pueblos Nórdicos y EscandinávicosRESUMEN
Left ventricular dysfunction in dogs after the administration of doxorubicin (DOX) has been extensively examined. However, the effects of DOX on right ventricular (RV) function remain unknown. Therefore, the present study investigated whether the chemotherapy treatment with DOX decreases RV function. Twelve dogs (five with multicentric lymphoma, four with hemangiosarcoma, two with thyroid cancer, and one with lung adenocarcinoma) that received at least two doses of DOX were prospectively enrolled. Echocardiography and the measurement of troponin I were performed prior to each administration of DOX and approximately one month after the last administration. Right ventricular function was assessed by the RV fractional area change and RV Tei index. Two (n=4), three (n=3), four (n=3), and five (n=2) doses of DOX were administered. While no significant differences were observed in the RV fractional area change, the RV Tei index was significantly impaired after two doses of DOX. Troponin I level significantly increased after four doses. Cumulative doses of DOX correlated with the RV Tei index (r=0.77, P<0.001). The present results demonstrated that the chemotherapy treatment with DOX decreased RV function in a dose-dependent manner in dogs.
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Antibióticos Antineoplásicos , Enfermedades de los Perros , Doxorrubicina , Ecocardiografía , Troponina I , Animales , Perros , Doxorrubicina/administración & dosificación , Enfermedades de los Perros/tratamiento farmacológico , Masculino , Femenino , Antibióticos Antineoplásicos/uso terapéutico , Troponina I/sangre , Ecocardiografía/veterinaria , Función Ventricular Derecha/efectos de los fármacos , Disfunción Ventricular Derecha/veterinaria , Disfunción Ventricular Derecha/tratamiento farmacológico , Linfoma/veterinaria , Linfoma/tratamiento farmacológico , Estudios Prospectivos , Hemangiosarcoma/veterinaria , Hemangiosarcoma/tratamiento farmacológicoRESUMEN
BACKGROUND: Among the large animals, the heart of sheep is functionally and structurally very similar to the human heart. In research, sheep are used as an animal model to study the process of cardiac disease pathogenesis and treatment. Therefore, determining the normal values of the heart structures of sheep with echocardiography is of particular emphasis. The purpose of the present research is to define the normal echocardiography values of heart in Iranian Shall breed sheep. MATERIALS AND METHODS: In 20 healthy Iranian Shall male sheep weighing 30-35 kg and aged 4-6 months, standing echocardiography was done from the right parasternal approach concentrated on the 3rd to 5th intercostal spaces by 2.5-5 MHz phased array transducer in the longitudinal and transverse views by B-mode, M-mode and Doppler systems. In M-mode echocardiographic, the parameters of interventricular septal, left ventricular internal diameter, left ventricular free wall, right ventricular free wall and right ventricular internal diameter in diastole and systole as well as end point septal separation, ejection fraction (EF) slope, aortic root diameter, left atrial appendage, left atrial diameter/aortic valve diameter, left ventricular ejection time, fractional shortening, end-diastolic volume, end-systolic volume, EF, stroke volume and cardiac output and in pulsed-wave spectral Doppler echocardiographic, the parameters of mitral valve maximum velocity (Vmax), mitral valve mean velocity (Vmean), mitral valve maximum pressure gradient (PGmax), mitral valve mean pressure gradient (PGmean), mitral valve velocity time integral (VTI), mitral valve E-wave (MV-E), MV-E pressure gradient, mitral valve A-wave (MV-A), MV-A pressure gradient, aortic Vmax, aortic valve Vmean, aortic valve PGmax, aortic valve PGmean, aortic valve VTI, left ventricular outflow tract (LVOT)-Vmax, LVOT-Vmean were measured. RESULTS: All the sheep in this study were healthy and had no signs of heart disease. In this study, the parameters of M-mode and spectral Doppler echocardiographic were assessed and recognized in Iranian Shall sheep. The results demonstrated the parameters of echocardiographic could be dependably determined in Shall sheep which, established normal reference values for these parameters and left ventricular function indices in healthy Shall sheep. These results can be beneficial in appropriate imagination, recognition and measuring cardiac structures. CONCLUSION: This study can be exerted as a reference for the assessment and diagnosis of heart diseases in sheep medicine and human cardiovascular research in sheep experimental models.
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Ecocardiografía , Oveja Doméstica , Animales , Masculino , Valores de Referencia , Irán , Ecocardiografía/veterinaria , Oveja Doméstica/fisiología , Corazón/diagnóstico por imagen , Corazón/anatomía & histología , Ovinos/fisiologíaRESUMEN
A 6-month-old male intact miniature Australian Shepherd presented for surgical consultation for a previously diagnosed patent ductus arteriosus. Echocardiogram revealed a patent ductus arteriosus and a hyperechoic oscillating lesion within the main pulmonary artery. Blood cultures and eventual post-mortem examination revealed Candida tropicalis endocarditis. This case report highlights a rare case of fungal endocarditis with both echocardiographic and post-mortem findings.
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Candida tropicalis , Candidiasis , Enfermedades de los Perros , Conducto Arterioso Permeable , Conducto Arterioso Permeable/veterinaria , Conducto Arterioso Permeable/complicaciones , Animales , Masculino , Candida tropicalis/aislamiento & purificación , Enfermedades de los Perros/microbiología , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/diagnóstico por imagen , Perros , Candidiasis/veterinaria , Candidiasis/diagnóstico , Endocarditis/veterinaria , Endocarditis/diagnóstico , Endocarditis/microbiología , Endocarditis/diagnóstico por imagen , Ecocardiografía/veterinaria , Resultado FatalRESUMEN
INTRODUCTION/OBJECTIVE: The purpose of this study was to investigate the echocardiographic effects of intravenous medetomidine and vatinoxan in dogs with stage B1 mitral valve disease. We hypothesised medetomidine-vatinoxan would reduce the need for manual restraint during echocardiography without producing detrimental cardiovascular effects or echocardiographic changes. ANIMALS: Twelve client-owned dogs with stage B1 mitral valve disease. METHODS: A transthoracic echocardiographic examination was performed before and after sedation with intravenous medetomidine (10 µg/kg) and vatinoxan (200 µg/kg). Vital parameters were also recorded, and the level of sedation was assessed subjectively. The data were analysed with Student's t-tests with an alpha level of <0.05. RESULTS: End-systolic volume and left ventricular systolic diameter increased (from 0.89 ± 0.19 mL/kg to 1.13 ± 0.29 mL/kg and 0.96 ± 0.12 cm to 1.10 ± 0.10 cm, respectively) and ejection fraction (from 66.33 ± 4.0% to 56.23 ± 9.54%) and fractional shortening (from 36.13 ± 5.42% to 27.24 ± 5.6%) decreased significantly after sedation. End diastolic volume, left ventricular diastolic diameter, and left atrial size remained statistically unchanged, while aortic (from 1.34 ± 0.2 m/s to 0.99 ± 0.14 m/s) and pulmonic (from 0.94 ± 0.16 m/s to 0.66 ± 0.15 m/s) velocities decreased significantly. No dogs had a mean arterial pressure below 65 mmHg. Sedation enabled echocardiographic examination without manual restraint. No adverse effects were observed with the dose studied. CONCLUSIONS: Echocardiographic parameters were not completely comparable with the baseline values, which should be taken into consideration when evaluating dogs sedated with intravenous medetomidine-vatinoxan.
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Enfermedades de los Perros , Ecocardiografía , Medetomidina , Animales , Perros , Medetomidina/administración & dosificación , Medetomidina/farmacología , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/diagnóstico por imagen , Masculino , Ecocardiografía/veterinaria , Femenino , Hipnóticos y Sedantes/farmacología , Hipnóticos y Sedantes/administración & dosificación , Quinolizinas/farmacología , Quinolizinas/administración & dosificación , Insuficiencia de la Válvula Mitral/veterinaria , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/tratamiento farmacológicoRESUMEN
Double outlet right atrium is a rare congenital cardiac abnormality that has been previously reported in humans and cats, but not in dogs. A double outlet right atrium is typically characterized by the presence of a leftward deviation of the interatrial septum and atrial septal defect. Therefore, the right atrium drains into both ventricles. The unique features consistent with double outlet right atrium were identified by transthoracic echocardiography and computed tomography in a puppy. This case report describes the clinical, echocardiographic, and tomographic findings of a five-month-old Cocker Spaniel diagnosed with this rare congenital abnormality.
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Enfermedades de los Perros , Ecocardiografía , Atrios Cardíacos , Perros , Animales , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/congénito , Enfermedades de los Perros/diagnóstico , Ecocardiografía/veterinaria , Atrios Cardíacos/anomalías , Atrios Cardíacos/diagnóstico por imagen , Tomografía Computarizada por Rayos X/veterinaria , Masculino , Femenino , Defectos del Tabique Interatrial/veterinaria , Defectos del Tabique Interatrial/diagnóstico por imagenRESUMEN
BACKGROUND: Rate control (RC; meanHRHolter ≤ 125 bpm) increases survival in dogs with atrial fibrillation (AF). The mechanisms remain unclear. HYPOTHESIS/OBJECTIVES: Investigate echocardiographic and biomarker differences between RC and non-RC (NRC) dogs. Determine if changes post-anti-arrhythmic drugs (AAD) predict successful RC in subsequent Holter monitoring. Evaluate if early vs late RC affects survival. ANIMALS: Fifty-two dogs with AF. METHODS: Holter-derived mean heart rate, echocardiographic and biomarker variables from dogs receiving AAD were analyzed prospectively at each re-evaluation and grouped into RC or NRC. The primary endpoint was successful RC. Between group comparisons of absolute values, magnitude of change from admission to re-evaluations and end of study were performed using Mann-Whitney tests or unpaired t-tests. Logistic regression explored variables associated with inability to achieve RC at subsequent visits. Kaplan-Meier survival analysis was used to compare survival time of early vs late RC. RESULTS: At visit 2, 11/52 dogs were RC; at visit 3, 14/52 were RC; and at visit 4, 4/52 were RC. At the end of study, 25/52 remained NRC. At visit 2, both groups had increased cardiac dimensions, but NRC dogs had larger dimensions; biomarkers did not differ. At the end of study, RC showed decreased cardiac dimensions and end-terminal pro-brain natriuretic peptide (NT-proBNP) compared with NRC. No variables were useful at predicting RC success in subsequent visits. Survival analysis found no differences between early vs late RC. CONCLUSIONS AND CLINICAL IMPORTANCE: The RC dogs had decreased cardiac dimensions and NT-proBNP, suggesting HR-mediated reverse-remodeling might benefit survival, even with delayed RC achievement. Pursuit of RC is crucial despite initial failures.
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Fibrilación Atrial , Biomarcadores , Enfermedades de los Perros , Ecocardiografía , Péptido Natriurético Encefálico , Animales , Perros , Fibrilación Atrial/veterinaria , Enfermedades de los Perros/sangre , Enfermedades de los Perros/diagnóstico por imagen , Ecocardiografía/veterinaria , Biomarcadores/sangre , Masculino , Femenino , Péptido Natriurético Encefálico/sangre , Antiarrítmicos/uso terapéutico , Electrocardiografía Ambulatoria/veterinaria , Frecuencia Cardíaca , Estudios Longitudinales , Fragmentos de Péptidos/sangre , Estudios ProspectivosRESUMEN
A 2-year-old castrated Russian Blue cat presented with inappetence, depression, and labored respirations. Radiography findings suggested left lung atelectasis; however, the ultrasonography findings did not indicate lung atelectasis. The left pulmonary artery (PA) was abnormally small on echocardiography; further, there were no other cardiac anomalies. Computed tomography revealed an abnormally small left PA and left lung. Furthermore, bronchiectasis and tree-in-bud patterns were observed in the lung lobes. Based on these findings, the cat was diagnosed with isolated left PA hypoplasia, presumed left lung hypoplasia, and feline chronic bronchial disease. Early diagnosis of this disease is important because it can cause serious complications, including recurrent respiratory infection, bronchiectasis, massive hemoptysis, and pulmonary hypertension.
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Enfermedades de los Gatos , Enfermedades Pulmonares , Pulmón , Arteria Pulmonar , Gatos , Animales , Enfermedades de los Gatos/diagnóstico por imagen , Enfermedades de los Gatos/congénito , Enfermedades de los Gatos/patología , Arteria Pulmonar/anomalías , Arteria Pulmonar/diagnóstico por imagen , Pulmón/anomalías , Pulmón/diagnóstico por imagen , Pulmón/patología , Enfermedades Pulmonares/veterinaria , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Bronquiales/veterinaria , Enfermedades Bronquiales/diagnóstico por imagen , Enfermedades Bronquiales/congénito , Tomografía Computarizada por Rayos X/veterinaria , Masculino , Enfermedad Crónica , Ecocardiografía/veterinariaRESUMEN
INTRODUCTION: To echocardiographically evaluate a large number of apparently healthy Czechoslovakian wolfdogs (CWDs) to identify possible subclinical cardiac abnormalities and to generate reference intervals. ANIMALS: One-hundred and seventeen apparently healthy client-owned CWDs. MATERIALS AND METHODS: Standard two-dimensional, M-mode, and Doppler echocardiographic measurements were obtained on non-sedated, manually restrained standing dogs. Animals with no relevant echocardiographic abnormalities were used to generate reference intervals. Echocardiographic variables were compared between males and females and between dogs with and without mitral regurgitation (MR). RESULTS AND DISCUSSION: Among the 117 CWDs, 103 dogs were used to generate reference intervals. The 14 dogs with abnormalities had more than trivial MR (12 dogs), subaortic stenosis (one dog), and equivocal subaortic stenosis (one dog). The 44 males were heavier than 59 females (P<0.001) and had a larger maximum left atrial dimension (P=0.015), left ventricular internal dimension at end-diastole (P<0.001) and systole (P<0.001), and thicker interventricular septum thickness at end-diastole (P=0.016). A positive linear correlation was identified between bodyweight and aortic root and left atrial diameters and left ventricular dimensions and between age and aortic root and left atrial diameter and peak late transmitral flow velocity. A negative linear correlation was identified between age and peak early transmitral flow velocity and the ratio between peak early and late transmitral flow velocities. No differences in echocardiographic-derived cardiac dimensions were detected between healthy dogs and dogs with more than trivial MR. CONCLUSIONS: In this population of CWDs, subclinical cardiac abnormalities were uncommon, and they were mainly classified as MR.
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Ecocardiografía , Perros , Animales , Masculino , Femenino , Ecocardiografía/veterinaria , Valores de Referencia , Enfermedades de los Perros/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/veterinaria , Insuficiencia de la Válvula Mitral/diagnóstico por imagenRESUMEN
Doxorubicin is an anthracycline antitumor antibiotic with dose-dependent and cumulative cardiotoxicity. However, the necessity for serial cardiac evaluation is unknown in dogs without risk factors for dilated cardiomyopathy (DCM). This study aimed to investigate serial changes in echocardiographic and electrocardiographic measures in small- and medium-sized dogs after four doxorubicin doses. We included 17 dogs, weighting < 20â¯kg, with multicentric lymphoma. All dogs received doxorubicin over 30â¯min every 4 weeks as part of a multi-drug chemotherapy protocol. The average doxorubicin dose was 3.8 times per dog. Clinical cardiotoxicity was not observed during the monitoring period. The incidence of developing arrhythmia was not significantly associated with the number of doxorubicin doses received (P = 0.600). The development of valvular regurgitations and mitral regurgitation in these dogs was not significantly associated with the number of doxorubicin doses (P = 0.363 and P = 0.779, respectively). The other echocardiographic results were not significantly different between each evaluation. In conclusion, our results showed no significant cardiotoxicity under echocardiogram and electrocardiogram in small- and medium-sized dogs without risk factors for DCM after four doses of doxorubicin in a 30-minute infusion method.
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Antibióticos Antineoplásicos , Enfermedades de los Perros , Doxorrubicina , Ecocardiografía , Electrocardiografía , Linfoma , Animales , Perros , Doxorrubicina/uso terapéutico , Doxorrubicina/administración & dosificación , Enfermedades de los Perros/tratamiento farmacológico , Antibióticos Antineoplásicos/uso terapéutico , Antibióticos Antineoplásicos/administración & dosificación , Antibióticos Antineoplásicos/efectos adversos , Femenino , Masculino , Linfoma/veterinaria , Linfoma/tratamiento farmacológico , Ecocardiografía/veterinaria , Electrocardiografía/veterinaria , Cardiotoxicidad/veterinaria , Cardiotoxicidad/etiologíaRESUMEN
BACKGROUND: Pulmonary hypertension (PH) in dogs with myxomatous mitral valve disease (MMVD) is caused by increased pulmonary venous pressure. Thrombosis, vascular remodeling, and vasoconstriction mediated by platelets could exacerbate PH. HYPOTHESIS: Dogs with PH will exhibit a hypercoagulable state, characterized by increased platelet activation, platelet-leukocyte, and platelet-neutrophil aggregate formation. ANIMALS: Eleven dogs (≥3.5 kg) diagnosed with MMVD and PH and 10 dogs with MMVD lacking PH. METHODS: Prospective cohort ex vivo study. All dogs underwent echocardiographic examination, CBC, 3-view thoracic radiographs, and heartworm antigen testing. Severity of PH and MMVD were assessed by echocardiography. Viscoelastic monitoring of coagulation was assessed using thromboelastography (TEG). Platelet activation and platelet-leukocyte/platelet-neutrophil interactions were assessed using flow cytometry. Plasma serotonin concentrations were measured by ELISA. RESULTS: Unstimulated platelets from dogs with MMVD and PH expressed more surface P-selectin than MMVD controls (P = .03). Platelets from dogs with MMVD and PH had persistent activation in response to agonists. The number of platelet-leukocyte aggregates was higher in dogs with MMVD and PH compared with MMVD controls (P = .01). Ex vivo stimulation of whole blood resulted in higher numbers of platelet-neutrophil aggregates in dogs with MMVD and PH (P = .01). Assessment of hypercoagulability based on TEG or plasma serotonin concentrations did not differ between groups. CONCLUSION AND CLINICAL IMPORTANCE: Platelet hyperresponsiveness and increased platelet-neutrophil interaction occur in dogs with MMVD and PH, suggesting that platelets play a role of in the pathogenesis of PH. Clinical benefits of antiplatelet drugs in dogs with MMVD and PH require further investigation.
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Plaquetas , Enfermedades de los Perros , Hipertensión Pulmonar , Perros , Animales , Enfermedades de los Perros/sangre , Enfermedades de los Perros/fisiopatología , Hipertensión Pulmonar/veterinaria , Hipertensión Pulmonar/sangre , Masculino , Femenino , Estudios Prospectivos , Activación Plaquetaria/fisiología , Neutrófilos , Tromboelastografía/veterinaria , Serotonina/sangre , Ecocardiografía/veterinaria , Insuficiencia de la Válvula Mitral/veterinaria , Insuficiencia de la Válvula Mitral/sangre , Insuficiencia de la Válvula Mitral/fisiopatologíaRESUMEN
OBJECTIVE: To determine if emergency and critical care residents can identify moderate to severe precapillary pulmonary hypertension on cardiologist-obtained cineloops using a pulmonary hypertension score (PHS) and report the interobserver variability of the PHS. DESIGN: Multicenter, retrospective, case-control study from 2017 to 2021. SETTING: Private referral center and veterinary teaching hospital. ANIMALS: One hundred and thirty-five client-owned dogs that underwent diagnostic echocardiography. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records of dogs with stage B1 myxomatous mitral valve disease (MMVD) and dogs diagnosed with precapillary pulmonary hypertension (PCPH) via echocardiograms were reviewed. Dogs were categorized by a cardiologist into 5 groups (normal, B1 MMVD, mild, moderate, and severe PCPH) based on Doppler pulmonary pressure gradients and right heart morphology. Cineloops from each case were subjectively evaluated by emergency and critical care residents for the presence of right atrial and ventricular enlargement, right ventricular hypertrophy, interventricular septal flattening, and pulmonary artery and trunk enlargement to form a composite pulmonary hypertension score out of 8 (PHS8). When available, signs of peritoneal effusion and distention of the caudal vena cava were subjectively assessed to generate a pulmonary hypertension score out of 10 (PHS10). There was excellent discrimination of moderate to severe PCPH versus grouped absent to mild PCPH using PHS8 (area under the receiver operator curve [AUC] [95% confidence interval, CI] = 0.90 [0.84-0.95], P < 0.0001) and PHS10 (AUC [95% CI] = 0.89 [0.81-0.97], P < 0.0001). PHS8 ≥3 was 64% sensitive and 98% specific for moderate to severe PCPH (positive likelihood ratio [LR+] 32, negative likelihood ration [LR-] 0.37). PHS10 ≥ 3.3 was 64% sensitive and 92% specific for moderate to severe PCPH (LR+ 8, LR- 0.39). Interobserver agreement was good to excellent (intraclass correlation coefficient [ICC] = 0.74 [95% CI: 0.66-0.80], n = 135). CONCLUSIONS: Residents identified moderate to severe PCPH in dogs using PHS on cineloops previously obtained by a cardiologist. The interrater agreement was good to excellent with limited training. Prospective studies to determine if residents can obtain diagnostic images for PHS are warranted.
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Enfermedades de los Perros , Hipertensión Pulmonar , Animales , Perros , Hipertensión Pulmonar/veterinaria , Hipertensión Pulmonar/diagnóstico , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/diagnóstico por imagen , Estudios Retrospectivos , Estudios de Casos y Controles , Femenino , Masculino , Ecocardiografía/veterinariaRESUMEN
OBJECTIVE: The objective of this study was to evaluate the signalement, clinical features, and echocardiographic findings of cats diagnosed with patent ductus arteriosus (PDA) as well as short- and medium-term outcome after successful ligation of the PDA. MATERIAL AND METHODS: Over a 10-year period 17 cats were diagnosed with PDA by transthoracic echocardiography. Thirteen cats were surgically treated by thoracotomy and ligation of the PDA. RESULTS: In all cats, a heart murmur was detected. In 88.2% of the cases, this presented as grade 4 out of 6 murmur (15/17 cats). A continuous murmur was more common (10/17 cats; 58.9%) than a systolic murmur (7/17 cats; 41.1%). Echocardiography showed that left ventricular internal diameter end diastole (LVIDd) and left ventricular internal diameter end systole (LVIDs) were significantly above reference values in the majority of cats. Mean diameter of the PDA measured at the widest point of the vessel was 3.4 mm (± 1.08 mm) and mean maximum flow velocity amounted to 5,06 m/sec (2,6m/sec-6,4m/sec). Surgery was successfully performed in all cats treated by surgical ligation and all of these patients were discharged after postoperative inpatient therapy. One cat experienced perioperative bleeding from the PDA, which was stopped efficaciously. This cat exhibited a residual shunt directly postoperatively; this could no longer be visualized in a re-check echocardiography 3 months later. Six cats were followed over a longer period of time. CONCLUSIONS: The surgical prognosis in this case study is very good with a postoperative survival rate of 100%. CLINICAL RELEVANCE: Surgical treatment of PDA is curative in animals not displaying advanced cardiac lesions. The auscultation of a heart murmur can provide initial findings indicative of PDA. Therefore, cardiac auscultation is warranted at every first presentation of a kitten. It must however be taken into consideration that not every cat with PDA necessarily has a continuous murmur but may display a systolic heart murmur. Therefore, it is important give utmost attention to the patients' clinical signs.
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Enfermedades de los Gatos , Conducto Arterioso Permeable , Ecocardiografía , Animales , Gatos , Conducto Arterioso Permeable/veterinaria , Conducto Arterioso Permeable/cirugía , Conducto Arterioso Permeable/diagnóstico , Enfermedades de los Gatos/cirugía , Enfermedades de los Gatos/diagnóstico , Estudios Retrospectivos , Ecocardiografía/veterinaria , Ligadura/veterinaria , Soplos Cardíacos/veterinaria , Soplos Cardíacos/diagnóstico , Soplos Cardíacos/cirugía , Soplos Cardíacos/etiología , Femenino , MasculinoRESUMEN
An 11-year-old female spayed German Wirehaired Pointer with a 1-week history of lethargy, hyporexia, diarrhea, and coughing presented with pericardial effusion causing cardiac tamponade. An echocardiogram revealed no structural cause for pericardial effusion. The pericardial effusion was an exudate with mixed macrophagic and neutrophilic inflammation. Morulae occasionally were found within neutrophils. The pericardial fluid and blood were qPCR and cPCR positive for Anaplasma phagocytophilum (NC State University, Vector-borne Disease Diagnostic Laboratory, Raleigh, NC). The dog's blood was negative by ELISA (Vetscan Flex4 Rapid Test, Zoetis, Parsippany, NJ) for A. phagocytophilum antibodies at initial presentation and subsequently positive (SNAP4DxPlus, IDEXX, Westbrook, ME) 7 days later. After pericardiocentesis and administration of doxycycline (5 mg/kg PO q12h for 14 days), a repeat echocardiogram performed 1 month later showed no recurrence of pericardial effusion.
Asunto(s)
Anaplasma phagocytophilum , Enfermedades de los Perros , Doxiciclina , Ehrlichiosis , Derrame Pericárdico , Animales , Femenino , Derrame Pericárdico/veterinaria , Derrame Pericárdico/microbiología , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/microbiología , Anaplasma phagocytophilum/aislamiento & purificación , Perros , Ehrlichiosis/veterinaria , Ehrlichiosis/complicaciones , Ehrlichiosis/diagnóstico , Doxiciclina/uso terapéutico , Antibacterianos/uso terapéutico , Ecocardiografía/veterinaria , Pericardiocentesis/veterinariaRESUMEN
BACKGROUND: Hemodynamic classification of pulmonary hypertension (PH) has important clinical implications. However, only a few echocardiographic variables have been used to hemodynamically classify PH in dogs. OBJECTIVE: To evaluate the echocardiographic pulmonary to left atrial ratio index (ePLAR) in dogs with PH. ANIMALS: Forty-six dogs with intermediate to high probability of PH. METHODS: Cross-sectional study. Variables were compared between dogs with precapillary PH [PrePH (n = 24)] vs postcapillary PH [PostPH (n = 22)], and with combined PH [CombPH (n = 14)] vs isolated PH [IsoPH (n = 8)] using the t-, Mann-Whitney, Pearson's Chi, or Fisher's exact test. The receiver operating characteristic curve and Youden index were used to identify the optimal ePLAR cutoff value to differentiate among the groups, intraclass correlation coefficients (ICC) were used to determine the reliability of measurements. RESULTS: The mean (SD) ePLAR of the PrePH was higher than that of the PostPH group [0.36 (0.13) vs 0.26 (0.09), respectively; P = .005]. The median (interquartile range) ePLAR of the CombPH was higher than that of the IsoPH subgroup [0.29 (0.24-0.38), vs 0.20 (0.16-0.23), respectively; P = .001]. The best cutoff value of ePLAR for identifying IsoPH was <0.245 [AUC at cutoff point = 0.86; sensitivity (95% confidence interval [CI]) = 0.71 (0.47-0.95); specificity (95% CI) = 1 (0.76-1)]. The ICC analysis indicated a high degree of reliability. CONCLUSIONS AND CLINICAL IMPORTANCE: ePLAR can be considered a valid noninvasive variable to hemodynamically classify PH in dogs with an intermediate to high probability of PH. Assessment of ePLAR can be useful in the therapeutic management of PH in dogs.
Asunto(s)
Enfermedades de los Perros , Ecocardiografía , Hemodinámica , Hipertensión Pulmonar , Animales , Perros , Hipertensión Pulmonar/veterinaria , Hipertensión Pulmonar/diagnóstico por imagen , Hipertensión Pulmonar/fisiopatología , Hipertensión Pulmonar/clasificación , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/fisiopatología , Enfermedades de los Perros/clasificación , Ecocardiografía/veterinaria , Estudios Transversales , Masculino , Femenino , Atrios Cardíacos/fisiopatología , Atrios Cardíacos/diagnóstico por imagenRESUMEN
BACKGROUND: In people, obesity is a risk factor for cardiovascular disease, associated with systemic hypertension, cardiac remodelling and systolic and diastolic dysfunction. Weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. In cats, far less is known regarding the effects of obesity and subsequent weight reduction on cardiovascular morphology and function. This prospective study aimed to assess cardiac morphology and function, heart rate variability, cardiac biomarkers and body composition before and after controlled weight reduction in cats with obesity. Body composition analysis (by dual energy x-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, systemic arterial systolic blood pressure, electrocardiography, plasma cardiac biomarkers) were performed prior to weight management in twenty cats with obesity. These investigations were repeated in eleven cats that reached target weight. RESULTS: At baseline, systemic hypertension was not documented, but the majority of cats with obesity (15 out of 19) showed echocardiographic evidence of diastolic dysfunction. Eleven of 20 cats had increased maximal end-diastolic septal or left ventricular free wall thickness (≥ 6.0 mm) at baseline. Median (interquartile range) percentage of weight lost in the cats reaching target weight was 26% (17-29%), with a median reduction in body fat mass of 45% (26-64%). Both the end-diastolic left ventricular free wall (median magnitude of change -0.85 mm, IQR -0.05 mm to -1.55 mm, P = 0.019; median percentage reduction 14.0%) and end-diastolic interventricular septum (median magnitude of change -0.5 mm, IQR -0.2 mm to -1.225 mm, P = 0.047; median percentage reduction 7.9%) thickness decreased after weight reduction. Following weight reduction, pulsed wave tissue Doppler imaging of the left ventricular free wall was consistent with improved diastolic function in 4 out of 8 cats, however there was no significant difference in overall diastolic function class. Further, there was no change in heart rate variability or cardiac biomarkers with weight reduction. CONCLUSION: An increase in left ventricular wall thickness and diastolic dysfunction were common echocardiographic features in cats with obesity within our study and may be reversible with successful weight and fat mass loss. Further studies are required to clarify the clinical consequences of these findings.