Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology
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Publications in this journal
Article: Single left coronary ostium and an anomalous prepulmonic right coronary artery in 2 dogs with congenital pulmonary valve stenosis.[show abstract] [hide abstract]
ABSTRACT: A coronary artery anomaly characterized by the presence of a single left coronary ostium with absence of the right coronary ostium and an anomalous prepulmonic right coronary artery course was observed in two dogs with concurrent congenital pulmonary valve stenosis. This unique coronary artery anatomy is similar to the previously described single right coronary ostium with anomalous prepulmonic left coronary artery, the so-called type R2A anomaly, in that an anomalous coronary artery encircles the pulmonary valve annulus. Both dogs of this report, a boxer and an English bulldog, were of breeds known to be at risk for the type R2A anomaly. As such, veterinarians should be aware that the echocardiographic presence of a left coronary ostium in a dog with pulmonary valve stenosis does not exclude the possibility of a prepulmonic coronary artery anomaly that may enhance the risk of complications during balloon pulmonary valvuloplasty. A descriptive naming convention for coronary artery anomalies in dogs is also presented, which may be preferable to the older coding classification scheme.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 05/2013;
Article: Common two-dimensional echocardiographic estimates of aortic linear dimensions are interchangeable.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVE: To compare two echocardiographic methods of measuring aortic diameter in short-axis projections. METHODS: Right-parasternal short-axis 2-dimensional projections of the left atrium and aorta were obtained from dogs and cats undergoing routine cardiac evaluation. Two investigators measured the aortic valve linear dimension using 2 methods: along the commissure between the non-coronary and right-coronary cusps and along the commissure between the non-coronary and left-coronary cusps. Inter-observer and intra-observer variability and agreement were assessed by comparing blinded measurements with each method by 4 trained observers on a standardized set of images. Measurements were compared for agreement using the limits of agreement analysis. Variability between observers was compared by examining residuals and intraclass correlation. RESULTS: 274 canine and 100 feline aortic valve images were measured in the first part of the study. One observer demonstrated slight proportional bias, while the other observer showed more variability (less agreement). When results were pooled for both investigators, no bias was identified, and 95% limits of agreement were ±10% of the mean measurement for both species. In the second part of the study, 106 images were measured. Intraobserver variability was <4% for all observers. Inter-observer agreement was very high. Individual bias was identified in some observers, but was considered clinically inconsequential. Normalized differences between the 2 methods of measurement were below ±15% of the measured value for all observers. CONCLUSIONS: Our results show sufficient agreement between two common methods used to measure aortic linear dimensions to suggest that these methods are interchangeable.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 05/2013;
Article: Influence of heart rate on myocardial function using two-dimensional speckle-tracking echocardiography in healthy dogs.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVE: The objective of this study was to evaluate the influence of heart rate (HR) on myocardial function assessed by two-dimensional speckle-tracking echocardiography (2D-STE) in healthy dogs. ANIMALS: Thirteen healthy beagle dogs. METHODS: Animals were anesthetized and HR was controlled with right atrial pacing. Myocardial function of each dog was assessed using 2D-STE at pacing rates of 120, 140, 160, and 180 bpm. RESULTS: All strain and strain rate variables in the longitudinal, circumferential, and radial directions were not significantly different between pacing rates. Peak early diastolic torsion rate at 180 bpm was significantly increased compared with that at 120 bpm (P = 0.003). CONCLUSION: Torsion rate in early diastole was elevated at 180 bpm, which may reflect improved myocardial relaxation with higher HR. Changes in left ventricular torsion during tachycardia may play an important role in preserving stroke volume in the presence of shortened ejection and filling times.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 05/2013;
Article: An echocardiographic study of healthy Border Collies with normal reference ranges for the breed.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVES: The objectives of this study were to obtain standard echocardiographic measurements from healthy Border Collies and to compare these measurements to those previously reported for a general population of dogs. ANIMALS: Standard echocardiographic data were obtained from twenty apparently healthy Border Collie dogs. These data (n = 20) were compared to data obtained from a general population of healthy dogs (n = 69). METHODS: Border Collies were deemed healthy based on normal history, physical examination, complete blood count, serum biochemical profile, electrocardiogram, and blood pressure, with no evidence of congenital or acquired heart disease on echocardiographic examination. Standard two dimensional, M-mode, and Doppler echocardiographic measurements were obtained and normal ranges determined. The data were compared to data previously obtained at our hospital from a general population of normal dogs. RESULTS: Two dimensional, M-mode, and Doppler reference ranges for healthy Border Collies are presented in tabular form. Comparison of the weight adjusted M-mode echocardiographic means from Border Collies to those from the general population of dogs showed Border Collies to have larger left ventricular systolic and diastolic dimensions, smaller interventricular septal thickness, and lower fractional shortening. CONCLUSIONS: There are differences in some echocardiographic parameters between healthy Border Collies and the general dog population, and the echocardiographic reference ranges provided in this study should be used as breed specific reference values for Border Collies.
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ABSTRACT: Throughout civilization, animals have played a pivotal role in the advancement of science and medicine. From as early as 400 BC when Hippocrates recognized that diseases had natural causes, the steadfast advances made by biologists, scientists, physicians and scholars were fueled by timely and important facts and information- much of it gained through animal observations that contributed importantly to understanding anatomy, physiology, and pathology. There have been many breakthroughs and historic developments. For example, William Harvey in the 16th and 17th centuries clarified the importance of the circulatory system, aided by observations in dogs and pigs, which helped to clarify and confirm his concepts. The nineteenth century witnessed advances in physical examination techniques including auscultation and percussion. These helped create the basis for enhanced proficiency in clinical cardiology. An explosion of technologic advances that followed in the 20th century have made possible sophisticated, accurate, and non-invasive diagnostics. This permitted rapid patient assessment, effective monitoring, the development of new cardiotonic drugs, clinical trials to assess efficacy, and multi-therapy strategies. The latter 20th century has marshaled a dizzying array of advances in medical genetics and molecular science, expanding the frontiers of etiologies and disease mechanisms in man, with important implications for animal health. Veterinary medicine has evolved during the last half century, from a trade designed to serve agrarian cultures, to a diverse profession supporting an array of career opportunities ranging from private, specialty practice, to highly organized, specialized medicine and subspecialty academic training programs in cardiology and allied disciplines.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 02/2013;
Article: Scanning through the pain: Ergonomic considerations for performing echocardiography of animals.[show abstract] [hide abstract]
ABSTRACT: Work-related musculoskeletal disorders (MSD) are a common problem among sonographers, with prevalence in human sonographers of 80-90%. However, this problem appears to be largely neglected in the veterinary literature. Awareness of MSDs, ergonomic redesign, workplace management, and physical self-care are components to reducing the risk of developing MSDs. Work-place redesign and alterations in work flow management are discussed, and a template for a more ergonomically favorable echocardiogram table is provided.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 02/2013;
Article: The Journey of the Journal.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 02/2013;
Article: Normal electrocardiographic QT interval in race-fit Standardbred horses at rest and its rate dependence during exercise.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVES: Cardiac repolarization, measured as QT and T(peak) to T(end) (T(p)T(e)) intervals on the ECG, is important, as irregularities caused by diseases, ventricular hypertrophy, drugs and genetic defects can trigger arrhythmias which predispose human patients to syncope and sudden cardiac death. In horses, repolarization is not well described and therefore QT analysis cannot yet be used diagnostically. Therefore, we sought to describe reference values for the normal QT and T(p)T(e) intervals in Standardbreds and to determine the best method for heart rate (HR) correction. ANIMALS: 30 Standardbreds. METHODS: QT and T(p)T(e) intervals were measured during rest and exercise and plotted against HR converted to R(peak) to R(peak) interval (RR). Data were fitted with relevant regression models. Intra- and inter-observer agreement was assessed using Bland-Altman analyses. RESULTS: Data were best described by a piecewise linear model (r(2) > 0.97). Average prediction error of this model was smaller than for both Bazett and Fridericia corrections. Coefficient of repeatability of intra- and inter-observer variability was 8.76 ms and 5.64 ms respectively and coefficient of variation was 1.77% and 2.76% respectively. T(p)T(e) increased with RR in stallions. CONCLUSIONS: The QT interval in Standardbred horses shortens with decreasing RR interval (increasing HR) as in humans, but in a markedly different order as it clearly follows a piecewise linear model. The equine QT interval can be measured easily and there is small intra- and inter-observer variability. This model of the equine QT interval provides clinicians with a method that could support a diagnosis of repolarization disturbances in horses.
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ABSTRACT: A bicuspid aortic valve (BAV) demonstrating moderate valvular stenosis and mild insufficiency was identified in an asymptomatic 1-year-old male cryptorchid English bulldog by transthoracic and transesophageal echocardiography. The BAV was most consistent with type 3 morphology, based upon human classification. Pulmonary valve dysplasia with mild pulmonary stenosis and a suspected persistent left cranial vena cava were also identified. Although BAV is the most common congenital cardiac malformation in humans, it is rare in the dog.
Article: Effects of vagal maneuvers on heart rate and Doppler variables of left ventricular filling in healthy cats.[show abstract] [hide abstract]
ABSTRACT: BACKGROUND: Evaluation of left ventricular (LV) diastole is clinically important in cats with heart disease. Diastolic dysfunction is a main characteristic of feline cardiomyopathy and is associated with clinical signs and poor outcome. Numerous echocardiographic indices characterizing LV diastole exist, of which Doppler variables of transmitral flow and mitral annular motion are used most often. However, rapid heart rate (HR), a common finding in cats examined in the veterinary hospital environment, may cause summation of flow waves limiting interpretation of diastolic function. OBJECTIVE: To evaluate the effects of vagal maneuvers (gentle eyeball pressure and nasal planum massage) on HR and Doppler variables of LV diastolic filling. ANIMALS: Twenty-four healthy client-owned cats with summated transmitral flow waves at baseline. METHODS: Prospective observational study. Transthoracic echocardiography was performed and Doppler transmitral and mitral annular tissue Doppler velocities recorded both before and during vagal maneuvers. Data were compared using a paired t-test. RESULTS: Application of vagal maneuvers temporarily decreased HR in all cats (mean reduction ± SD; 42 ± 22 bpm). The duration of HR reduction (<5 s, 5-10 s, and >10-15 s) was evenly distributed among groups (8 cats in each). Summated Doppler transmitral flow and mitral annular tissue velocity waves were separated during vagal maneuvers in 71% and 72% of cats, respectively. No adverse effects were observed. CONCLUSIONS: Vagal maneuvers may be utilized as a simple non-pharmacologic tool in the Doppler evaluation of LV diastolic function in healthy cats.
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ABSTRACT: OBJECTIVE: To characterize the electrocardiogram (ECG) of anesthetized adult emus (Dromaius novaehollandiae). ANIMALS: Ten clinically healthy adult emus anesthetised for routine physical examination and an electrocardiogram, for both monitoring and investigation into any evidence of cardiac disease. METHODS: The ECGs for each emu were obtained in right lateral recumbency, using a modified electrode placement that replicated the standard bipolar leads used in small mammals. Lead II was used for waveform analysis. RESULTS: Median P wave amplitude was 0.55 mV (range: 0.2-0.92 mV) and P wave duration was 0.06 s (0.04-0.09 s). S wave amplitude measured 1.42 mV (0.92-2.12 mV), T wave amplitude 0.67 mV (0.16-0.83 mV) and QRS duration was 0.07 s (0.07-0.12 s). Ninety percent of the QRS complexes were of rS type. CONCLUSION: Our study provides electrocardiographic baseline data for anesthetized adult emus.
Article: Cardiomyocyte calcium cycling in a naturally occurring German shepherd dog model of inherited ventricular arrhythmia and sudden cardiac death.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVE: To further characterize arrhythmic mechanisms in German shepherd dogs (GSDs) affected with inherited ventricular arrhythmias by evaluating intracellular calcium cycling and expression of calcium handling genes. ANIMALS: Twenty five GSDs, 9 backcross dogs, and 6 normal mongrel dogs (controls) were studied. The GSDs and backcross dogs were from a research colony of inherited ventricular arrhythmias. The control research dogs were purchased. METHODS: Action potentials (APs) and pseudo-electrocardiograms (ECG) were recorded from left ventricular (LV) wedge preparations of GSDs and normal dogs. Midmyocardial (Mid) LV cells from GSDs and normal mongrels were isolated by enzymatic digestion. Cells were either field stimulated or voltage clamped and calcium transients were measured by confocal microscopy using the indicator Fluo-3AM. Expression of calcium handling genes was measured by quantitative RT-PCR. RESULTS: Mean calcium transient decay (tau) was not different between affected GSDs and control dogs, but striking cell-to-cell variability for tau was observed within affected GSDs and between affected GSDs and controls (P < 0.0001 each); within-dog variability accounted for 75% of total variability. Calcium sparks and afterdepolarizations occurred in GSD but not control cells. ATP2A2/SERCA2a expression was significantly reduced (P = 0.0063) in affected GSDs and inversely correlated (P = 0.0006) with severity of ventricular arrhythmias. CONCLUSIONS: German shepherd dogs with inherited ventricular arrhythmias have electrophysiologic abnormalities in calcium cycling associated with reduced ATP2A2/SERCA2a expression. These animals provide a unique opportunity to study calcium remodeling at the genetic and molecular level in familial ventricular arrhythmias.
Article: Cardiac biomarker changes in camels (Camelus dromedarius) secondary to road transportation.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVES: Little is known about cardiac biomarkers in camels despite their extensive use as draft animals. This study was designed to establish reference ranges for the cardiac biomarkers cardiac troponin I (cTnI) and creatine kinase myocardial b fraction (CK-MB) in healthy camels and to investigate their changes in response to road transportation. ANIMALS: Twenty-five healthy camels transported for a 5 h round-trip journey. METHODS: None of the camels had evidence of cardiac abnormalities on cardiac auscultation, echocardiography or electrocardiography. Three blood samples were obtained from each camel: 24 h before transportation (T0), within 2 h after unloading (T1) and 24 h after transportation (T2). RESULTS: The mean cTnI concentration in the camels was 0.032 ± 0.023 ng/mL. All the camels had resting cTnI concentrations of <0.08 ng/mL. At T1, the cTnI concentration was significantly higher (P < 0.001) in all 25 camels compared to values at T0. The CK-MB concentration in the camels was 0.19 ± 0.05 ng/mL. All the camels had resting CK-MB concentrations of <0.33 ng/mL. At T1, the CK-MB concentration was higher in 3/25 camels compared to values at both T0 and T2. Concerning the hematobiochemical variables, significant increases were detected at T1 in total white blood cells, total protein, globulin, magnesium and phosphorus. Cardiac troponin I, CK-MB and all the hematobiochemical parameters had returned to their pre-transport values at T2. CONCLUSIONS: 5 h road transportation might have transient adverse effects on the cardiac muscle of healthy camels.
Article: Clinical assessment of systolic myocardial deformations in dogs with chronic mitral valve insufficiency using two-dimensional speckle-tracking echocardiography.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVE: The objective of this study was to clinically assess myocardial deformations in dogs with chronic mitral valve insufficiency (CMVI) using two-dimensional speckle-tracking echocardiography (2D-STE). ANIMALS: 87 dogs with CMVI. METHODS: Dogs were placed into 1 of 3 classes, based on the International Small Animal Cardiac Health Council classification. In addition, 20 weight- and age-matched healthy dogs were enrolled as controls. The dogs were examined for myocardial deformations using 2D-STE, and strain and strain rate in the longitudinal, circumferential, and radial directions were evaluated. RESULTS: Class II and III dogs had higher circumferential strain than class I dogs (P = 0.002 and P = 0.001, respectively) and controls (P < 0.001 and P < 0.001, respectively). Class III dogs had higher radial strain than class I dogs (P = 0.001) and controls (P < 0.001). Class III dogs had higher radial strain rate than class I dogs (P = 0.006) and controls (P = 0.001). Other deformations, including longitudinal deformations, were not significantly different between classes of CMVI or between CMVI dogs and controls. CONCLUSIONS: In the clinical progression of CMVI in dogs, myocardial deformations, as assessed by 2D-STE, differed according to myocardial contractile direction. Thus, assessments of multidirectional myocardial deformations may be important for better assessment of clinical cardiac function in dogs with CMVI.
Article: Cutting balloon catheterization for interventional treatment of cor triatriatum dexter: 2 Cases.[show abstract] [hide abstract]
ABSTRACT: Cutting balloon dilatation was performed successfully in two dogs with cor triatriatum dexter and clinical signs of ascites. The cutting balloon catheter uses incisional microtomes embedded in a balloon catheter. During balloon expansion, these microtomes incise the adjacent tissue, decreasing circumferential wall stress. This theoretically reduces both the likelihood of fracturing the adjacent tissues in an uncontrolled manner and the potential neoproliferative response to standard balloon dilatation and the subsequent incidence of re-stenosis. In both cases described, clinical signs resolved completely following cutting balloon dilatation of the anomalous membrane. Based on the outcome of these 2 cases, cutting balloon dilatation appears to be a viable treatment option for dogs affected with cor triatriatum dexter.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 11/2012;
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ABSTRACT: An 8 year old female spayed Boxer dog, diagnosed with concurrent vasovagal syncope and arrhythmogenic right ventricular cardiomyopathy, presented for routine evaluation approximately three months following epicardial pacemaker implantation. Routine device interrogation revealed intermittent loss of ventricular capture and intermittent failure to appropriately sense. Following evaluation of chronic impedance data, failure of the pacemaker lead-header interface or lead conductor fracture was suspected. Radiographic and pacemaker interrogator findings suggested incomplete lead insertion into the device header with intermittent loss of ventricular capture and variable pacemaker sensing. We hypothesize that either the presence of a loose or cross-threaded set screw or operator error at the time of device implantation may have caused this complication. This report details the diagnosis of mechanical failure of the lead-header interface, a complication not previously reported in a veterinary patient.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 11/2012;
Article: Effect of sample volume size and sampling method on feline longitudinal myocardial velocity profiles from color tissue Doppler imaging.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVES: The aims of this study were to compare the effect of sample volume (SV) size settings and sampling method on measurement variability and peak systolic (s'), and early (e') and late (a') diastolic longitudinal myocardial velocities using color tissue Doppler imaging (cTDI) in cats. ANIMALS: Twenty cats with normal echocardiograms and 20 cats with hypertrophic cardiomyopathy. METHODS: We quantified and compared empirical variance and average absolute values of s', e' and a' for three cardiac cycles using eight different SV settings (length 1,2,3 and 5 mm; width 1 and 2 mm) and three methods of sampling (end-diastolic sampling with manual tracking of the SV, end-systolic sampling without tracking, and random-frame sampling without tracking). RESULTS: No significant difference in empirical variance could be demonstrated between most of the tested SVs. However, the two settings with a length of 1 mm resulted in a significantly higher variance compared with all settings where the SV length exceeded 2 mm (p < 0.001). There was an overall significant effect of sampling method on the variability of measurements (p = 0.003) and manual tracking obtained the lowest variance. No difference in average values of s', e' or a' could be found between any of the SV settings or sampling methods. CONCLUSION: Within the tested range of SV settings, an SV length of 1 mm resulted in higher measurement variability compared with an SV length of 3 and 5 mm, and should therefore be avoided. Manual tracking of the sample volume is recommended.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 11/2012;
Article: Prospective echocardiographic and tissue Doppler screening of a large Sphynx cat population: Reference ranges, heart disease prevalence and genetic aspects.[show abstract] [hide abstract]
ABSTRACT: OBJECTIVES: (1) To investigate heart morphology and function using echocardiography and tissue Doppler imaging (TDI), (2) to determine heart disease prevalence and characteristics, and (3) to assess potential genetic features in a population of Sphynx cats presented for cardiovascular screening. ANIMALS: A total of 147 echocardiographic examinations, including 33 follow-ups, were performed by trained observers on 114 Sphynx cats of different ages (2.62 ± 1.93 years [0.5-10.0]) from 2004 to 2011. METHODS: Sphynx cats underwent a physical examination, conventional echocardiography, and, if possible, two-dimensional color TDI. RESULTS: Conventional echocardiographic findings included 75/114 normal (65.8%) and 39/114 (34.2%) abnormal examinations with a diagnosis of either congenital heart diseases (n = 16) or hypertrophic cardiomyopathy (HCM, n = 23). In adult healthy cats, a significant body weight effect was observed for several echocardiographic variables, including end-diastolic left ventricular (LV) free wall (P < 0.01), interventricular septum (P < 0.001), and LV diameter (P < 0.001). Mitral valve dysplasia (MVD) was observed as a single or associated defect in 15/16 cats with congenital heart diseases. A significant increase in HCM prevalence (P < 0.001) was observed according to age. The pedigree analysis of a large family (n = 81) suggested an autosomal dominant mode of inheritance with incomplete penetrance for HCM. CONCLUSIONS: Body weight should be taken into account when interpreting values of diastolic myocardial wall thicknesses in Sphynx cats. Additionally, HCM and MVD are two relatively common heart diseases in this feline breed. More pedigree data are required to confirm the inheritance pattern of HCM at the breed level.
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ABSTRACT: OBJECTIVE: To describe the pharmacokinetics of oral pimobendan in healthy cats. ANIMALS: 18 purpose-bred cats. METHODS: In 10 cats, blood samples were collected before, and at multiple time points after, a single oral dose of pimobendan (0.28 ± 0.04 mg/kg). In 8 cats, blood samples were collected at 3 various time points on the first and third days of twice daily oral dosing of pimobendan for a total of 7 doses (0.31 ± 0.04 mg/kg). Plasma concentrations of pimobendan were quantified by high pressure liquid chromatography coupled to tandem mass spectrometry. RESULTS: A 1-compartment open model with first order absorption in and elimination from the central compartment with a lag time best describes the disposition of pimobendan. Two cats were removed from final pharmacokinetic descriptive analysis due to delayed minimal absorption from gastrointestinal adverse effects. After a lag time (0.3 ± 0.06 h), pimobendan was rapidly absorbed (absorption half-life = 0.2 ± 0.08 h) and eliminated (elimination half-life = 1.3 ± 0.2 h). Maximum plasma concentrations (34.50 ± 6.59 ng/mL) were high and were predicted 0.9 h after drug administration. Apparent volume of distribution at steady state (per bioavailability) was large (8.2 ± 2.5 L/kg). The multi-dose study showed the pharmacokinetic model to be robust. CONCLUSION: When administered a similar dose on a per weight basis, pimobendan has a substantially longer elimination half-life and maximal drug plasma concentration in cats as compared to those previously reported in dogs.Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 10/2012;
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