Journal of Veterinary Cardiology最新文献

Introduction/objectives

Left atrial fractional shortening (LAFS%) is a widely used index of left atrial systolic function in cats that has been shown to predict development of hypertrophic cardiomyopathy (HCM) and cardiac mortality. It can be determined by two methods: from an M-mode right parasternal short-axis view (LAFS%^RPSA-MM) or two-dimensional right parasternal long-axis four-chamber view (LAFS%^RPLA-2D). We aimed to assess the agreement between LAFS%^RPSA-MM and LAFS%^RPLA-2D in cats and to evaluate the correlation between LAFS%^RPSA-MM and LAFS%^RPLA-2D and left ventricular systolic performance.

Animals, materials, and methods

One hundred and seventeen cats were enrolled in the study: 40 control, 41 HCM stage B (asymptomatic), and 36 HCM stage C (symptomatic) cats. This was a retrospective case–control study. Bland–Altman analysis was used to assess agreement between LAFS%^RPSA-MM and LAFS%^RPLA-2D across the whole cohort and in cats with asymptomatic and symptomatic HCM. Correlation analysis was used to assess associations between LAFS% methods and forward aortic flow, left ventricular fractional shortening, and aortic root motion.

Results

The LAFS% determined by LAFS%^RPSA-MM and LAFS%^RPLA-2D was similar (P=0.8), but Bland–Altman analysis showed wide limits of agreement between methods. There was a good correlation between LAFS%^RPSA-MM and LAFS%^RPLA-2D and aortic root motion (r = 0.78 and r = 0.71, respectively) and a fair correlation with left ventricular fractional shortening (r = 0.31 and r = 0.29, respectively). None of the methods showed a correlation with indices of aortic flow.

Conclusions

Our study suggests a poor agreement between LAFS%^RPSA-MM and LAFS%^RPLA-2D, and thus, these methods should not be used interchangeably. Both echocardiographic methods showed good correlation with aortic root motion.

Introduction

Loss of respiratory sinus arrhythmia (RSA) is a negative prognostic factor in dogs with myxomatous mitral valve disease (MMVD). The aim of this study was to calculate the percentage (%) of RSA in healthy dogs and dogs in various MMVD classes.

Animals

Control and MMVD dogs were prospectively included in the study.

Materials and methods

Respiratory sinus arrhythmia was calculated from a dual channel electrocardiography and breathing curve recording using the peak-to-trough method, in percent of the average heart rate.

Results

One hundred and forty-nine dogs were studied, including 24 control and 125 MMVD dogs of different severity classes. An overall %RSA decrease was documented with increasing disease severity up to the Ca class along with a relative %RSA increase in the Cc class. The %RSA magnitude differed between B2 and Ca (P<0.001), and between Ca and Cc (P = 0.001) groups, respectively. The %RSA showed a medium negative correlation with the La:Ao ratio (r2 = −0.568, P<0.001) and with the E-wave velocity (r2 = −0.561, P<0.001).

Discussions

A decrease in %RSA was shown with increased disease severity up to acute congestive heart failure (CHF). Dogs receiving cardiac therapy leading to stabilized CHF might restore their ability to exhibit RSA, often revealing a higher %RSA compared to those in acute CHF.

Study limitations

Low number of respiratory cycles for analysis. Therapy effect not evaluated.

Conclusions

The findings of this study can serve as the basis for future risk stratification and carry the potential of proving an additional clinical marker for diagnostic and therapeutic decisions making when managing MMVD dogs.

A 10-year-old male castrated Somali cat presented with neurologic signs, severe systemic hypertension, and hypokalemia. Abdominal ultrasonography demonstrated a left adrenal mass, and the serum aldosterone concentration was increased. Computed tomography and follow-up diagnostic testing confirmed a left adrenal mass consistent with functional adenocarcinoma; additional findings included chronic airway and parenchymal disease. Transthoracic echocardiography revealed biatrial enlargement, with abdominal and pericardial effusion, consistent with right-sided congestive heart failure. The cat was treated for congestive heart failure and adrenalectomy was performed. Cardiac structure and function returned to normal within 6 months postoperatively. This report highlights a case of reversible congestive heart failure secondary to primary hyperaldosteronism.

A one-year-old male intact American bulldog was presented for evaluation of previously diagnosed pulmonary stenosis. Echocardiography identified ultra-severe stenosis with an instantaneous trans-pulmonary pressure gradient of 240 mmHg. Angiography confirmed the presence of an anomalous coronary artery with a prepulmonic course of the left coronary artery arising from a single right coronary ostium consistent with a type R2A coronary anomaly. A trans-pulmonary stent was successfully placed transvenously with diameter sizing based on coronary compression testing. No coronary compression was present on postimplantation angiography. A marked reduction in the pressure gradient was obtained on postoperative echocardiography (reduction to 68 mmHg), despite selecting a stent diameter less than the pulmonary annulus diameter. This is the first report of the use of coronary compression testing in transvenous trans-pulmonic stent implantation in a dog with a type R2A coronary artery anomaly. Selection of a stent diameter less than the pulmonary annulus diameter conveyed a clinically relevant reduction in the trans-pulmonic pressure gradient while avoiding coronary compression in this case.

An 18-year-old female neutered Domestic Shorthair cat was referred for investigation of seizure-like episodes. Physical and neurological examination were unremarkable, as were systemic arterial blood pressure, cardiac troponin I, complete blood count and biochemistry profile. Diagnostic tests included transthoracic echocardiography which ruled out any structural cardiomyopathy, and electrocardiography which showed an underlying regular wide QRS-complex rhythm with pronounced shortening of the PR interval. Considering the findings, a diagnosis of suspected ventricular pre-excitation secondary to an accessory pathway was made. Further investigations were declined and, as no periods of tachycardia were seen on the five-minute electrocardiogram, no antiarrhythmic treatment was started.