Prognostic value of echocardiographic indices of left atrial morphology and function in dogs with myxomatous mitral valve disease

Background: The prognostic relevance of left atrial (LA) morphological and functional variables, including those derived from speckle tracking echocardiography (STE), has been little investigated in veterinary medicine. Objectives: To assess the prognostic value of several echocardiographic variables, with a focus on LA morphological and functional variables in dogs with myxomatous mitral valve disease (MMVD). Animals: One-hundred and fifteen dogs of different breeds with MMVD. Methods: Prospective cohort study. Conventional morphologic and echo-Doppler variables, LA areas and volumes, and STE-based LA strain analysis were performed in all dogs. A survival analysis was performed to test for the best echocardiographic predictors of cardiac-related death. Results: Most of the tested variables, including all LA STE-derived variables were univariate predictors of cardiac death in Cox proportional hazard analysis. Because of strong correlation between many variables, only left atrium to aorta ratio (LA/Ao > 1.7), mitral valve E wave velocity (MV E vel > 1.3 m/s), LA maximal volume (LAVmax > 3.53 mL/kg), peak atrial longitudinal strain (PALS < 30%), and contraction strain index (CSI per 1% increase) were entered in the univariate analysis, and all were predictors of cardiac death. However, only the MV E vel (hazard ratio [HR], 4.45; confidence interval [CI], 1.76-11.24; P <.001) and LAVmax (HR, 2.32; CI, 1.10-4.89; P =.024) remained statistically significant in the multivariable analysis. Conclusions and Clinical Importance: The assessment of LA dimension and function provides useful prognostic information in dogs with MMVD. Considering all the LA variables, LAVmax appears the strongest predictor of cardiac death, being superior to LA/Ao and STE-derived variables

Evaluating the accuracy of a six-lead smartphone-based electrocardiographic device compared with standard electrocardiography in brachymorphic dogs

BackgroundNo previous study has evaluated the accuracy of a six-lead smartphone-based electrocardiographic (s-ECG) device in dogs. MethodsThis was a prospective multicentre study. Patients referred for cardiologic consultation were selected. In each patient, a 30-second electrocardiogram was simultaneously acquired with a novel six-lead s-ECG and a standard six-lead ECG machine (st-ECG). A board-certified cardiologist evaluated each recording. Nineteen ECG variables, including heart rate and rhythm, as well as quantitative and qualitative features of waves, segments and intervals, were analysed. Agreement between s-ECG and st-ECG was evaluated using Cohen's kappa coefficient and the Bland-Altman test. ResultsSeventy-five dogs were enrolled, and 140 ECG tracings were analysed. There was perfect agreement between the two methodologies for heart rate and rhythm classification, both in dogs with sinus rhythm and those with pathological rhythms. Although some disagreement was found when comparing measurements of quantitative variables obtained with the s-ECG and the st-ECG, none of the differences was of clinical relevance. LimitationsThe sample size was limited, and the interobserver variability was not analysed. ConclusionThe six-lead s-ECG studied herein is comparable to the st-ECG for heart rate and rhythm assessment, and seems clinically acceptable for the interpretation of waves, segments and intervals in dogs

Echocardiographic values in healthy Pugs: Effect of body weight, age, and sex

Background: Transthoracic echocardiography represents the main noninvasive technique for evaluating cardiac morphology and function in dogs. In dogs with particular somatotypes, such as brachymorphic dogs, breed-specific echocardiographic values are needed for a proper echocardiographic interpretation. Nowadays, the Pug represents one of the most popular brachymorphic canine breeds worldwide. However, data on echocardiographic measurements in this breed are currently limited. Aim: We aimed to determine echocardiographic values in a population of apparently healthy Pugs, and to assess the possible effects of body weight (BW), age, and sex on selected echocardiographic variables, with particular emphasis on those related to the left-sided cardiac chambers. Methods: Apparently healthy Pugs underwent a full physical examination, a 1-minute six-lead electrocardiogram, and a complete transthoracic echocardiography. Twenty-four echocardiographic variables were measured by combining M-mode, two-dimensional and Doppler modalities, and relative values were determined by applying the statistical procedures recommended by the Clinical and Laboratory Standards Institute. Moreover, the effect of selected demographic variables on echocardiographic measurements was tested using a linear mixed model. Results: The investigation included 86 Pugs. Echocardiographic values were provided for each variable and compared with previous veterinary literature. A statistically significant effect of BW, age, and sex was documented for several of the tested variables. Doppler examination demonstrated a trivial pulmonary regurgitation in 24/86 (27.9%) Pugs. Moreover, a persistent left cranial vena cava was suspected in 4/86 (4.7%) dogs. Conclusion: Echocardiographic features of the Pug were addressed and echocardiographic values were made available for clinical use. Because our findings were obtained using a standardized echocardiographic analysis in a population of 86 healthy Pugs, they may act as a reliable guide for an accurate echocardiographic interpretation in this breed

Echocardiographic predictors of first onset of atrial fibrillation in dogs with myxomatous mitral valve disease

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Prevalence and prognostic role of L wave and selected clinical and echocardiographic variables in dogs with atrial fibrillation

Background: Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. Hypothesis/objectives: To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. Animals: Fifty-five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. Methods: Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all-cause mortality using Cox proportional hazards regression models. Results: L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI]&nbsp;=&nbsp;47%-72%) but their presence did not influence outcome. Increased left ventricular end-systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR]&nbsp;=&nbsp;4.41, 95% CI&nbsp;=&nbsp;1.18-16.54; P&nbsp;=&nbsp;.03) and all-cause mortality (HR&nbsp;=&nbsp;9.39, 95% CI&nbsp;=&nbsp;2.49-35.32; P &lt; .001). Heart rate assessed during echocardiography (Echo-HR) represented an additional significant predictor of cardiac death (HR&nbsp;=&nbsp;1.01, 95% CI&nbsp;=&nbsp;1.00-1.01; P&nbsp;=&nbsp;.04) and all-cause mortality (HR&nbsp;=&nbsp;1.01, 95% CI&nbsp;=&nbsp;1.00-1.01; P&nbsp;=&nbsp;.04). Conclusions and clinical importance: L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo-HR represented independent predictors of negative outcome in these animals

The ultrasonographic medullary 'rim sign' versus medullary 'band sign' in cats and their association with renal disease

Background Medullary rim sign (MRS) refers to a hyperechoic line in the renal medulla, reported on ultrasound examination (US) in both dogs and cats with and without kidney disease (KD). Objective To describe the different aspects of MRS in cats and to assess its association with KD. Animals Cats that underwent US examination, with MRS (study group) with and without KD and without MRS with and without KD (control groups). Methods Retrospective case-control study: cats with MRS, with or without KD (rim sign groups) and cats without MRS, with or without KD (control groups). Ultrasonographic images were blindly reviewed with attention given to the thickness and margins of the MRS recorded. Results Eighty-four cats with MRS were included and 60 cats recruited for each control group. The MRS had 2 distinct aspects: a thin hyperechoic line with well-defined margins (MRS-line) in 50/84 cats (59%) and a thick hyperechoic band with ill-defined margins (MRS-band) in 34/84 cats (41%). Twenty of 50 (40%) cats with MRS-lineand 25/34 (74%) of cats with MRS-bandhad KD. The frequency of MRS-linewas higher in cats without KD, whereas the presence of MRS-bandwas more frequent in cats with KD (P= .003). Conclusions and Clinical Importance A thick hyperechoic ill-defined band (for which the term medullary band sign is proposed) was more frequently associated with KD, whereas a thin hyperechoic well-defined line (true MRS) may be seen in cats with or without KD

Contrast-enhanced ultrasonography of the pancreas in healthy cats

Background: This study describes the pattern of ultrasonographic contrast enhancement of the pancreatic body and left lobe using a second-generation commercial contrast medium (Sonovue) in 10 clinically healthy cats. Results: Following contrast medium administration, microbubbles were observed within the splenic artery. This was followed by an inflow of contrast medium into the pancreatic capillary beds, providing a uniformly contrast-enhanced pancreas at peak intensity (PI). At the time of PI, a replenishment of the splenic and portal veins started and increased progressively during the wash-out phase. During the wash-out phase, the echogenicity of the pancreatic parenchyma decreased progressively. Perfusion parameters included arrival time (4.69 \ub1 1.26 s), time to peak from injection (7.52 \ub1 1.88 s), time to peak from initial rise (2.84 \ub1 0.88 s), peak intensity (6.58 \ub1 2.66 a.u.), and wash-in rate (2.11 \ub1 1.79 a.u./s). Conclusions: This perfusion pattern of normal pancreatic parenchyma may be useful for characterising cats with exocrine pancreatic disorders

Transient myocardial thickening associated with acute myocardial injury and congestive heart failure in two Toxoplasma gondii-positive cats

In this report, we provide detailed clinical, laboratory, electrocardiographic and echocardiographic descriptions of two Toxoplasma gondii-positive cats diagnosed with transient myocardial thickening (TMT) and acute myocardial injury (MI). In both cases, aetiological diagnosis was based on the antibody screening test (all cats had IgM titres ⩾1:64) and MI was demonstrated by a concomitant severe increase of the serum concentration of cardiac troponin I (5.1-23.6 ng/ml; upper hospital limit &lt;0.2 ng/ml). In both cats, TMT and MI were aggravated by left atrial dilation and dysfunction, as well as congestive heart failure. In one cat, atrial standstill was also documented, while the other cat showed an intracardiac thrombus. Both cats underwent an extensive diagnostic work-up aimed at excluding additional comorbidities that could contribute to able to contribute to TMT and MI, and received appropriate antiprotozoal (ie, clindamycin) and cardiovascular therapy (eg, furosemide, pimobendan and clopidogrel). This was followed by a simultaneous decline in T gondii serology titres, normalisation of troponin level and the resolution of clinical, electrocardiographic, radiographic and echocardiographic abnormalities. In the light of these results, therapies were interrupted and subsequent controls ruled out any disease relapse

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CLASSIFICAZIONE DEI RESIDUI; CAUSE,FORMAZIONE, FATTORI LEGATI AGLI ANIMALI; IDENTIFICAZIONE E PERICOLOSITA' DEI RESIDUI; SOSTANZE ANTIBIOTICHE, INSETTICIDI, MICOTOSSINE, STRUMENTAZIONI DIAGNOSTICHE E LEGISLAZIONE