Endocardiális myocardiális pacemaker elektródák hatása a szívizomzatra = The influence of myocardial pacemaker electrodes to the heart musculature

Huszonkét 3-4 hónapos, sertésbe összesen 28 pacemaker elektródát ültettünk be. A kísérleti állatokat 3 hónapon keresztül tartottuk. A kísérlet során az állatok több mint felében tapasztaltunk súlyos fokú komplikáció kialakulását, így végül 10 állatba beültetett 13 elektróda elektromos adatait tudtuk feldolgozni. Nem találtunk szignifikáns különbséget sem a kétféle fixációjú ingerelt elektróda jelnagysága, sem küszöb ingerlési potenciálja között. Nem volt szignifikáns különbség az aktív fixációjú endocardiális ingerelt és ingerlés nélküli elektródák ellenállásában, küszöb ingerlési potenciáljában, ill. jelnagyságában sem. Szöveti reakciókat 20 sertésből származó szívizom mintákon vizsgáltuk. A vizsgált elváltozások előfordulásában sem a pacemaker elektróda típusa, sem az ingerlő feszültség nem volt meghatározó. A nem ingerelt elektródák végénél és környezetükben sokszor az ingereltekével azonos reakciók jelentek meg. Így azt a következtetést vontuk le, hogy a pacemaker elektródák körül kialakuló reakcióban az elektródavégek elektromos tulajdonságainak nincs meghatározó szerepe. Mostani vizsgálatainkban nem tudtunk a bekövetkező szövettani reakció mértéke és az elektróda elektromos paramétereinek megváltozása között sem összefüggést találni. Kutatásunk során vizsgáltuk a setések más cardiovascularis paramétereit, továbbá a cardialis memória előfordulását is. Leírtuk a pacemaker beültetések komplikációit és ezek megelőzésének lehetőségeit is. | Pacemaker implantations were performed in twenty-two 3-4 months old swine. The animals were kept for 3 months. Severe complications were met in more than half of the experimental animals, thus 13 electrodes from 10 animals were ready for electronic testing at the end of the study. We didn't find significant difference between the threshold potential and the mean signal amplitude of the active (screw in) and passive fixated endomyocardial electrodes. Similarly, no significant differences were found between the threshold potential, mean signal amplitude and impedance of the paced and non-paced screw in electrodes. Histological samples were obtained from twenty pacemaker implanted swine. There was no association between the observed histological lesions and the electrode types or the pacing voltages. Similar histological lesions were found around the tip of paced and non-paced screw-in endomyocardial electrodes. Therefore we suggest that the histological lesions are determined almost exclusively by the electrode material and not by the fixation type or pacing parameters. We couldn't find association between the different histological lesions and the measured electrode parameters during this study. We also investigated and described other cardiovascular parameters of the pig and the occurrence of cardiac memory during pacing. We analyzed the possible causes and prevention of pacemaker implantation complication in this species

Occurrence of mitral valve insufficiency in clinically healthy Beagle dogs

Chronic degenerative valve disease (CDVD) is the most common cardiac disease in dogs, usually resulting in mitral valve insufficiency (MVI). The goal of this study was to investigate the occurrence of MVI in clinically healthy Beagle populations. A total of 79 adult healthy Beagles (41 females and 38 males; age: 5.6 ± 2.7 years, range 1.4 to 11.7 years) were examined. The diagnosis of MVI was based on the detection of a systolic murmur heard above the mitral valve, and was confirmed by colour flow Doppler (CFD) echocardiography. Systolic mitral valve murmurs were detected in 20/79 dogs (25.3%), of them 11 males and 9 females with no statistically significant gender difference (P = 0.6059). The strength of the murmur on the semi-quantitative 0/6 scale yielded intensity grade 1/6 in 10 dogs, grade 2/6 in 4 dogs, and grade 3/6 in 6 dogs. Mild to moderate MVI was detected by CFD in all these 20 dogs with systolic murmurs. Of them, 17 dogs had mild and 3 demonstrated moderate MVI, showing 10–30% and 30–50% regurgitant jets compared to the size of the left atrium, respectively. The age of dogs with MVI was 7.1 ± 2.3 years, which was significantly different from that of dogs without MVI (5.1 ± 2.7 years, P = 0.0029). No significant differences in body weight (P = 0.1724) were found between dogs with MVI (13.8 ± 2.8 kg) and those without MVI (12.8 ± 3.0 kg). Mitral valve disease causing MVI is relatively common in Beagle dogs, just like in other small breed dogs reported in the literature

Intracoronary Injection of In Situ Forming Alginate Hydrogel Reverses Left Ventricular Remodeling After Myocardial Infarction in Swine

ObjectivesThis study sought to determine whether alginate biomaterial can be delivered effectively into the infarcted myocardium by intracoronary injection to prevent left ventricular (LV) remodeling early after myocardial infarction (MI).BackgroundAlthough injectable biomaterials can improve infarct healing and repair, the feasibility and effectiveness of intracoronary injection have not been studied.MethodsWe prepared a calcium cross-linked alginate solution that undergoes liquid to gel phase transition after deposition in infarcted myocardium. Anterior MI was induced in swine by transient balloon occlusion of left anterior descending coronary artery. At 4 days after MI, either alginate solution (2 or 4 ml) or saline was injected selectively into the infarct-related coronary artery. An additional group (n = 19) was treated with incremental volumes of biomaterial (1, 2, and 4 ml) or 2 ml saline and underwent serial echocardiography studies.ResultsExamination of hearts harvested after injection showed that the alginate crossed the infarcted leaky vessels and was deposited as hydrogel in the infarcted tissue. At 60 days, control swine experienced an increase in left ventricular (LV) diastolic area by 44%, LV systolic area by 45%, and LV mass by 35%. In contrast, intracoronary injection of alginate (2 and 4 ml) prevented and even reversed LV enlargement (p < 0.01). Post-mortem analysis showed that the biomaterial (2 ml) increased scar thickness by 53% compared with control (2.9 ± 0.1 mm vs. 1.9 ± 0.3 mm; p < 0.01) and was replaced by myofibroblasts and collagen.ConclusionsIntracoronary injection of alginate biomaterial is feasible, safe, and effective. Our findings suggest a new percutaneous intervention to improve infarct repair and prevent adverse remodeling after reperfused MI

Angiostrongylosis-related restrictive pneumopathy assessed by arterial blood gas analysis in a dog

Pulmonary angiostrongylosis was diagnosed by the Baermann method and larval identification from faecal and bronchoalveolar lavage samples in a five-month- old male mongrel dog with dyspnoea and cough. Arterial blood gas analysis indicated arterial hypoxaemia and restrictive pneumopathy. In addition to the palliative treatment, fenbendazole was administered (50 mg/kg/24 h per os) for 14 days. The respiratory signs subsided within a short time clinically, but serial arterial blood gas analysis demonstrated an ongoing ventilation disorder. Repeated haematology, thoracic radiography, bronchoscopy and blood gas analysis were performed to follow the course of the disease. The most severe eosinophilia was detected after the beginning of the anthelmintic therapy, and the arterial pO2 level was permanently low. Arterial blood gas analysis provided the most adequate information about the course of the pneumopathy and it greatly facilitated the patient’s medical management

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

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 \ub1 standard deviation, 1.3 \ub1 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

Long-term Incidence and risk of noncardiovascular and all-cause mortality in apparently healthy cats and cats with preclinical hypertrophic cardiomyopathy

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 &lt; .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

Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele

Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14–8.23; P < 0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19–3.77; P = 0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08–3.47; P = 0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10–5.50; P = 0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30–0.72; P = 0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01–1.04; P < 0.001) and age (OR, 1.17; 95% CI, 1.08–1.26; P < 0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54–0.69) and a specificity of 0.63 (95% CI, 0.59–0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study.Supplemental Table S1. Number of dogs included from each institution and years reviewed.Supplemental Table S2. Included breeds.Supplemental Table S3. Distribution of various reasons given for performing cholecystectomy in the 179 subclinical dogs with gallbladder mucocele (GBM).Supplemental Table S4. Distribution of clinical signs associated with systemic illness in 982 dogs with gallbladder mucocele.Supplemental Table S5. Distribution of reasons for death in-hospital (i.e. euthanized and died) in 179 dogs with gallbladder mucocele that underwent cholecystectomy.http://www.elsevier.com/locate/tvjlhj2020Companion Animal Clinical Studie

Proteinuria in dogs and cats Part 2. Treatment of proteinuria in dogs and cats - Literature review

SUMMARY In the second part of their review the authors summarize the therapeutic possibilities of proteinuria. The treatment of proteinuria is indicated if the proteinuria is persistent (the urinary protein/creatinine ratio is > 0,5 in dogs and > 0,4 in cats at three different occasions at least 2 weeks apart with inactive urinary sediment) and we do not find any underlying extrarenal cause or the proteinuria is still present in spite of the adequate treatment of the underlying disease. The medical care consists of standard therapy alone or along with immunosuppressant therapy. The first step of standard therapy is „kidney diet”, which contains high quality but restricted amount of proteins, reduced amount of phosphorus and sodium, and has a decreased omega 6:3 fatty acid ratio. The first-choice drugs are those blocking the renin-angiotensin-aldosterone system (ACE-inhibitors, angiotensin receptor blockers or aldosterone blockers). Anticoagulants, antihypertensive agents, fluid or diuretic therapy can be added if necessary. Histopathologic evaluation of kidney biopsy samples helps us to differentiate between the different types of glomerulopathies. The two main categories are immune complex-mediated glomerulonephritis (including: mem-branous, membranoproliferative glomerulonephritis, mixed glomerulonephritis, focal segmental glomerulosclerosis type II) and non-immune complex glomerulopathies (including: amyloidosis, focal segmental glomerulosclerosis type I, minimal change disease, juvenile nephropathies, miscellaneous diseases). Immunosuppressant therapy is indicated in case of histopathologic evidence of an immune-mediated glomerulonephritis. Immunosuppressant therapy trial should be considered in dogs even in the absence of histopathologic diagnosis in case of worsening azotaemia and/or hypoalbuminemia despite standard ther-apy. Immunosuppressant therapy is contraindicated where familial nephropathies or amyloidosis can be suspected