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Hypertensive cardiomyopathy in horses: 5 cases (1995–2011)

Cristobal Navas de Solis LV, MS, DACVIM1,2, JoAnn Slack DVM, MS, DACVIM3, Raymond C. Boston PhD4, and Virginia B. Reef DVM, DACVIM, DACVSMR5
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  • 1 New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348
  • | 2 Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
  • | 3 New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348
  • | 4 New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348
  • | 5 New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348

Abstract

Objective—To describe the prognosis and clinical, echocardiographic, and pathological features of hypertensive cardiomyopathy in horses.

Design—Retrospective case series.

Animals—5 horses with cardiac hypertrophy and systemic hypertension.

Procedures—Demographics, history, physical and cardiological examination findings, diagnosis, clinical progression, prognosis, and pathological findings were obtained from medical records.

Results—The primary diagnosis was chronic laminitis in 3 horses and chronic renal failure in 2. Persistent tachycardia, hypertension, chronic laminitis, or a combination of these prompted the cardiac evaluations. Blood pressure values (median [range]), measured noninvasively, were determined as 190 mm Hg (183 to 261 mm Hg) for systolic pressure, 126 mm Hg (100 to 190 mm Hg) for diastolic pressure, and 155 mm Hg (126 to 222 mm Hg) for mean pressure. No arrhythmias were reported. For the left ventricle, all horses had increased relative wall thickness, mean wall thickness, and ventricular mass. The interventricular septum was thickened at end diastole (n = 5) and in peak systole (4). The left ventricular internal diameter was small at end diastole (n = 4) and in peak systole (3). The left ventricular free wall was thickened at end diastole (n = 3) and in peak systole (4). No associations between blood pressure and variables consistent with hypertrophy were detected. All horses were euthanized because of the grave prognosis of the primary diseases. All 3 horses that underwent postmortem evaluation had cardiovascular abnormalities.

Conclusions and Clinical Relevance—Hypertensive cardiomyopathy should be considered as a comorbid diagnosis in horses with laminitis or chronic renal failure. Information about the development, progression, reversibility, importance of early detection, and long-term sequelae of this condition is needed.

Contributor Notes

Presented as a poster at the American College of Veterinary Internal Medicine Forum, New Orleans, May-June 2012.

Address correspondence to Dr. Navas de Solis (crisnavasdes@gmail.com).