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Abstract

OBJECTIVE

To assess recording accuracy of right atrial and ventricular depolarization during 12-lead ECG when precordial lead V1 was positioned at each of 5 locations on the thorax of dogs with various thoracic conformations.

ANIMALS

60 healthy client-owned dogs.

PROCEDURES

20 dogs were allocated to each of 3 groups (brachymorphic, mesomorphic, or dolichomorphic) on the basis of thoracic conformation. Each dog remained unsedated and was positioned in right lateral recumbency for a series of five 12-lead surface ECGs, with V1 located adjacent to the sternum in the fifth intercostal space (ICS; control), at the costochondral junction (CCJ) of the right first ICS (1st-R), at the CCJ of the right third ICS, at the right third ICS where the thorax was the widest, and at the CCJ of the left first ICS. Electrocardiographic variables were compared among the 5 ECG tracings.

RESULTS

When V1 was at the control location, the P wave was positive for all dogs; however, consistent recording of right atrial and ventricular depolarization (ie, R wave-to-S wave ratio [R/S] < 1) occurred more frequently for brachymorphic dogs (16/20) than for dolichomorphic (7/20) and mesomorphic (6/20) dogs. When V1 was at the 1st-R location, the P wave was negative for most dogs, and R/S was < 1 for the majority of dogs in the brachymorphic (19/20), mesomorphic (17/20), and dolichomorphic (16/20) groups. The median R/S for V1 at the 1st-R location was significantly lower than that for the other 4 V1 locations.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that placement of V1 at the 1st-R location provided correct evaluation of right atrial and ventricular depolarization in most dogs regardless of thoracic conformation.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To evaluate the diagnostic usefulness of focused cardiac ultrasonography and selected echocardiographic variables for predicting fluid responsiveness in conscious, spontaneously breathing dogs with various clinical conditions.

ANIMALS

26 dogs (15 males and 11 females) with a median age of 84 months (range, 12 to 360 months) and median body weight of 8 kg (range, 2 to 35 kg) referred for various clinical conditions.

PROCEDURES

Left ventricular end-diastolic internal diameter normalized to body weight (LVIDDn), left ventricular volume score (LVVS), left ventricular end-diastolic volume index (EDVI), aortic velocity time integral (VTIAo), and aortic peak flow velocity (VmaxAo) were echocardiographically measured before and after IV administration of a bolus of lactated Ringer solution (4 mL/kg) over a 1-minute period. Dogs were classified on the basis of the observed change in aortic stroke volume following fluid administration as responders (≥ 15%) or nonresponders (< 15%) to fluid administration. Receiver operating characteristic curves were generated for the ability of LVVS, LVIDDn, EDVI, VTIAo, and VmaxAo to predict responder status.

RESULTS

13 dogs were classified as responders and 13 as nonresponders. Areas under the receiver operating characteristic curves (95% confidence intervals) for predicting fluid responsiveness were as follows: VTIAo, 0.91 (0.74 to 0.99); LVIDDn, 0.85 (0.66 to 0.96); EDVI, 0.85 (0.65 to 0.96); LVVS, 0.85 (0.65 to 0.96); and VmaxAo, 0.75 (0.54 to 0.90).

CONCLUSIONS AND CLINICAL RELEVANCE

The evaluated echocardiographic variables were useful for noninvasive prediction of fluid responsiveness in conscious dogs and could be valuable for informing clinical decisions regarding fluid therapy.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To determine variability of global longitudinal strain (GLS) and strain rate (SR) measurements in dogs with and without cardiac disease derived from 2-D speckle tracking echocardiography (STE) by use of various software.

ANIMALS

2 cohorts comprising 44 dogs (23 cardiovascularly healthy and 21 with cardiac disease) and 40 dogs (18 cardiovascularly healthy and 22 with cardiac disease).

PROCEDURES

Transthoracic echocardiographic images in each cohort were analyzed with vendor-independent software and vendor-specific 2-D STE software for each of 2 vendors. Values for GLS and SR obtained from the same left parasternal apical views with various software were compared. Intraobserver and interobserver variability was determined, and agreement among results for the various software was assessed.

RESULTS

Strain analysis was not feasible with vendor-independent software for 20% of images obtained with the ultrasonography system of vendor 1. Intraobserver and interobserver coefficient of variation was < 10% for GLS values, whereas SR measurements had higher variance. There was a significant difference in GLS and SR obtained for each cohort with different software. Evaluation of Bland-Altman plots revealed wide limits of agreement, with variance for GLS of up to 6.3 units in a single dog.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of longitudinal strain analysis were not uniform among software, and GLS was the most reproducible measurement. Significant variability in results among software warrants caution when referring to reference ranges or comparing serial measurements in the same patient because changes of < 6.5% in GLS might be within measurement error for different postprocessing software.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To determine the relationship between acute volume overload and echocardiographic indices of right ventricular (RV) function and dyssynchrony in healthy dogs.

ANIMALS 7 healthy Beagles.

PROCEDURES Right heart catheterization and echocardiography were performed in 7 healthy anesthetized Beagles at baseline and after induction of volume overload. Volume overload was induced by IV infusion of lactated Ringer solution (150 mL/kg/h for 90 minutes). Echocardiographic indices of RV function, including peak velocity of systolic tricuspid annular motion, tricuspid annulus plane systolic excursion, fractional area change, RV Tei index, RV longitudinal strain (RVLS), and systolic RV longitudinal strain rate (RVLSR), were obtained by use of speckle tracking echocardiography (STE). In addition, SD of the systolic shortening time of the right ventricle for the 6 segments (RV-SD6) was determined with STE.

RESULTS Volume overload significantly increased the RV end-diastolic pressure, compared with the baseline value. Echocardiographic indices of RV function, except for septal RVLSR, were significantly enhanced by volume overload. In contrast, RV-SD6 did not change with volume overload. Although echocardiographic indices of RV function, except for septal RVLSR, were correlated with RV end-diastolic pressure, RV-SD6 was not correlated.

CONCLUSIONS AND CLINICAL RELEVANCE Echocardiographic indices of RV function, including RVLS and RVLSR, were affected by acute short-term volume overload. Therefore, results for assessment of RV function by use of STE in dogs with clinical conditions associated with right-sided chronic volume overload, such as tricuspid and pulmonic regurgitation, should be interpreted with caution.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To investigate cardiac structural and functional changes by tissue Doppler imaging (TDI) and strain imaging in dogs with spontaneous type 1 diabetes mellitus.

ANIMALS 30 client-owned dogs, of which 10 had normotensive type 1 diabetes mellitus and 20 were healthy.

PROCEDURES All dogs underwent physical examination, laboratory analyses, standard echocardiography, and TDI.

RESULTS On TDI and strain imaging, transmitral peak early diastolic velocity (E)-to-tissue Doppler–derived peak early diastolic velocity at basal segment (E') of septum ratio, E:lateral E’ ratio, and septal tissue Doppler–derived peak late diastolic velocity at basal segment (A') were significantly higher and the septal E':A’ ratio and lateral longitudinal strain were significantly lower for diabetic dogs than for control dogs. Furthermore, in diabetic dogs, serum glucose and fructosamine concentrations after a 12-hour period of food withholding were positively correlated with regional systolic functional variables (septal and lateral longitudinal strain) and left ventricular filling pressure indices (E:septal E’ and E:lateral E’ ratios) but were negatively correlated with diastolic functional variables (E:transmitral peak late diastolic velocity and septal and lateral E':A’ ratios).

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that myocardial function in diabetic dogs may be altered before the development of clinical heart-associated signs and that the change may be more readily detected by TDI and strain imaging than by conventional echocardiography. In addition, findings indicated that hyperglycemia could have detrimental effects on myocardial function, independent of hypertension, other cardiac diseases, and left ventricular hypertrophy, in dogs with type 1 diabetes.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To investigate use of the plethysmographic variability index (PVI) and perfusion index (PI) for evaluating changes in arterial blood pressure in anesthetized tigers (Panthera tigris).

ANIMALS 8 adult tigers.

PROCEDURES Each tiger was anesthetized once with a combination of ketamine, midazolam, medetomidine, and isoflurane. Anesthetic monitoring included assessment of PI, PVI, direct blood pressure measurements, anesthetic gas concentrations, esophageal temperature, and results of capnography and ECG. Mean arterial blood pressure (MAP) was maintained for at least 20 minutes at each of the following blood pressure conditions: hypotensive (MAP = 50 ± 5 mm Hg), normotensive (MAP = 70 ± 5 mm Hg), and hypertensive (MAP = 90 ± 5 mm Hg). Arterial blood gas analysis was performed at the beginning of anesthesia and at each blood pressure condition.

RESULTS Mean ± SD PI values were 1.82 ± 2.38%, 1.17 ± 0.77%, and 1.71 ± 1.51% and mean PVI values were 16.00 ± 5.07%, 10.44 ± 3.55%, and 8.17 ± 3.49% for hypotensive, normotensive, and hypertensive conditions, respectively. The PI values did not differ significantly among blood pressure conditions. The PVI value for the hypotensive condition differed significantly from values for the normotensive and hypertensive conditions. The PVI values were significantly correlated with MAP (r = −0.657). The OR of hypotension to nonhypotension for PVI values ≥ 18% was 43.6.

CONCLUSIONS AND CLINICAL RELEVANCE PVI was a clinically applicable variable determined by use of noninvasive methods in anesthetized tigers. Values of PVI ≥ 18% may indicate hypotension.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To compare blood flow velocities of the portal vein (PV) and caudal vena cava (CVC) measured by use of pulsed-wave Doppler ultrasonography in clinically normal dogs and dogs with primary immune-mediated hemolytic anemia (IMHA).

ANIMALS 11 client-owned dogs admitted to a veterinary teaching hospital for management of primary IMHA and 21 staff- or student-owned clinically normal dogs.

PROCEDURES Flow velocities in the PV and CVC at the porta hepatis were evaluated in conscious unsedated dogs with concurrent ECG monitoring; evaluations were performed before dogs with IMHA received heparin or blood transfusions. Three measurements of peak velocity at end expiration were obtained for each vessel, and the mean was calculated. Results were compared between IMHA and control groups.

RESULTS Mean ± SD blood flow velocity in the CVC differed between control (63.0 ± 18.6 cm/s) and IMHA (104 ± 36.9 cm/s) groups. Variance in dogs with IMHA was significantly greater than that for the clinically normal dogs. No significant difference in blood flow velocity in the PV was detected between IMHA and control dogs.

CONCLUSIONS AND CLINICAL RELEVANCE Higher blood flow velocities were detected by use of pulsed-wave Doppler ultrasonography in the CVC of dogs with naturally occurring IMHA and may be used to predict anemia in patients suspected of having IMHA.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To investigate mechanisms by which anti-inflammatory doses of orally administered intermediate-acting glucocorticoids (prednisone) could predispose dogs to progression of heart disease or congestive heart failure.

ANIMALS 11 client-owned dogs with allergic dermatitis and 11 matched healthy control dogs.

PROCEDURES Clinicopathologic, echocardiographic, and hemodynamic variables were measured. Dogs with allergic dermatitis then received prednisone (1 mg/kg, PO) once daily for 14 consecutive days beginning on day 0 (baseline), followed by a tapering and washout period; control dogs received no treatment. Measurements were repeated on days 7, 14, and 35. Linear mixed modeling was used to compare changes in variables across measurement points and between dog groups.

RESULTS Prednisone administration caused no significant changes in serum sodium or potassium concentration, blood glucose concentration, or target echocardiographic variables. The change from baseline in systolic arterial blood pressure at day 7 was significantly greater in prednisone-treated dogs than in control dogs. Expected changes in hematologic and serum biochemical values with prednisone administration (neutrophilia, eosinopenia, isosthenuria, and high serum alkaline phosphatase and alanine aminotransferase activities) also occurred in the prednisone-treated dogs.

CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that anti-inflammatory doses of orally administered glucocorticoids have the potential to adversely impact cardiac function in dogs by causing an increase in blood pressure and thus increased cardiac afterload.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate accuracy of quantification of right ventricle volume (RVV) by use of 3-D echocardiography (3DE) and ECG-gated multidetector CT (MDCT).

ANIMALS 6 healthy hound-cross dogs.

PROCEDURES ECG-gated MDCT and complete 3DE examinations were performed on each dog. Right ventricular end-diastolic volumes (EDVs), end-systolic volumes (ESVs), stroke volume (SV), and ejection fraction (EF) were measured for 3DE and MDCT data sets by use of software specific for RVV quantification. Correlation and level of agreement between methods were determined. Intraobserver and interobserver variability were assessed for 3DE.

RESULTS No significant differences were detected between SV and EF obtained with MDCT and 3DE. Significant differences were detected between right ventricular EDV and ESV obtained with MDCT and 3DE. No significant difference in heart rate was detected between methods. The correlation between MDCT and 3DE was very good (r = 0.87) for EDV and ESV, moderate (r = 0.60) for EF, and poor (r = 0.31) for SV. Bland-Altman analysis revealed a systematic underestimation of RVV derived by use of 3DE, compared with the RVV derived by use of MDCT (mean bias, 15 and 10.3 mL for EDV and ESV, respectively). Intraobserver (EDV, 12%; ESV, 18%) and interobserver (EDV, 14%; ESV, 11%) variability were acceptable for 3DE.

CONCLUSIONS AND CLINICAL RELEVANCE There was substantial variance for RVV measured by use of 3DE in healthy dogs and a significant underestimation of volumes, compared with results for MDCT, despite the fact there were no significant differences in SV and EF.

Full access
in American Journal of Veterinary Research
Authors SeungWoo Jung and Amy Bohan

Abstract

OBJECTIVE To characterize expression profiles of circulating microRNAs via genome-wide sequencing for dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve degeneration (MMVD).

ANIMALS 9 healthy client-owned dogs and 8 age-matched client-owned dogs with CHF secondary to MMVD.

PROCEDURES Blood samples were collected before administering cardiac medications for the management of CHF. Isolated microRNAs from plasma were classified into microRNA libraries and subjected to next-generation sequencing (NGS) for genome-wide sequencing analysis and quantification of circulating microRNAs. Quantitative reverse transcription PCR (qRT-PCR) assays were used to validate expression profiles of differentially expressed circulating microRNAs identified from NGS analysis of dogs with CHF.

RESULTS 326 microRNAs were identified with NGS analysis. Hierarchical analysis revealed distinct expression patterns of circulating microRNAs between healthy dogs and dogs with CHF. Results of qRT-PCR assays confirmed upregulation of 4 microRNAs (miR-133, miR-1, miR-let-7e, and miR-125) and downregulation of 4 selected microRNAs (miR-30c, miR-128, miR-142, and miR-423). Results of qRT-PCR assays were highly correlated with NGS data and supported the specificity of circulating microRNA expression profiles in dogs with CHF secondary to MMVD.

CONCLUSIONS AND CLINICAL RELEVANCE These results suggested that circulating microRNA expression patterns were unique and could serve as molecular biomarkers of CHF in dogs with MMVD.

Full access
in American Journal of Veterinary Research