OBJECTIVE To evaluate 3 contrast medium infusion (CMI) protocols for CT angiography (CTA) and measurement of major artery diameters in African grey parrots (Psittacus erithacus).
ANIMALS 9 African grey parrots with no detectable cardiovascular disease.
PROCEDURES Each bird was anesthetized and underwent placement of an IV catheter in the left basilic vein and 16-slice CTA scanning (started at peak aortic enhancement) with each of 3 CMI protocols at ≥ 1-month intervals. Protocol 1 involved catheter flushing with saline (0.9% NaCl) solution and IV infusion of iopamidol (2 mL) followed by saline solution (0.2 mL; total infused volume, 5 mL). Protocol 2 involved IV infusion of iopamidol (2 mL) followed by saline solution (0.4 mL; total infused volume, 2.4 mL). Protocol 3 involved catheter flushing with saline solution and IV administration of iopamidol (2 mL; total infused volume, 4.8 mL). The diameters of 6 major arteries were measured by 2 observers, and intra- and interobserver agreement, time-enhancement variables, and patient factors affecting contrast medium enhancement were assessed.
RESULTS Among the 3 CMI protocols, CTA-derived arterial diameters differed significantly. Measurements obtained with protocol 2 were significantly larger than those obtained with the other protocols. Uniformity of the time-enhancement variables differed among CMI protocols. Patient factors had nonsignificant effects on contrast medium enhancement.
CONCLUSIONS AND CLINICAL RELEVANCE Of the CMI protocols assessed, a 2-phase CMI protocol with a post-CMI saline solution flush was the most reliable for CTA-derived measurements of the major thoracic and abdominal arteries in African grey parrots. However, further technique modification is needed.
OBJECTIVE To compare cardiac output (CO) measured by use of CT coronary angiography and thermodilution (criterion-referenced standard) at various CO values, record adverse effects, and determine the time needed to measure CO.
ANIMALS 5 healthy purpose-bred Beagles (2 males and 3 females).
PROCEDURES A prospective nonrandomized crossover study was conducted. Dogs were premedicated with butorphanol tartrate (0.2 mg•kg−1, IM). Anesthesia was induced by IV administration of etomidate (1 to 2 mg•kg−1) and midazolam (0.25 mg•kg−1). Orotracheal intubation was performed, and anesthesia was maintained by administration of isoflurane. The CO was determined by use of thermodilution and by use of CT at 3 CO values. Dobutamine was infused at various rates to obtain the 3 CO values.
RESULTS 13 values were obtained and analyzed. The mean ± SD difference between methods was 0.09 ± 0.71 L•min−1 (95% confidence interval [CI], 0.52 to −0.34 L•min−1). Only 1 of 13 values was located on the 100% agreement line (ie, 0 line), 7 of 13 values were located within the 95% CI, and 5 of 13 values were outside the 95% CI.
CONCLUSIONS AND CLINICAL RELEVANCE For this study, there was poor agreement between the 2 methods. The 95% CI interval was 0.52 to −0.34 L•min−1, and 5 of 13 values were outside the 95% CI. Therefore, results for the CT method appeared to be inappropriate for use in making clinical decisions.
OBJECTIVE To evaluate the accuracy of cardiac output (CO) estimated by use of ECG-gated multidetector CT (MDCT) and 1-, 2-, and 3-D echocardiography and by use of thermodilution.
ANIMALS 6 healthy hound-cross dogs.
PROCEDURES Electrocardiogram-gated contrast-enhanced 64-slice MDCT and 1-, 2-, and 3-D echocardiography were performed on each dog. The CO for ECG-gated MDCT was calculated as volumetric measurements of stroke volume multiplied by mean heart rate. Echocardiographic left ventricle end-diastolic volumes and end-systolic volumes were measured by use of the Teichholz method (1-D echocardiography) and a single-plane method of disks (2-D echocardiography). Real-time 3-D echocardiographic left ventricle volumes were measured with 3-D functional analysis software on right long-axis and left apical views. The CO of each dog was measured in triplicate by use of thermodilution. Mean CO values, correlations, and limits of agreement for MDCT, echocardiographic modalities, and thermodilution were compared.
RESULTS CO measured by use of MDCT, 2-D echocardiography, and 3-D echocardiography had the strongest correlations with CO measured by use of thermodilution. No significant difference in CO was detected between MDCT, any echocardiographic method, and thermodilution. Bland-Altman analysis revealed a systematic underestimation of CO derived by use of MDCT, 2-D echocardiography, and 3-D echocardiography.
CONCLUSIONS AND CLINICAL RELEVANCE Use of MDCT, 2-D echocardiography, and 3-D echocardiography to measure CO in healthy dogs was feasible. Measures of CO determined by use of 3-D echocardiography on the right long-axis view were strongly correlated with CO determined by use of thermodilution, with little variance and slight underestimation.
OBJECTIVE To measure serum homocysteine concentrations in dogs with myxomatous mitral valve disease (MMVD) and identify any association between this variable and stage of MMVD.
ANIMALS 53 client-owned dogs with MMVD and 10 healthy control Beagles.
PROCEDURES Dogs with MMVD were allocated to 3 groups in accordance with the staging system for chronic valvular heart disease in dogs and cats of the American College of Veterinary Internal Medicine. Blood samples were collected from all dogs, and serum homocysteine and cardiac troponin 1 concentrations were measured by enzyme immunoassay and chemiluminescence immunoassay, respectively. Analyte values were tested for associations with each other and with stage of MMVD.
RESULTS A significant correlation was identified between serum homocysteine concentration and stage of MMVD. Mean ± SD concentrations were 6.72 ± 1.65 μmol/L for control dogs, 13.37 ± 4.16 μmol/L for dogs with stage B MMVD, 18.86 ± 6.73 μmol/L for dogs with stage C disease, and 28.26 ± 4.48 μmol/L for dogs with stage D disease. In addition, serum homocysteine concentration was correlated with serum cardiac troponin 1 (r = 0.34) and creatinine (r = 0.46) concentrations, systolic blood pressure (r = 0.57), and left atrium-to-aortic root ratio (r = 0.28), all of which were positively correlated with stage of MMVD.
CONCLUSIONS AND CLINICAL RELEVANCE Serum homocysteine concentrations of dogs with MMVD were significantly higher than those of control dogs, and significant correlations were identified between these values and several risk factors for heart failure. Measurement of serum homocysteine concentration may be useful in the prediction of severity of disease in dogs with MMVD.
OBJECTIVE To determine the plasma total antioxidant capacity, erythrocyte superoxide dismutase activity, whole blood glutathione peroxidase activity, and plasma coenzyme Q10 (CoQ10) concentration in dogs with various stages of cardiovascular diseases and in healthy dogs; assess the influence of cardiac treatment on the levels of antioxidant variables, plasma CoQ10 concentration, and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration, and determine any correlation between the disease severity (NT-proBNP concentration) and antioxidant variables or CoQ10 concentration.
ANIMALS 43 dogs with various types and stages of cardiovascular diseases (congenital and acquired) and 29 healthy dogs.
PROCEDURES Blood samples were collected from all dogs for spectrophotometric assessment of antioxidant variables. Plasma CoQ10 concentration was determined with a high-performance liquid chromatography–atmospheric pressure chemical ionization–tandem mass spectrometry method. Serum NT-proBNP concentration was measured with an ELISA.
RESULTS Values for antioxidant variables did not differ among groups of dogs with cardiovascular diseases, regardless of disease stage or treatment. Plasma CoQ10 concentration was significantly increased in treated dogs with congestive heart failure (CHF), compared with untreated patients. However, plasma CoQ10 concentration did not differ among heart failure classes. A significant, negative correlation between serum NT-proBNP and plasma CoQ10 concentrations was identified in treated CHF-affected dogs, suggesting that low plasma CoQ10 concentration may be associated with increased severity of CHF.
CONCLUSIONS AND CLINICAL RELEVANCE The antioxidant variables evaluated were not altered in dogs with CHF, regardless of cardiac disease stage or treatment. Further investigation into the possible effects of CoQ10 supplementation in dogs with advanced stages of CHF is warranted.
OBJECTIVE To determine effects of a combination of acepromazine maleate and butorphanol tartrate on conventional echocardiographic variables and on strain values obtained by use of 2-D speckle tracking echocardiography (STE) in healthy dogs.
ANIMALS 18 healthy medium- and large-size adult dogs.
PROCEDURES Transthoracic echocardiographic examination (2-D, M-mode, color flow, spectral Doppler, and tissue Doppler ultrasonography) and high-definition oscillometric blood pressure measurement were performed before and after dogs were sedated by IM administration of a combination of acepromazine (0.02 mg/kg) and butorphanol (0.2 mg/kg). Adequacy of sedation for echocardiographic examination was evaluated. Circumferential and longitudinal global and segmental strains of the left ventricle (LV) were obtained with 2-D STE by use of right parasternal short-axis and left parasternal apical views. Values before and after sedation were compared.
RESULTS The sedation combination provided adequate immobilization to facilitate echocardiographic examination. Heart rate and mean and diastolic blood pressures decreased significantly after dogs were sedated. A few conventional echocardiographic variables differed significantly from baseline values after sedation, including decreased end-diastolic LV volume index, peak velocity of late diastolic transmitral flow, and late diastolic septal mitral and tricuspid annulus velocities, increased ejection time, and increased mitral ratio of peak early to late diastolic filling velocity; global strain values were not affected, but 1 segmental (apical lateral) strain value decreased significantly.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that acepromazine and butorphanol at the doses used in this study provided sedation adequate to facilitate echocardiography, with only mild influences on conventional and 2-D STE variables.
OBJECTIVE To compare left ventricle (LV) volume and function variables obtained by use of 1-D, 2-D, and real-time 3-D echocardiography versus ECG-gated multidetector row CT (MDCT) angiography, which was considered the criterion-referenced standard.
ANIMALS 6 healthy, purpose-bred dogs.
PROCEDURES Dogs were anesthetized and administered a constant rate infusion of esmolol, and 1-D, 2-D, and 3-D echocardiography and ECG-gated, contrast-enhanced MDCT were performed. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume, and ejection fraction (EF) were calculated by use of the Teichholz method for 1-D echocardiography, single-plane and biplane modified Simpson method of disks (MOD) and area-length method for 2-D echocardiography, and real-time biplane echocardiography (RTBPE) and real-time 3-D echocardiography (RT3DE) for 3-D echocardiography. Volumes were indexed to body surface area and body weight. Median values, correlations, and limits of agreement were compared between echocardiographic modalities and MDCT.
RESULTS EDV and ESV measured by use of RTBPE and RT3DE had the strongest correlations with results for MDCT. Values obtained for EDV, ESV, stroke volume, and EF did not differ significantly between echocardiographic methods and MDCT. Use of RT3DE and RTBPE slightly underestimated EDV, ESV, and EF, compared with values for MDCT, as determined with Bland-Altman analysis.
CONCLUSIONS AND CLINICAL RELEVANCE Values for EDV and ESV obtained by use of 3-D echocardiography, including RTBPE and RT3DE, had the highest correlation with slight underestimation, compared with values obtained by use of MDCT. This was similar to results for 3-D echocardiography in human medicine.
OBJECTIVE To elucidate the relationship between acute volume overload and left atrial phasic function in healthy dogs.
ANIMALS 6 healthy Beagles.
PROCEDURES Dogs were anesthetized. A Swan-Ganz catheter was placed to measure mean pulmonary capillary wedge pressure (PCWP). Cardiac preload was increased by IV infusion with lactated Ringer solution at 150 mL/kg/h for 90 minutes. Transthoracic echocardiography was performed before (baseline) and at 15, 30, 45, 60, 75, and 90 minutes after volume loading began. At each echocardiographic assessment point, apical 4-chamber images were recorded and analyzed to derive time–left atrial area curves. Left atrial total (for reservoir function), passive (for conduit function), and active (for booster-pump function) fractional area changes were calculated from the curves.
RESULTS Volume overload resulted in a significant increase from baseline in PCWP from 15 to 90 minutes after volume loading began. All fractional area changes at 15 to 90 minutes were significantly increased from baseline. In multiple regression analysis, quadratic regression models were better fitted to the relationships between PCWP and each of the total and active fractional area changes than were linear regression models. A linear regression model was better fitted to the relationship between PCWP and passive fractional area change.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that left atrial phasic function assessed on the basis of left atrial phasic areas was enhanced during experimental cardiac volume loading in healthy dogs. The effect of volume load should be considered when evaluating left atrial phasic function by indices derived from left atrial phasic sizes.
OBJECTIVE To investigate the in vitro stability of atrial natriuretic peptide (ANP) in plasma samples under various storage conditions and the influence of anesthesia on plasma ANP concentration in cats.
ANIMALS 1 cat with congestive heart failure and 5 healthy adult mixed-breed cats.
PROCEDURES A plasma sample from the cat with heart failure was serially diluted, and dilutional parallelism of ANP concentration was evaluated. Plasma samples containing aprotinin or serum samples from the 5 healthy cats were kept at room temperature (27°C) for ≤ 12 hours. Plasma samples from the same healthy cats were stored at −70°, −20°, or 4°C for ≤ 14 days. Plasma samples were obtained from the healthy cats before and during isoflurane anesthesia. Plasma ANP concentrations were measured at a commercial laboratory by use of a human ANP chemiluminescence assay.
RESULTS Intra- and interassay coefficients of variation were 1.5% and 2.5%, respectively, and dilutional parallelism was established. Although ANP concentration decreased by 82.4 ± 13.6% (mean ± SD) after sample storage for 12 hours at room temperature, this decrease was prevented by aprotinin. Plasma ANP concentrations were stable for 7 days at −20°C and for 14 days at −70°C. However, concentrations decreased markedly to 57.6 ± 6.9% at −20°C and to 18.0 ± 3.0% at 4°C after 14 days. Plasma ANP concentration decreased significantly in cats during anesthesia and was correlated with blood pressure.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that aprotinin should be added routinely in preparation of plasma samples from cats for measurement of ANP concentration, and those samples, if stored, should be frozen immediately at ≤ −20°C. General anesthesia or systemic blood pressure may affect plasma ANP concentration in cats.
OBJECTIVE To assess platelet closure time (CT), mean platelet component (MPC) concentration, and platelet component distribution width (PCDW) in dogs with subclinical chronic valvular heart disease.
ANIMALS 89 Cavalier King Charles Spaniels (CKCSs) and 39 control dogs (not CKCSs).
PROCEDURES Platelet count, MPC concentration, PCDW, and Hct were measured by use of a hematology analyzer, and CT was measured by use of a platelet function analyzer. Murmur grade and echocardiographic variables (mitral valve regurgitant jet size relative to left atrial area, left atrial-to-aortic diameter ratio, and left ventricular internal dimensions) were recorded. Associations between explanatory variables (sex, age, murmur grade, echocardiographic variables, platelet count, and Hct) and outcomes (CT, MPC concentration, and PCDW) were examined by use of multivariate regression models.
RESULTS A model with 5 variables best explained variation in CT (R2, 0.74), with > 60% of the variance of CT explained by mitral valve regurgitant jet size. The model of best fit to explain variation in MPC concentration included only platelet count (R2, 0.24). The model of best fit to explain variation in PCDW included platelet count and sex (R2, 0.25).
CONCLUSIONS AND CLINICAL RELEVANCE In this study, a significant effect of mitral valve regurgitant jet size on CT was consistent with platelet dysfunction. However, platelet activation, as assessed on the basis of the MPC concentration and PCDW, was not a feature of subclinical chronic valvular heart disease in CKCSs.