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- Author or Editor: Josefa Fernández del Palacio x
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Abstract
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.
Abstract
Objective—To compare measurements of blood flow in the common femoral artery obtained by duplex Doppler ultrasonography (DDU) and a reference ultrasonic transit-time flow (TTF) method and to examine the impact of Doppler spectral waveform measurement techniques on volumetric estimates.
Animals—5 healthy female pigs.
Procedure—Femoral arterial blood flow was measured simultaneously in anesthetized pigs by use of a TTF probe (left femoral artery) and transcutaneous DDU (right femoral artery). A range of flow states was induced pharmacologically by using xylazine, bradykinin, dobutamine, and isoflurane. Volumetric blood flow was calculated from DDU waveforms, using the product of the flow velocity integral (FVI), the cross-sectional vessel area, and heart rate. Three calculations of FVI were obtained by manually tracing the Doppler spectral envelopes at the outer envelope, the modal, and the inner envelope of the spectral dispersion pattern. Data analysis included calculation of Pearson correlation coefficients and Bland-Altman limits of agreement.
Results—Blood flow measured by DDU was more closely correlated with TTF measurements when the modal or inner envelope tracing method was used ( r, 0.76 and 0.78; limits of agreement, –100 to 54.2 and –48.5 to 77.0 mL/min, respectively). Limits of agreement for the outer envelope tracing method were –238.5 to 64 mL/min.
Conclusion and Clinical Relevance—Transcutaneous DDU is a reliable noninvasive technique for measuring blood flow in the femoral artery of pigs over a range of flow states. Tracing the inner envelope of the Doppler spectral dispersion pattern provided the best estimate of blood flow in this study. (Am J Vet Res 2003;64:43–50)
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.
Abstract
Case Description—An 11-year-old neutered female domestic longhair cat was evaluated because of a 1-week history of progressive dyspnea, signs of depression, and loss of appetite. A histiocytic sarcoma had been excised from the mammary gland 6 weeks earlier.
Clinical Findings—Physical examination findings were consistent with pleural effusion, and thoracic and abdominal radiography and ultrasonography revealed pleural effusion, a thoracic mass involving the aorta and pulmonary artery, and a caudal abdominal mass that most likely represented enlarged iliac lymph nodes. Cytologic examination of the pleural fluid and fine-needle aspirates from the iliac and right popliteal lymph nodes revealed abundant cells with neoplastic characteristics of indeterminate origin. The clinical diagnosis was generalized malignant neoplasia.
Treatment and Outcome—Pleural drainage was necessary every 5 to 6 days. Exploratory thoracotomy and biopsy of the mass were recommended for better characterization of the thoracic disease. Simultaneously, palliative treatment by advancement of the omentum into the thorax was performed. A final diagnosis of disseminated histiocytic sarcoma was made, and treatment with doxorubicin was begun after surgery. During the 13 months after surgery, the cat was free from signs of respiratory tract disease and had normal activity levels with good exercise tolerance. Fifteen months after surgery, the cat's clinical condition worsened and the cat died.
Clinical Relevance—Findings suggested that thoracic omentalization may be considered for palliative treatment of cats with refractory neoplastic pleural effusion when frequent thoracocentesis is necessary and other treatments are not suitable.
Abstract
Objective—To evaluate the usefulness of Doppler ultrasonography as a method to assess changes in digital vascular dynamics in horses with systemic inflammatory response syndrome (SIRS) or laminitis.
Design—Cross-sectional study.
Animals—42 adult Andalusian horses.
Procedures—Group 1 included 9 healthy horses, group 2 included 19 horses with SIRS without (n = 9) or with (10) a palpable increase in digital pulse intensity, and group 3 included 14 horses with laminitis without (8) or with (6) radiographic evidence of rotation or distal displacement (sinking) of the third phalanx. Qualitative spectrum characteristics and quantitative Doppler measurements of the lateral palmar digital artery were obtained for horses in each group.
Results—4 spectra, characterized by a positive systolic peak followed by several positive diastolic peaks, were observed in group 1 horses, group 2 horses, and group 3 horses that lacked radiographic changes. In the group 3 horses that had radiographic changes, laminar blood flow was detected. Diameter of the lateral palmar digital artery was significantly larger in the group 3 horses than in the group 2 horses; blood flow was significantly higher in the group 2 horses that had an increase in digital pulse intensity than in the group 2 horses without an increase in digital pulse intensity; velocity-time integral and acceleration time were significantly lower in group 3 horses, compared with group 2 horses.
Conclusions and Clinical Relevance—Results suggested that Doppler ultrasonography may be a useful complementary tool to detect digital blood flow changes of horses with SIRS, especially if they have a palpable increase in digital pulse intensity, or laminitis.