{"title":"Echocardiographic classification of dogs with aortic stenosis: potential utility of a novel staging system","authors":"W. Davis , A. Francis , K. Borgeat","doi":"10.1016/j.jvc.2024.12.001","DOIUrl":"10.1016/j.jvc.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Severity of aortic stenosis (AS) in humans is classified using a staging system based on two-dimensional echocardiographic changes, which considers the extent of global cardiac damage. Currently, classification of canine AS is based on trans-aortic pressure gradient (PG) alone. This study aimed to retrospectively classify dogs with AS based on an adapted human staging system, exploring feasibility of classification and the association between stage and features such as PG and clinical signs.</div></div><div><h3>Animals</h3><div>This study included 87 client-owned dogs.</div></div><div><h3>Materials and methods</h3><div>Clinical and echocardiographic data were retrieved from computerised records. Dogs were classified according to a modified human staging system (stages: 0/1/2+). Descriptive statistics were explored. Differences in signalment, PG, and clinical signs between stages were evaluated using appropriate statistical tests. Significance was identified if P<0.05 after correction for multiple comparisons.</div></div><div><h3>Results</h3><div>Forty-one dogs were classified as stage 0, 36 as stage 1, and 10 as stage 2+<em>.</em> No difference in signalment or weight was identified between stages. Dogs classified as stage 2+ were more likely to have clinical signs than those in stages 0 or 1 (50% vs. 7% [P=0.004] and 17% [P=0.043], respectively) and had a higher PG than dogs in stage 0 (90 mmHg [35–143 mmHg] vs. 25 mmHg [18–182 mmHg], P=0.001).</div></div><div><h3>Conclusions</h3><div>This study presents an alternative way to classify dogs with AS. Data support further study of the staging system to compare whether or not this classification has additional value over assessment of PG alone.</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"58 ","pages":"Pages 17-25"},"PeriodicalIF":1.5,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Journal title page and editorial board","authors":"","doi":"10.1016/S1760-2734(24)00118-8","DOIUrl":"10.1016/S1760-2734(24)00118-8","url":null,"abstract":"","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"56 ","pages":"Page i"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K.E. Davis , L.C. Visser , J.A. Boon , E.S. Ross , J.N. Sankisov , A.C. Laws
{"title":"Echocardiographic estimates of stroke volume in healthy dogs: comparability, reference intervals, and reproducibility","authors":"K.E. Davis , L.C. Visser , J.A. Boon , E.S. Ross , J.N. Sankisov , A.C. Laws","doi":"10.1016/j.jvc.2024.10.008","DOIUrl":"10.1016/j.jvc.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>: This study aimed to compare estimates of stroke volume (SV) from different anatomic sites and to generate reference intervals for indices such as shunt volume (ShuntVol) or regurgitant volume (RegVol) in a large sample of healthy dogs.</div></div><div><h3>Animals, Materials and Methods</h3><div>Ninety healthy dogs underwent an echocardiogram, where SV was assessed at the level of the pulmonary valve (SV<sub>PV</sub>), aortic valve (SV<sub>AV</sub>), mitral valve (SV<sub>MV</sub>), and left ventricle using the difference in end-diastolic volume and end-systolic volume from a right parasternal long-axis four-chamber view (SV<sub>LV_RPLx</sub>) and left apical four-chamber view (SV<sub>LV_Ap4Ch</sub>). Eight dogs underwent repeated echocardiograms by the same operator on three different days and by three different operators on the same day. Bland–Altman plots and 95% reference intervals were generated. Reproducibility was described using coefficients of variation and reproducibility coefficients.</div></div><div><h3>Results</h3><div>Mean differences (95% limits of agreement) for ShuntVol (SV<sub>PV</sub>-SV<sub>AV</sub>), RegVol<sub>LV_RPLx</sub> (SV<sub>LV_RPLx</sub>-SV<sub>AV</sub>), RegVol<sub>LV_Ap4Ch</sub> (SV<sub>LV_Ap4Ch</sub>-SV<sub>AV</sub>), and RegVol<sub>MV</sub> (SV<sub>MV</sub>-SV<sub>AV</sub>) were as follows: −0.14 (−0.72, 0.44), −0.05 (−0.59, 0.48), −0.16 (−0.71, 0.39), and 0.12 (−0.76, 1.00) mL/kg, respectively. All but RegVol<sub>LV_RPLx</sub> showed significant (P<0.01) fixed bias. Reference intervals for ShuntVol, RegVol<sub>LV_RPLx</sub>, RegVol<sub>LV_Ap4Ch</sub>, and RegVol<sub>MV</sub> were as follows: −0.85-0.64, −0.65-0.58, −0.77-0.52, and −0.91-1.06 mL/kg, respectively. Intra-operator and interoperator coefficients of variation were lowest for SV<sub>AV</sub> and highest for SV<sub>MV</sub> and SV<sub>LV_AP4Ch</sub>.</div></div><div><h3>Conclusions</h3><div>Echocardiographic estimates of SV are not interchangeable and can exhibit wide limits of agreement. Reference intervals help provide a frame of reference to assess disease severity in dogs with a shunting lesion (ShuntVol) and mitral regurgitation (RegVol).</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"57 ","pages":"Pages 27-38"},"PeriodicalIF":1.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Romito , M. Bertarello , C. Mazzoldi , S. Fasoli , F. Dondi , P. Castagna , N.G. Pelle , P. Paradies , C. Valente , H. Poser , C. Guglielmini
{"title":"Efficacy and safety of different antiarrhythmic protocols used for rate control in dogs with secondary atrial fibrillation","authors":"G. Romito , M. Bertarello , C. Mazzoldi , S. Fasoli , F. Dondi , P. Castagna , N.G. Pelle , P. Paradies , C. Valente , H. Poser , C. Guglielmini","doi":"10.1016/j.jvc.2024.10.006","DOIUrl":"10.1016/j.jvc.2024.10.006","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Studies comparing the effects of antiarrhythmic protocols used for rate control in dogs with secondary atrial fibrillation (AF) are currently limited; therefore, this study aimed to report detailed data on the efficacy and therapy-related side-effects (TRSEs) of different antiarrhythmic protocols in dogs with secondary AF.</div></div><div><h3>Animals, Materials, and Methods</h3><div>Dogs with secondary AF treated with combination therapy with diltiazem and digoxin (CT<sub>Dilt+Digox</sub>), diltiazem monotherapy (MT<sub>Dilt</sub>), digoxin monotherapy (MT<sub>Digox</sub>), or amiodarone monotherapy (MT<sub>Amiod</sub>) were retrospectively evaluated. Signalment, clinical, diagnostic, therapeutic, and outcome data were retrieved. Electrocardiographically, antiarrhythmic efficacy was defined by a reduction in the mean heart rate on Holter monitoring ≤125 beats/minutes. Statistical analysis was performed to compare selected data, including the rate of efficacy and TRSEs as well as the median survival time, between dogs treated with different antiarrhythmic protocols.</div></div><div><h3>Results</h3><div>Fifty-four dogs were included, with 28 receiving the CT<sub>Dilt+Digox</sub> and 26 receiving monotherapies (MT<sub>Digox</sub> = 16; MT<sub>Dilt</sub> = 5; MT<sub>Amiod</sub> = 5). The efficacy rate documented in dogs treated with CT<sub>Dilt+Digox</sub> was significantly higher than that observed in dogs from the composite monotherapy group (i.e., MT<sub>Dilt</sub>+MT<sub>Digox</sub>+MT<sub>Amiod</sub>) (P=0.048). The rate of TRSEs documented in dogs treated with CT<sub>Dilt+Digox</sub> was similar to that observed in dogs from the composed monotherapy group (P=0.129). The median survival time documented in dogs treated with CT<sub>Dilt+Digox</sub> was significantly longer than that observed in dogs of the MT<sub>Digox</sub> group (P=0.01).</div></div><div><h3>Discussion</h3><div>In dogs with secondary AF we included, CT<sub>Dilt+Digox</sub> was well tolerated and provided clinically relevant benefits compared to the use of a single antiarrhythmic drug.</div></div><div><h3>Limitations</h3><div>Retrospective design; heterogeneous sample size of categories analyzed; clinicopathological data available for many, but not all, dogs.</div></div><div><h3>Conclusions</h3><div>Our findings support the indication to generally consider CT<sub>Dilt+Digox</sub> as a first-line antiarrhythmic treatment in dogs with secondary AF.</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"57 ","pages":"Pages 8-19"},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B.G. Barnett, H.K. Hammond, C.L. Chen, J.A. Grimes, L.E. Markovic
{"title":"Diagnosis and hybrid interventional and surgical removal of ectopic heartworms (Dirofilaria immitis) in a dog","authors":"B.G. Barnett, H.K. Hammond, C.L. Chen, J.A. Grimes, L.E. Markovic","doi":"10.1016/j.jvc.2024.10.005","DOIUrl":"10.1016/j.jvc.2024.10.005","url":null,"abstract":"<div><div>An adult male castrated French bulldog mix was presented for suspected caval syndrome and bilateral pelvic limb paresis. After emergency transjugular heartworm extraction, abdominal ultrasound revealed occlusive adult heartworms in the abdominal aorta extending into the pelvic limb arteries. Hybrid interventional and surgical extraction was pursued, and heartworms were removed via bilateral femoral arteriotomy and caudal abdominal aortotomy. Ectopic dirofilariasis involving the aorta and pelvic limb arteries is rarely reported; therefore, the underlying mechanism, incidence, and treatment of aberrant heartworms are poorly understood. This case report describes a unique hybrid approach involving heartworm extraction via femoral arteriotomy interventionally and aortotomy surgically.</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"57 ","pages":"Pages 20-26"},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. García-Guasch , A.M. Bello , A. García-Urdiales , D. Massegur-Yeste , C. Olmedo-Bosch
{"title":"Transjugular patent ductus arteriosus occlusion in a cat using the Vet-PDA Occluder™ device","authors":"L. García-Guasch , A.M. Bello , A. García-Urdiales , D. Massegur-Yeste , C. Olmedo-Bosch","doi":"10.1016/j.jvc.2024.10.004","DOIUrl":"10.1016/j.jvc.2024.10.004","url":null,"abstract":"<div><div>A 5-month-old, female, entirely domestic short-haired cat was referred for evaluation of a continuous heart murmur. No associated clinical signs were reported. Transthoracic echocardiography revealed a large, left-to-right shunting patent ductus arteriosus (PDA). Transjugular occlusion of the defect was achieved using a Vet-PDA Occluder™ device, a new conic-shaped nitinol spiral device designed for PDA closure in small-sized dogs weighing less than 3 kg. Resolution of the continuous heart murmur was identified after device deployment. This case report demonstrates that the Vet-PDA Occluder™ can be a feasible option in feline patients for the occlusion of PDA and describes the technique step by step.</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"57 ","pages":"Pages 1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Agreement of echocardiographic and catheterization-based methods of transpulmonary pressure gradient measurement in dogs","authors":"K.E. Murphy , L.E. Markovic , D.B. Adin , K.E. Moy-Trigilio , A.E. Coleman","doi":"10.1016/j.jvc.2024.10.001","DOIUrl":"10.1016/j.jvc.2024.10.001","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Doppler echocardiographic estimation of transpulmonary pressure gradient (PG) is widely used to determine severity of pulmonary valve stenosis and indication for transcatheter intervention. The objective of this study was to describe agreement between Doppler echocardiographic methods of transpulmonary PG estimation and direct peak-to-peak pressure gradient at catheterization (PG<sub>cath</sub>) in dogs. We hypothesized that with reference to PG<sub>cath</sub>, mean echocardiographic PG (PG<sub>echo-mean</sub>) would have less bias than peak modal instantaneous echocardiographic PG (PG<sub>echo-peak</sub>).</div></div><div><h3>Animals</h3><div>Client-owned dogs with congenital pulmonary valve stenosis that underwent balloon pulmonary valvuloplasty at one of two veterinary teaching hospitals between June 2012 and May 2022 were included in this study.</div></div><div><h3>Materials and Methods</h3><div>Cases that underwent transthoracic echocardiography and subsequent balloon pulmonary valvuloplasty separated by 30 or fewer days were retrospectively identified. For each echocardiogram, average PG<sub>echo-mean</sub> (mmHg) and average PG<sub>echo-peak</sub> (mmHg) were calculated from stored spectral Doppler recordings. Peak right ventricular-to-peak pulmonary artery PG data (mmHg) were obtained from catheterization reports. Bland–Altman analysis was used to assess agreement between echocardiographic and catheterization data.</div></div><div><h3>Results</h3><div>Data from 209 dogs (n = 215 instances) were evaluated. Proportional bias, greater at higher gradients, was observed for PG<sub>echo-mean</sub> versus PG<sub>cath</sub> (P<0.001). A constant bias of −38.12 mmHg was observed for PG<sub>echo-peak</sub> versus PG<sub>cath</sub> (P=0.62). Bias for both echocardiographic variables had wide limits of agreement that increased with PG.</div></div><div><h3>Conclusions</h3><div>PG<sub>echo-mean</sub> and PG<sub>echo-peak</sub> underestimated and overestimated PG<sub>cath</sub>, respectively, preventing their interchangeability with PG<sub>cath</sub>.</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"56 ","pages":"Pages 116-125"},"PeriodicalIF":1.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. McMullen, K.L. Maneval, C.S. Ferrel, M. Holland, R.L. Winter
{"title":"Unilateral pulmonary edema in a dog with a large, left-to-right shunting patent ductus arteriosus","authors":"M. McMullen, K.L. Maneval, C.S. Ferrel, M. Holland, R.L. Winter","doi":"10.1016/j.jvc.2024.10.002","DOIUrl":"10.1016/j.jvc.2024.10.002","url":null,"abstract":"<div><div>A 4-month-old, 5.0-kg male castrated mixed-breed dog was presented for further evaluation of a heart murmur. A grade 6/6 left basilar, continuous heart murmur, and bounding femoral arterial pulses were observed, consistent with a patent ductus arteriosus (PDA). Transthoracic echocardiography confirmed the diagnosis of a large, left-to-right shunting PDA with severe left heart volume overload. Thoracic radiography revealed severe, alveolar lung disease in the right cranial, right middle, and right caudal lung lobes; no pulmonary infiltrate was observed in the left lung lobes. Unilateral pulmonary edema secondary to the PDA was diagnosed, which later resolved with medical management and transcatheter occlusion of the PDA with an Amplatz Canine Ductal Occluder. Unilateral pulmonary edema secondary to a PDA has not been previously reported in the dog.</div></div>","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"56 ","pages":"Pages 111-115"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Journal title page and editorial board","authors":"","doi":"10.1016/S1760-2734(24)00087-0","DOIUrl":"10.1016/S1760-2734(24)00087-0","url":null,"abstract":"","PeriodicalId":48788,"journal":{"name":"Journal of Veterinary Cardiology","volume":"55 ","pages":"Page i"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142359008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}