Feasibility of radial and circumferential strain analysis using 2D speckle tracking echocardiography in cats

The purpose of the present study is to investigate the feasibility of strain analysis using speckle tracking echocardiography (STE) in cats and to evaluate STE variables in cats with hypertrophic cardiomyopathy (HCM). Sixteen clinically healthy cats and 17 cats with HCM were used. Radial and circumferential strain and strain rate variables in healthy cats were measured using STE to assess the feasibility. Comparisons of global strain and strain variables between healthy cats and cats with HCM were performed. Segmental assessments of left ventricle (LV) wall for strain and strain rate variables in cats with HCM were also performed. As a result, technically adequate images were obtained in 97.6% of the segments for STE analysis. Sedation using buprenorphine and acepromazine did not affect any global strain nor strain rate variable. In LV segments of cats with HCM, reduced segmental radial strain and strain rate variables had significantly related with segmental LV hypertrophy. It is concluded that STE analysis using short axis images of LV appeared to be clinically feasible in cats, having the possibility to be useful for detecting myocardial dysfunctions in cats with diseased heart.     

Comparison of different radiographic scores with associated echocardiographic measurements and prediction of heart enlargement in dogs with and without myxomatous mitral valve disease

IntroductionStaging of myxomatous mitral valve disease (MMVD) requires an echocardiographic examination along with thoracic radiographs. The aims of this study were to calculate mean values for radiographic scores vertebral heart size (VHS), left atrial width (LA_Width), radiographic left atrial dimension (RLAD), and vertebral left atrial size (VLAS) in conventional and grayscale inverted images in healthy dogs and dogs with different stages of MMVD, and to find cutoff values for a stage assignment.AnimalsOne hundred fifty dogs in different stages of MMVD and 50 unaffected dogs were evaluated.MethodsRadiographic scores, echocardiographic left atrium-to-aorta ratio and normalized left ventricular internal dimension at end-diastole, and results of a clinical examination were obtained. Analyses were performed to evaluate the correlation between radiographic scores and echocardiographic values, to determine cutoff values for a radiographic stage assignment, and to compare measurements in conventional and inverted radiographs.ResultsAfter excluding breed-specific higher VHS, the means of VHS, LA_Width, RLAD, and VLAS were similar in the control group and stage B1. All radiographic scores increased in stages B2 and C. The cutoff values identifying heart enlargement, and therefore differentiating stages B1 and B2, were 11.0 for VHS, 1.8 for LA_Width, 2.0 for RLAD, and 2.3 for VLAS. Besides RLAD, scores were similar in conventional and inverted radiographs.ConclusionCutoff values for the different radiographic scores for stage assignment were calculated. Radiographic cardiac scores using either conventional or inverted grayscale could be a tool to differentiate between different stages of MMVD when echocardiography is unavailable.     

Detection of intra‐cardiac thrombi and congestive heart failure in cats using computed tomographic angiography

Arterial thromboembolism is a life‐threatening condition in cats most commonly secondary to cardiac disease. Echocardiography is the reference standard to evaluate for presence of a thrombus. In humans, computed tomographic (CT) angiography is becoming widely used to detect left atrial thrombi precluding the use of sedation. The purpose of this prospective, controlled, methods comparison pilot study was threefold: (1) describe new CT angiography protocol used in awake cats with cardiac disease and congestive heart failure; (2) determine accuracy of continuous and dynamic acquisition CT angiography to identify and characterize cardiac thrombi from spontaneous echocardiographic contrast using transthoracic echocardiography as our reference standard; (3) identify known negative prognostic factors and comorbidities of the thorax that CT angiography may provide that complement or supersede echocardiographic examination. Fourteen cats with heart disease were recruited; 7 with thrombi and 7 with spontaneous echocardiographic contrast. Echocardiography and awake CT angiography were performed using a microdose of contrast. Six of 7 thrombi were identified on CT angiography as filling defects by at least one reviewer within the left auricle (n = 6) and right heart (n = 1). Highest sensitivity (71.4%) was in continuous phase and highest specificity (85.7%) was in dynamic studies with fair to moderate interobserver agreement (0.38 and 0.44). CT angiography identified prognostic cardiac information (left atrial enlargement, congestive heart failure, arterial thromboembolism) and comorbidities (suspected idiopathic pulmonary fibrosis, asthma). This study indicates CT angiography can readily identify cardiac thrombi, important prognostic information and comorbidities, and can be safely performed in cats with cardiac disease and congestive heart failure.     

Laparoscopic left hepatectomy in swine: a safe and feasible technique

A purely laparoscopic four-port approach was created for left hepatectomy in pigs. A polyethylene loop was placed on the left two hepatic lobes for traction and lift. Next, penetrating ligation of the lobes using of a double row of silk sutures was performed to control bleeding. A direct hepatic transection was completed using a monopolar hook electrode without meticulous dissection of the left hepatic vein. The raw surface of the liver was coagulated and sealed with fibrin glue. Lobes were retrieved through an enlarged portal. Laparoscopic hepatic lobectomy was completed in all pigs without the use of specialized instruments and with a mean operative time of 179 ± 9 min. No significant perioperative complications were observed. The average weight of each resected lobe was 180 ± 51 g. Complete blood count as well as serum organics and enzyme levels normalized after about 2 weeks. During necropsy, adhesion of the hepatic raw surface to the gastric wall and omentum were observed. No other abnormalities were identified. This minimally invasive left hepatectomy technique in swine could serve as a useful model for investigating liver diseases and regeneration, and offer preclinical information to improve hepatobiliary surgical procedures.     

Left abomasal displacement between the uterus and rumen during bovine twin pregnancy

Here, we describe two cases of left displaced abomasum (LDA) in Holstein cattle at 6 and 9 months of twin gestation. Clinical examination revealed signs of proximal ileus with marked abdominal distension, but no ping sounds. An unusually high position of the gravid uterine horn on the left side was observed with ultrasound. Left exploratory laparotomy confirmed that the abomasum was displaced to the left and entrapped between the rumen and twin gravid uterine horn. A left surgical approach was necessary to correct the condition. Both animals recovered and gave birth to healthy twins. The present cases indicate that the subomental position of a heavy twin gravid uterine horn is a possible mechanical cause of LDA.     

Upper airway dysfunction associated with collapse of the apex of the corniculate process of the left arytenoid cartilage during exercise in 15 horses

OBJECTIVE: To report dynamic collapse of the apex of the left corniculate process under the right corniculate process into the airway at the dorsal apposition of the paired arytenoid cartilages during exercise as a cause of upper airway dysfunction in horses. DESIGN: Retrospective study. ANIMALS: Fifteen horses with a history of poor performance and/or upper respiratory tract noise during exercise. METHODS: Video recordings of all horses referred for upper airway evaluation using high-speed treadmill videoendoscopy (HSTV) between January 1998 and December 2003 were reviewed. Records of horses that developed dynamic collapse of the apex of the left corniculate process into the airway were included. Clinical history, age, gender, breed, and use of the horse were retrieved. RESULTS: Of 309 horses referred for examination for poor performance and/or upper respiratory tract noise during exercise, 15 (4.9%) had collapse of the apex of the left corniculate process under the right and into the airway at the dorsal apposition between the paired arytenoid cartilages during HSTV. There were 3 females and 13 males, aged from 2 to 5 years. Five horses had previous surgery for left recurrent laryngeal neuropathy (RLN): 2 had nerve muscle pedicle graft and 3 had laryngeal prosthesis. During HSTV, all 15 horses had progressive collapse of the apex of the left corniculate process under the right at the dorsal apposition of the 2 arytenoid cartilages, and into the dorsal aspect of the rima glottidis. Review of video recordings revealed that collapse of the apex of the corniculate process was followed by progressive collapse of the left aryepiglottic fold and left vocal fold. The ventral aspect of the left corniculate cartilage maintained abduction in all horses. Two horses also had progressive collapse of the right vocal fold, 1 had rostral displacement of the palatopharyngeal arch, and another had dorsal displacement of the soft palate. CONCLUSIONS: Dynamic collapse of the apex of the left corniculate process of the arytenoid cartilage under the right is an uncommon cause of upper airway dysfunction in horses and the pathogenesis is unclear. We speculate that the left arytenoideus transversus muscle is unable to support the dorsal apposition between the arytenoid cartilages. This loss of support allows the elastic cartilage of the left corniculate process to collapse under the right and into the airway, as inspiratory pressure increases during exercise. This condition may be associated with an unusually advanced neuropathy of the adductor components of the left recurrent laryngeal nerve and may be an unusual manifestation of RLN; however, this is speculative and further investigation is required to determine its cause. CLINICAL RELEVANCE: Dynamic collapse of the apex of the left corniculate process and into the airway at the dorsal apposition between the paired arytenoid cartilages can only be diagnosed during HSTV. It is an uncommon cause of upper airway dysfunction but may affect the athletic potential of racing Thoroughbreds and Standardbreds.     

手术致奶牛真胃左方变位对机体相关指标的影响

用外科手术的方法将奶牛真胃固定在瘤胃与左侧腹壁之间,建立奶牛左方真胃变位模型并于术前和术后采样。奶牛真胃人工左方变位后,瘤胃液和真胃液中的K^＋和Cl^-浓度升高（P〈0．05）,Na。浓度降低（P〈0．05）;而血清中Na^＋浓度升高,K^＋,Cl^-和Ca^2＋的浓度降低。瘤胃液中pH值和乙酸浓度降低（P〈0．05...     

奶牛真胃左方变位手术前后血液生化参数的变化

为了解奶牛真胃左方变位(LDA)手术前后血液生化指标的变化,跟踪采集了100头围产期奶牛产后7、14、21和28 d尾静脉血液,后经确诊6例LDA患牛进行手术整复,并随机选择6头相应的健康牛为对照。通过检测12头牛手术前后1周血清中游离脂肪酸(NEFA)和β-羟丁酸(BHBA)等21项生化指标,调查患LDA奶牛机体能量代谢、肝功能和电解质状况,并分析手术前、后生化指标的变化。结果显示:术前多数患LDA奶牛机体能量负平衡指标升高,肝功能指标不同程度的升高,电解质变化不一;术后牛机体能量代谢指标多数恢复正常,肝功能指标部分恢复正常,部分仍升高,电解质多恢复正常。     

Clinical vignette Fortuitous diagnosis of a persitent left cranial vena by color flow Doppler echocardiography in a dog

A persistent left cranial vena cava is described in an asymptomatic three-year-old female Shi Tzu. The purpose of this report is to show the value of color flow Doppler echocardiography in the diagnosis of this uncommon congenital cardiovasular abnormality.     

Haemoabdomen and colitis following a colon displacement in a 9‐year‐old Thoroughbred mare

This report describes acute haemoabdomen following phenylephrine administration in a case treated for left dorsal displacement of the large colon. The horse also subsequently developed a severe colitis which was treated with aggressive medical therapy.     

Evaluation of left ventricular function with cardiac magnetic resonance imaging and echocardiography after administration of dobutamine and esmolol in healthy beagle dogs

Unlike echocardiography, cardiac magnetic resonance imaging (cardiac MRI) results in a near-exact assessment of cardiac structures and function. However, most veterinary studies have focused on dogs with normal cardiac function. We hypothesized that there would be significant differences in cardiac measurements between cardiac MRI and echocardiography when left ventricular (LV) function was abnormal. This study was undertaken to compare measurements of LV function produced by cardiac MRI and echocardiography in dogs whose LV function was altered by pharmacological agents. This study was conducted with six healthy beagle dogs. We increased left ventricular contractility by administration of dobutamine; we decreased cardiac contractility with esmolol. Stroke volume measurements were made by using both cardiac MRI and echocardiography under seven different conditions with general anesthesia: control, three doses of esmolol (100, 200, and 500 µg/kg/min), and three doses of dobutamine (10, 20, and 50 µg/kg/min). Experiments involving each condition were conducted at least 1 week apart. When LV contractility was normal, ejection fraction (EF) and stroke volume (SV), as measured by echocardiography and cardiac MRI, were not significantly different. However, when contractility was changed by pharmacological agents, EF and SV were overestimated by echocardiography, compared to MRI. Evaluation of cardiac function in patients treated with pharmacological agents should be conducted carefully because EF and SV measured by echocardiography can be overestimated, compared with EF and SV obtained by cardiac MRI.     

Diagnostic imaging and pacemaker implantation in a domestic goat with persistent left cranial vena cava

Difficulty was encountered with the insertion of a right atrial pacing lead via the left jugular vein during lead and pacemaker implantation in a clinically normal goat as part of an ongoing rapid atrial pacing – induced atrial fibrillation research project. Fluoroscopic visualization of an abnormal lead advancement path prompted angiographic assessment which revealed a persistent left cranial vena cava (PLCVC) and prominent coronary sinus communicating with the right atrium. Angiography facilitated successful advancement and securing of the pacing lead into the right side of the interatrial septum. Cardiac magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) allowed further characterization of this rare venous anomaly. Even though PLCVC has been reported once in a goat, to the authors' knowledge this is the first report to include MRI/MRA characterization of PLCVC and prominent coronary sinus with successful cardiac pacemaker implantation using the PLCVC.     

Influence of left atrial enlargement and body weight on the development of atrial fibrillation: retrospective study on 205 dogs

We studied 205 dogs with cardiac diseases associated with left atrial enlargement (LAE). On the basis of electrocardiogram results, they were divided into: Group A, 50 dogs with atrial fibrillation (AF) and Group B, 155 dogs without AF. Group B was further subdivided in Group BI (123 dogs with sinus rhythm) and Group BII (32 dogs with cardiac arrhythmias other than AF). Bodyweight (BW) and left atrial diameter (LA) of Group A dogs were significantly greater (P< 0.05) than dogs in all other groups. The left atrium/aorta (LA/Ao) ratio of Group A dogs was significantly higher (P< 0.05) than that of dogs of Group B and BI. Using the couple of variables BW and LA, the logistic regression models were able to predict "non-development of AF" (with 92.3% probability) vs. "development of AF" (with 74% probability), and "maintaining sinus rhythm" (with 95.1% probability) vs."development of AF" (with 86% probability).     

Effects of isoflurane on echocardiographic parameters in healthy dogs

Objective To study the echocardiographic effects of isoflurane at an end‐tidal concentration approximating 1.0 times the minimum alveolar concentration (MAC) in healthy unpremedicated dogs. Study design Prospective experimental trial. Animals Sixteen mature mongrel dogs of either sex weighing 11.06 ± 2.72 kg. Methods After performing a baseline echocardiogram in the awake animal, anesthesia was induced with increasing inspired concentrations of isoflurane via a face mask until tracheal intubation was possible. Following intubation, the end‐tidal concentration was decreased to 1.4% for the rest of the anesthetic period. Serial echocardiograms were recorded at 25, 40, and 55 minutes after the end‐tidal concentration was reached. Results No changes were observed in heart rate. However, significant decreases were seen in left ventricular end‐diastolic diameter (Mean maximal change: 13.8%), interventricular septal thickness during systole (15.2%), interventricular septal thickening fraction (72.2%), left ventricular free wall thickening fraction (63.5%), ejection fraction (39.9%), and fractional shortening (46.7%). In addition, peak flow velocities across mitral, pulmonic, and aortic valves were significantly lower than baseline values. Decreases were also observed in end‐diastolic left ventricular volume index (approximately 32.1% from the awake value), stroke index (58.2%), and cardiac index (55.3%) when compared with awake measurements. Conclusions and clinical relevance Our results indicate that 1 × MAC isoflurane caused significant myocardial depression in healthy dogs. These changes in myocardial function need to be considered carefully when isoflurane is to be used in dogs with poor cardiovascular reserve.     

Combined interventional procedure and cardiopulmonary bypass surgery in a dog with cor triatriatum dexter,patent foramen ovale,and pulmonary stenosis

A 2‐year‐old American Pit Bull dog was presented for surgical evaluation of imperforate cor triatriatum dexter (CTD) and patent foramen ovale (PFO). Echocardiography identified an imperforate CTD associated with a right‐to‐left shunting PFO and valvular pulmonary stenosis. A 2‐step interventional and surgical approach was used. Initially, a pulmonary balloon valvuloplasty was performed, and subsequently the dog underwent a surgical correction of the atrial anomaly under cardiopulmonary bypass.