Sphericity Index and E‐Point‐to‐Septal‐Separation (EPSS) to Diagnose Dilated Cardiomyopathy in Doberman Pinschers

Background

E‐point‐to‐septal‐separation (EPSS) and the sphericity index (SI) are echocardiographic parameters that are recommended in the ESVC‐DCM guidelines. However, SI cutoff values to diagnose dilated cardiomyopathy (DCM) have never been evaluated.

Objectives

To establish reference ranges, calculate cutoff values, and assess the clinical value of SI and EPSS to diagnose DCM in Doberman Pinschers.

Animals

One hundred seventy‐nine client‐owned Doberman Pinschers.

Methods

Three groups were formed in this prospective longitudinal study according to established Holter and echocardiographic criteria using the Simpson method of disk (SMOD): control group (97 dogs), DCM with echocardiographic changes (75 dogs) and “last normal” group (n = 7), which included dogs that developed DCM within 1.5 years, but were still normal at this time point. In a substudy, dogs with early DCM based upon SMOD values above the reference range but still normal M‐Mode measurements were selected, to evaluate if EPSS or SI were abnormal using the established cutoff values.

Results

ROC‐curve analysis determined <1.65 for the SI (sensitivity 86.8%; specificity 87.6%) and >6.5 mm for EPSS (sensitivity 100%; specificity 99.0%) as optimal cutoff values to diagnose DCM. Both parameters were significantly different between the control group and the DCM group (P < 0.001), but were not abnormal in the “last normal” group. In the substudy, EPSS was abnormal in 13/13 dogs and SI in 2/13 dogs.

Conclusions and Clinical Importance

E‐point‐to‐septal‐separation is a valuable additional parameter for the diagnosis of DCM, which can enhance diagnostic capabilities of M‐Mode and which performs similar as well as SMOD.     

M-mode,two-dimensional and Doppler echocardiographic findings in 40 healthy domestic pet rabbits

ObjectivesThe aim of the study was to report normal two-dimensional, M-mode, and Doppler echocardiographic findings from a large cohort of healthy, manually restrained, adult pet rabbits.Animals and methodsForty healthy pet rabbits [22 Dwarf Lops (DL), 14 French Lops (FL) and 4 Alaskan (AL)] underwent a full physical examination and conscious two-dimensional, M-mode, and Doppler echocardiography.ResultsThe median age of the rabbits was 21.5 months, the median weight was 2.9 kg (DL: 2.4 kg, AL: 4.35 kg, FL: 6.0 kg). Echocardiography with ECG monitoring was feasible in all rabbits. Left atrial and ventricular dimensions were significantly larger in FL as compared to DL; overall, a positive correlation with weight was present. No significant differences between breeds were identified for flow velocities. Trace regurgitation was detected at the aortic valve in 7/40 (17.5%) rabbits, at the tricuspid valve in 5/40 (12.5%) and at the pulmonic valve in 1/40 (2.5%) rabbits. Mitral inflow E and A waves were summated in 60% of cases.ConclusionsThe results of this study can be used as echocardiographic values in FL and DL for comparison with clinical cases, and may also be applicable for other breeds of similar sizes. Breed specific values should be used when measuring left atrial and ventricular sizes. However, no breed or size differences were found for the rest of the echocardiographic parameters, which may therefore be applicable for the general pet rabbit population.     

Echocardiographic and radiographic findings in a cohort of healthy adult green iguanas (Iguana iguana)

ObjectivesTo describe characteristics of echocardiography and cranial coelomic radiography in a cohort of iguanas.AnimalsTwenty apparently healthy adult green iguanas (Iguana iguana) from a reptile sanctuary.MethodsPhysical examination, radiography, two-dimensional and color Doppler echocardiography were performed to assess cardiac structures and function, and any related normal or abnormal findings were recorded.ResultsEchocardiographic examination was possible without sedation and allowed visualization of the great vessels, atria, and ventricle. Some structures could not be evaluated in a minority of the iguanas due to individual differences in bony conformation and imaging quality. Suspected abnormal echocardiographic findings in 3 iguanas included pericardial effusion (n = 1) and enlarged caudal vena cava and/or sinus venosus (n = 2). Objective measurements were repeatable as assessed by within-subject coefficient of variation, and reliable as assessed by intra-observer intraclass correlation coefficient. Left atrial and ventricular measurements were significantly correlated with body weight. Valve regurgitation was common, with atrioventricular valve regurgitation present in 53% (9/17) and aortic or pulmonic valve regurgitation in 71% (12/17) of otherwise normal iguanas. A heart murmur was not appreciated during examination of any of the iguanas. Heart size cannot be measured radiographically due to superimposition and silhouetting of other coelomic structures. Echocardiographic or radiographic findings consistent with mineralization of the great vessels were present in 76% of iguanas (13/17).ConclusionsEchocardiography in iguanas is well tolerated without sedation and allowed both subjective evaluation and structural measurements. Valve regurgitation and great vessel mineralization were commonly observed in this cohort of apparently healthy adult iguanas.     

超声处理对羔羊皱胃酶提取活性的影响

 以2～3周龄羔羊皱胃为原料，利用超声提取法研究了超声强度，提取时间，提取液NaCl浓度，皱胃与提取液比例以及提取液pH对羔羊皱胃酶（kid rennet）提取活性的影响。结果表明，超声强度是影响羔羊皱胃酶提取活性的主要因素，其次为NaCl浓度，提取时间和皱胃与提取液比例。在超声强度为30 W·cm-2下提取40 min，提取液NaCl浓度为8%，pH为3，皱胃与提取液比例为1∶15时，羔羊皱胃酶提取活性最高。     

Diagnosis of congenital aneurysmal giant right auricle in a dog

A five-year-old intact male Golden Retriever was sent to our center for a second cardiac evaluation after the diagnosis of right atrial dilatation. Transthoracic and transesophageal echocardiographic evaluation and echo-contrast study were performed. A diagnosis of aneurysmal right auricle was issued without any sign of other cardiac pathologies. The tomographic evaluation was necessary to estimate the dimension of the aneurysmal area and exclude pericardial defects that may justify this anomaly. This report describes a rare case of aneurysmal giant right auricle in dogs. The diagnosis is accurate with the association of echocardiography and computed tomography.     

Comparison of three two-dimensional echocardiographic methods of assessing left ventricular size in Doberman Pinschers

IntroductionCompare three methods of obtaining linear left ventricular dimensions within the same Doberman Pinscher (DP).AnimalsOne hundred and thirty-nine client-owned DP.Materials and MethodsLinear left ventricular dimensions were measured using two-dimensional short-axis (Sx-2D), motion-mode short-axis (Sx-MM), and motion-mode long-axis (Lx-MM) methods, then left ventricular volumes were obtained using monoplane Simpson's method of discs (SMOD). A Friedman test with Dunn's multiple comparisons was used to compare differences between methods. Bias and correlation were evaluated via Bland-Altman and Spearman's correlation. Sensitivity and specificity for diagnosing occult dilated cardiomyopathy (DCM) compared to SMOD were determined. Coefficients of variation (CVs) were calculated for intra- and inter-observer measurement variability.ResultsThere were significant differences between all linear dimensions in diastole and systole. Short-axis 2D measurements had significant bias compared with Sx-MM (diastole +1.19 mm, systole +1.65 mm) and Lx-MM (diastole +4.36 mm, systole +3.87 mm) as did Sx-MM compared with Lx-MM (diastole +3.17 mm, systole +2.22 mm). All linear dimensions had a moderate positive correlation with SMOD. The sensitivity and specificity of linear measurements to detect DCM were: Sx-2D (sensitivity 72.0%, specificity 88.5%), Sx-MM (sensitivity 52.0%, specificity 92.0%), and Lx-MM (sensitivity 37.5%, specificity 99.1%). All methods had acceptably low CV for intra- and inter-observer measurement variability.ConclusionsResults of this study suggest that linear measurements are repeatable and correlate with reference standard; however, there is a significant bias between measurements, and they should not be used interchangeably.