Comparison of Systolic Cardiac Function Before and After Treatment of Atrial Fibrillation in Horses With and Without Additional Cardiac Valve Insufficiencies

Clinical, electrocardiographic and echocardiographic examinations were conducted before therapy and 4 days after conversion to normal sinus rhythm in 15 horses with a history of atrial fibrillation of 2-6 months duration. Seven horses showed no other signs of cardiac disease. Four horses suffered additionally from mitral valve insufficiency, while six horses had aortic valve insufficiency, including two of the four horses with mitral valve insufficiency, but none had signs of congestive heart failure. Doppler echocardiographic estimates of various variables were made for assessment of systolic heart function. These included heart rate, stroke volume, cardiac output and cardiac output per kg of body weight (heart index). After conversion to normal sinus rhythm, the horses without heart valve insufficiency showed a statistically significantly decreased heart rate (-24%) and cardiac output (-3%), but an increase in stroke volume (+8.4%) and heart index (+9%). The horses with heart valve insufficiency experienced a statistically significant decrease in heart rate (-21%) after conversion to normal sinus rhythm, but showed an increase in all other variables. Cardiac output increased statistically significantly by 20%, stroke volume by 54% and heart index by 58%.     

The pathology of atrial fibrillation in dogs

Atrial fibrillation (AF) occurs in dogs in a number of settings, the most common of which is congestive heart failure. This paper reviews what is known about the pathology of AF in dogs, as well as its clinical relevance. We begin by discussing several experimental AF paradigms in dogs, the associated pathology, and its relevance to AF mechanisms. We then discuss clinical AF in dogs and its relationship to experimental pathology. Finally, we conclude by assessing the potential therapeutic relevance of understanding AF-related pathology in dogs, as well as its potential to have practical applications in the future.     

心钠素在肉鸡腹水综合征发生发展中的作用

大群艾维菌商品代肉鸡从1日龄起用高能日粮常规饲养，以获得自然腹水综合征（ascites syndrome，AS）病例。应用放射免疫分析方法，分别测定了2～6周龄正常组、轻度腹水组、重度腹水组内鸡血浆和5周龄时心、肝、肺、肾等组织心钠素（atrial natriuretic polypeptide,ANP）的含量；用右心导管法测定了平均肺动脉压（mPAP），并用常规方法测定了腹水心脏指数（AHI），同时还对血浆ANP的含量与AHI、mPAP的相关性进行了分析。结果发现，随着日龄的增长，ANP的含量增加，AHI、mPAP也随着发生明显的变化；随腹水程度的加深，mPAP、AHI以及肉鸡血浆、组织ANP的含量均显著（P〈0．05）或极显著（P〈0．01）升高，组织中ANP的含量明显比血浆中的高；另外还发现，不同腹水程度肉鸡血浆ANP含量与5～6周龄时的mPAP、4～5周龄时的AHI相关性显著（P〈0．05）。结果表明，ANP参与了肉鸡AS的发生和发展过程并与肉鸡发生AS的程度有密切关系。     

Over-expressed calreticulin interacts with integrin-α5 and calcineurin system to induce atrial remodeling in patients with atrial fibrillation and valvular disease

AIM: To determine whether calreticulin over-expression contributes to atrial fibrosis in the patients with atrial fibrillation (AF) and valvular heart disease (VHD).METHODS: Right and left atrial specimens were obtained from 78 patients undergoing valve replacement surgery. The patients were divided into sinus rhythm (SR) group, paroxysmal AF (PaAF) group and persistent AF (PeAF, AF lasting >6 months) group. The protein expression of calreticulin, integrin-α5, and transforming growth factor-β1 (TGF-β1) was measured. Immunoprecipitation was also performed to determine whether calreticulin interacted with either calcineurin B or integrin-α5. RESULTS: The protein expression of calreticulin, integrin-α5 and TGF-β1 was increased in AF groups, especially in the left atrium of the patients with mitral valve disease as compared with SR group. Calreticulin interacted with both calcineurin B and integrin-α5. The expression level of integrin-α5 was significantly correlated with the expression level of TGF-β1, while the expression level of calreticulin was correlated with that of integrin-α5 and TGF-β1. Under similar classification of the cardiac function, the expression level of calreticulin in PeAF group was higher than that in SR group. CONCLUSION: The expression of calreticulin, integrin-α5, and TGF-β1 is increased in the atrial tissues of the AF patients and is related to the AF type, suggesting that calreticulin is involved in atrial remodeling in AF and VHD patients.     

Plasma aldosterone, vasopressin and atrial natriuretic peptide in hypovolaemia: a preliminary comparative study of neonatal and mature horses

REASON FOR PERFORMING STUDY: Neonatal foals succumb rapidly to hypovolaemic shock in comparison to mature horses; they do not consistently increase their heart rate in response to hypotension and respond differently to fluid administration. The hormonal responses to hypovolaemia in the horse and foal require investigation. HYPOTHESIS: The hormonal responses to hypovolaemia and fluid administration differ between mature and neonatal horses. METHODS: Five mature horses and 5 neonatal foals fulfilling predetermined criteria for hypovolaemia, were included in the study. A blood sample was taken at admission and after normalisation of fluid balance. These were analysed for plasma aldosterone, vasopressin (AVP) and atrial natriuretic peptide (ANP). Normally distributed variables were compared using the Student's t test and nonparametric data using the Mann-Whitney U test. RESULTS: ANP, AVP and aldosterone were higher before fluid resuscitation than after fluid resuscitation in mature horses. Aldosterone was higher before than after fluid resuscitation in foals, and was higher in foals both before and after fluid resuscitation than in mature horses. ANP was lower in mature horses after fluid resuscitation than in foals. No other comparisons were significantly different. CONCLUSIONS: The hormonal responses of the mature and neonatal horses are different during hypovolaemia and following fluid resuscitation. POTENTIAL RELEVANCE: The differences in the hormonal responses to hypovolaemia and fluid resuscitation may be important when considering fluid resuscitation of hypovolaemic horses and foals, and warrants further investigation.     

Evaluation of plasma C-terminal atrial natriuretic peptide in healthy cats and cats with heart disease

BACKGROUND: The clinical implications of evaluating C-terminal atrial natriuretic peptide (ANP) concentration in cats are still controversial. HYPOTHESIS: The objective of this study was to investigate the relationship between plasma C-terminal ANP concentration and left atrial pressure (LAP) in healthy cats with volume overload (study 1), and to compare plasma C-terminal ANP in normal cats and cats with cardiomyopathy (study 2). ANIMALS: Five healthy adult cats were used in study 1, and clinically healthy cats (n=8) and cats with cardiomyopathy (n=14) were used in study 2. METHODS: In study 1, cats were anesthetized and given acetated Ringer's solution (100 mL/kg/h for 60 minute) via the cephalic vein. Hemodynamic measurements and blood samples, collected from the jugular vein, were performed at 10-min intervals. In study 2, blood samples from normal cats and cats with cardiomyopathy were collected from the cephalic vein. The plasma C-terminal ANP concentration was determined by radioimmunoassay for human alpha-ANP. RESULTS: In study 1, volume overload significantly increased the C-terminal ANP concentration and LAP from baseline. The C-terminal ANP concentration was strongly correlated with the mean LAP. In study 2, age, E wave velocity, and the ratios of the left atrium to aorta were significantly higher in the cats with cardiomyopathy compared with the normal cats. The C-terminal ANP concentration was significantly higher in the cats with cardiomyopathy compared with the normal cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Our results suggest that the measurement of plasma C-terminal ANP in cats may provide additional information for the diagnosis of heart disease.     

Atrial, SA nodal, and AV nodal electrophysiology in standing horses: normal findings and electrophysiologic effects of quinidine and diltiazem

BACKGROUND: Although atrial arrhythmias are clinically important in horses, atrial electrophysiology has been incompletely studied. HYPOTHESES: Standard electrophysiologic methods can be used to study drug effects in horses. Specifically, the effects of diltiazem on atrioventricular (AV) nodal conduction are rate-dependent and allow control of ventricular response rate during rapid atrial pacing in horses undergoing quinidine treatment. ANIMALS: Fourteen healthy horses. METHODS: Arterial blood pressure, surface electrocardiogram, and right atrial electrogram were recorded during sinus rhythm and during programmed electrical stimulation at baseline, after administration of quinidine gluconate (10 mg/kg IV over 30 minutes, n = 7; and 12 mg/kg IV over 5 minutes followed by 5 mg/kg/h constant rate infusion for the remaining duration of the study, n = 7), and after coadministration of diltiazem (0.125 mg/kg IV over 2 minutes repeated every 12 minutes to effect). RESULTS: Quinidine significantly prolonged the atrial effective refractory period, shortened the functional refractory period (FRP) of the AV node, and increased the ventricular response rate during atrial pacing. Diltiazem increased the FRP, controlled ventricular rate in a rate-dependent manner, caused dose-dependent suppression of the sinoatrial node and produced a significant, but well tolerated decrease in blood pressure. Effective doses of diltiazem ranged from 0.125 to 1.125 mg/kg. CONCLUSIONS AND CLINICAL IMPORTANCE: Standard electrophysiologic techniques allow characterization of drug effects in standing horses. Diltiazem is effective for ventricular rate control in this pacing model of supraventricular tachycardia. The use of diltiazem for rate control in horses with atrial fibrillation merits further investigation.     

Effects of temperature and adrenaline on the atrial myocardium of the cultured Atlantic salmon (Salmo salar)

The effects of acute temperature changes (2–17°C) on myocardial contractility with or without adrenergic activation were studied in the isolated spontaneously beating atrium of the Atlantic salmon (Salmo salar) reared at 8°C. The atrial frequency was markedly elevated (from 7 to 46 beats/min) by the rise in temperature from 2–17°C. Both the time to peak tension and to relaxation time were shortened. In contrast, the temperature effect on the maximal tension was modest. Exposure to exogenous adrenaline (1.1 nM–11 μM) resulted in a substantial enhancement of the maximal tension, notably at 2°C, while potentiation of the frequency at 2, 8 and 14°C, was less pronounced. The apparent affinity (pD₂) for adrenaline on the chronotropy was higher at 8 and 14°C than at 2°C. For the inotropic responses pD₂ was highest at the acclimation temperature (8°C). By comparison with data for the rainbow trout (Oncorhynchus mykiss) obtained by the same experimental design (Ask et al. 1981), species differences were apparent both in temperature dependence of contractile parameters and in their adrenergic activation. The Q₁₀ for the frequency in absence of adrenaline was higher in the salmon than in the trout for the temperature interval 2–17°C. The apparent affinities for adrenaline for the frequency at 8°C and 14°C and for the maximal tension responses at 2°C and 8°C were also highest for the salmon atrium.     

Analytic validation and comparison of three commercial immunoassays for measurement of plasma atrial/A-type natriuretic peptide concentration in horses

Measurement of atrial/A-type natriuretic peptide (ANP) concentrations may be of use for assessment of cardiac disease, and reliable data on the analytic performance of available assays are needed. To assess the suitability for clinical use of commercially available ANP assays, intra-assay and inter-assay coefficient of variation and dilution parallelism were calculated for three immunoassays (RIA_Pen, RIA_Phoen, and an ELISA_Pen) using blood samples from healthy and diseased horses to cover a wide range of ANP concentrations. Further, agreement between assays was assessed using linear regression and Bland–Altman analyses. For all assays, precision was moderate but acceptable and dilution parallelism was good. All assays showed analytic performance similar to other immunoassays used in veterinary medicine. However, the results from the three assays were poorly comparable. Our study highlights the need for an optimised species-specific assay for equine samples.