Heterogeneity of Hypertrophy in Feline Hypertrophic Heart Disease

Eighty-six cats with non-dilated left ventricular myocardial hypertrophy were studied retrospectively. Cats were categorized by two-dimensional echocardiography as having symmetric ventricular hypertrophy (Type I), asymmetric with predominant septal thickening hypertrophy (Type II), and asymmetric hypertrophy with predominant free-wall thickening (Type III). The distribution of hypertrophy was judged subjectively and objectively. Subjective and objective results were similar (P= 0.03) although overlap existed between groups. Morphologic patterns (Types I, II, and III) were compared with breed, age, sex, heart rate, percent fractional shortening, left atrial size, serum creatinine concentration, and the presence (yes/no) of pleural effusion, pulmonary edema, pericardial effusion, heart murmur, dyspnea, thromboembolism, hyperthyroidism, and being alive at the time of study. Interventricular septal thickness, left ventricular free wall thickness, percent fractional shortening, and left atrial size additionally were compared to 3-month survival. Cats with Type HI hypertrophy were more likely to experience thromboembolism than cats with Type II hypertrophy (P= 0.05) and cats with Type I hypertrophy were more likely to have heart murmurs than cats with Type III (P= 0.02). No other significant associations were found in comparison to pattern of hypertrophy. Both left atrial size and percent fractional shortening significantly correlated with 3-month survival (P < 0.001 for each). The degree of interventricular septal wall thickness was associated with 3-month survival (P= 0.02) when known hyperthyroid cats were excluded from the study group, while left ventricular free wall thickness consistently was not associated with survival. This study demonstrates the heterogeneity of hypertrophy in cats with hyper-trophic heart disease and provides predictors of survival (left atrial size, percent fractional shortening, and interventricular septal wall thickness when compared with euthanasia/spontaneous death data).