What’s new in cardiothoracics? - Veterinary Practice
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What’s new in cardiothoracics?

A summary of the latest academic publications, answering the question “what’s new?” in this month’s spotlight topic: cardiothoracics

Echocardiographic findings in dogs with brachycephalic obstructive airway syndrome

Maja Brloznik and others, University of Ljubljana, Slovenia

Brachycephalic dogs display many of the same features exhibited by human patients with obstructive sleep apnoea (OSA), a condition known to cause changes in cardiac function. The authors investigated whether changes similar to those seen in human OSA cases can be identified on echocardiographic examination in dogs with brachycephalic obstructive airway syndrome (BOAS). A comparison of the findings in 57 brachycephalic dogs and 10 dogs with more conventional skull anatomy demonstrated differences in several cardiac function parameters in BOAS cases. There were also differences between brachycephalic dogs with and without BOAS signs. The authors note that most changes in cardiac morphology and function can be attributed to the characteristic anatomical changes in brachycephalic dogs, not just to the symptomatic stage.

BMC Veterinary Research, 19

Atrial fibrillation rate as a predictor of recurrent heart rhythm abnormalities in horses

Rikke Buhl and others, University of Copenhagen, Denmark

Atrial fibrillation is the most common sustained cardiac arrhythmia in horses, with an estimated prevalence of 0.1 to 2.5 percent depending on the population sampled. A high proportion of horses that appear to have re-established normal cardiac rhythms will experience recurrent signs. The authors investigated atrial fibrillatory rate and its association with successful and constant cardioversion. In 64 out of 74 horses successfully treated with quinidine, 12 percent had recurrent signs. Meanwhile, in 121 patients that responded to transvenous electrical cardioversion (TVEC), 34 percent had recurrent atrial fibrillation. An atrial fibrillation rate above 380 fibrillations per minute was significantly associated with recurrent disease in TVEC-treated horses and those that failed to respond to quinidine treatment.

Equine Veterinary Journal, 54, 1013-1022

Effect of diet on cardiac biomarkers, echocardiogram findings and taurine levels in cats

Shelby Karp and others, Tufts University, North Grafton, Massachusetts

Incidents of dilated cardiomyopathy in dogs have been linked to diet, but there have been no attempts to find similar associations in cats. The authors compared cardiac size and function, cardiac biomarkers and taurine concentrations in healthy cats receiving diets with high or low levels of pulses. A greater proportion of the 21 cats in the high-pulse diet group were overweight or obese, but there were no differences between the two groups in key cardiac measurements, biomarker levels or blood taurine concentrations. However, there was a significant correlation between diet duration and left ventricular wall thickness measurement in the high-pulse diet group.

Journal of Feline Medicine and Surgery, 25

Use of smartwatches to evaluate heart rate and peripheral oxygen saturation

Latif Emrah Yanmaz and others, Burdur Mehmet Akif Ersoy University, Turkey

Smartwatches are increasingly being used to evaluate physiological parameters in humans. The authors investigated the accuracy and reliability of two such devices, the Apple Watch 6 and the Fenix 5X Plus, for measuring heart rate and peripheral oxygen saturation in cats. Results with the Fenix 5X Plus showed closer correspondence to conventional electrocardiography measurements than the Apple device when used on male cats under general anaesthesia for a castration procedure. However, peripheral oxygen measurements with the Apple watch were closer to those recorded using the reference transmittance pulse oximetry method than the Fenix device.

Journal of the American Veterinary Medical Association, 261, 205-209

NT-proBNP levels in dogs with myxomatous mitral valve disease

In Sung Jang and others, Kangwon National University, South Korea

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is considered the most reliable biomarker for heart disease in human patients. The authors investigated the levels of this compound found in dogs with stage B myxomatous mitral valve disease (MMVD). They found that levels of the biomarker were higher in dogs with stage B MMVD with systemic hypertension than in dogs with the same condition at the same stage of the pathological process that remained normotensive. They suggest that clinicians need to be aware NT-proBNP levels may be elevated in the presence of systemic hypertension.

Irish Veterinary Journal, 76

Measuring loop diuretic responsiveness in dogs with congestive heart failure

Mark Oyama and Darcy Adin, University of Pennsylvania, Philadelphia

Diuretics such as furosemide are routinely administered to dogs with congestive heart failure (CHF). The dosage and assessment of efficacy is usually based on clinical signs rather than a quantitative assessment of the drug’s action. However, in human CHF patients, treatment is increasingly guided by measurements of urine sodium concentration and urine volume. This approach has been shown to improve clinical outcomes. The authors reviewed the evidence on the potential value of offering a management plan based on quantifying the patient’s response to the administration of loop diuretics in dogs with CHF.

Journal of Veterinary Internal Medicine, 37, 12-21

Prevalence of atelectasis in sedated dogs examined with computed tomography

Elin Reimegård and others, Evidensia Södra Djursjukhuset, Stockholm, Sweden

Computed tomography is a valuable tool for investigating lung conditions in dogs; however, the patient must be sedated and in sternal recumbency during the procedure. This could, theoretically, lead to atelectasis or partial collapse in some areas of lung tissue, which may produce misleading results by suggesting pathological changes in healthy tissue or masking evidence of genuine disease. The authors carried out three consecutive thoracic scans in 20 dogs with healthy lungs over a period of up to 24 minutes after administering a sedative. They found no evidence of significant atelectasis, but there were signs of increased lung attenuation in the ventral lobes over time following the initial scan.

Acta Veterinaria Scandinavica, 64

Use of vasopressors in the treatment of vasodilatory hypotension in critical care centres

Kellyann Murphy and others, University of Pennsylvania, Philadelphia

Hypotension is a common problem in critically ill small animal patients, leading to significant mortality and morbidity if not promptly corrected. Treatment will depend on the underlying cause, and while sepsis is the issue seen most frequently, there can be a wide range of other causative factors. The authors questioned 734 US College of Veterinary Emergency and Critical Care diplomates on their approach to managing such cases. They found most respondents adhered to published human medical guidelines when choosing a first-line vasopressor, norepinephrine (ie noradrenalin). However, there was considerable variability in blood pressure measurement technique, cut-offs for initiating vasopressor use and choice of second-line vasopressors.

Journal of Veterinary Emergency and Critical Care, 32, 714-722

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