| 1. |
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| 2. |
- Häggström, Jens, et al.
(författare)
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Assessment of mitral valve morphology using three-dimensional echocardiography. Feasibility and reference values
- 2016
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 18, s. 156-167
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the feasibility of real time transthoracic three dimensional echocardiography (RT3DE) for evaluation of normal canine mitral valves (MVs), and to provide reference values for this technique.Animals: Forty-three cardiologically healthy, not sedated dogs.Methods: Transthoracic RT3DE mitral datasets were acquired during two consecutive 6-month periods. The datasets were analyzed using commercially available software. An MV model was drawn using a semiautomated procedure and MV variables were obtained and calculated. The ratio between annulus height and commissural diameter was used as an index of the annulus' saddle-shaped non-planarity. After evaluation of associations between measured variables and body size, the datasets were used to generate reference intervals. Coefficients of variation (CVs), variance components, and repeatability coefficients were calculated for the evaluation of intra-observer, inter-observer, and day-to-day variability.Results: Datasets could be analyzed in 34 of 43 (79%) dogs. 68 percent of datasets obtained during the first 6-month period could be analyzed and 90% obtained during the second period could be analyzed. An allometric relationship was identified for most MV variables. The MV annulus appeared elliptical and saddle-shaped. Inter and intra-observer CVs were less than 20%. Coefficient of variation greater than 20% was calculated for the inter-day variation for some variables. Operator and observer were primarily responsible for the variation of most of the variables.Conclusions: Evaluation of canine mitral valves by transthoracic RT3DE is feasible. Canine MVs of healthy dogs analyzed using RT3DE are elliptical and saddle-shaped. Reference intervals for the measured MV variables are proposed. (C) 2016 Elsevier B.V. All rights reserved.
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| 3. |
- Häggström, Jens
(författare)
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European Society of Veterinary Cardiology screening guidelines for dilated cardiomyopathy in Doberman Pinschers
- 2017
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 19, s. 405-415
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dilated cardiomyopathy (DCM) is the most common cardiac disease in large breed dogs and is inherited in Doberman Pinschers with a high prevalence (58%).Objective: The European Society for Veterinary Cardiology convened a task force to formulate screening guidelines for DCM in Dobermans.Recommendations: Screening for occult DCM in Dobermans should start at three years of age and use both Hotter monitoring and echocardiography. Yearly screening over the life of the dog is recommended, as a one-time screening is not sufficient to rule out future development of DCM. The preferred echocardiographic method is the measurement of the left ventricular volume by Simpson's method of discs (SMOD). Less than 50 single ventricular premature complexes (VPCs) in 24 h are considered to be normal in Dobermans, although detection of any number of VPCs is cause for concern. Greater than 300 VPCs in 24 h or two subsequent recordings within a year showing between 50 and 300 VPCs in 24 h is considered diagnostic of occult DCM in Dobermans regardless of the concurrent echocardiographic findings. The guidelines also provide recommendations concerning ancillary tests, that are not included in the standard screening protocol, but which may have some utility when recommended tests are not available or financially untenable on an annual basis. These tests include assay of cardiac biomarkers (Troponin I and N-Terminal pro-B-type Natriuretic Peptide) as well as a 5-min resting electrocardiogram (ECG).Conclusion: The current guidelines should help to establish an early diagnosis of DCM in Dobermans. Crown Copyright (C) 2017 Published by Elsevier B.V. All rights reserved.
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| 4. |
- Häggström, Jens
(författare)
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Increased normalized pulmonary transit times and pulmonary blood volumes in cardiomyopathic cats with or without congestive heart failure
- 2015
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 17, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate heart rate-normalized pulmonary transit times (nPTTs) in cardiomyopathic cats with or without congestive heart failure (CHF). To assess potential associations of echocardiographic variables and nPTT and to evaluate nPTT as a test for the presence of CHF.Animals: Forty-eight privately owned cats.Methods: nPTT was measured using echocardiography and the ultrasound contrast media SonoVue(R) in 3 groups of cats: healthy cats (group 1), cats with cardiomyopathy (CM) but without CHF (group 2), and cats with CM and CHF (group 3). Interrelations between pulmonary blood volume (PBV), nPTT, stroke volume (SV), and echocardiographic variables were investigated by means of linear univariate and multivariate analysis.Results: Median nPTT values in group 1, group 2, and group 3 were 3.63 (interquartile range [IQR], 3.20-4.22), 6.09 (IQR, 5.0-7.02), and 8.49 (IQR, 7.58-11.04), respectively. Values were significantly different between all 3 groups. Median PBVs in group 1, group 2, and group 3 were 27.94 mL (IQR, 21.02-33.17 mL), 42.83 mL (IQR, 38.46-50.36 mL) and 49.48 mL (IQR, 38.84-64.39 mL). SV, PBV, and shortening fraction <30% were significant predictors of nPTT. nPTT and left atrial to aortic root (LA:AO) ratio, not SV, were the main predictors of PBV.Conclusion: nPTT may be useful as a test for the presence of CHF in cats with CM and as a measure of cardiac performance. nPTT and LA:AO ratios predict CHF with equal accuracy. Increased PBV is significantly associated with higher nPTT and LA:AO ratios. (C) 2015 Elsevier B.V. All rights reserved.
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| 5. |
- Häggström, Jens, et al.
(författare)
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Increased NT-proANP predicts risk of congestive heart failure in Cavalier King Charles spaniels with mitral regurgitation caused by myxomatous valve disease
- 2014
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 16, s. 141-154
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the predictive value of plasma N-terminal pro-atrial natriuretic peptide (NT-proANP) and nitric oxide end-products (NOx) as markers for progression of mitral regurgitation caused by myxomatous mitral valve disease.Animals: Seventy-eight privately owned Cavalier King Charles spaniels with naturally occurring myxomatous mitral valve disease.Methods: Prospective longitudinal study comprising 312 measurements over a 4.5 year period. Clinical values were recorded, NT-proANP concentrations were measured by radioimmunoassay, and NOx were analyzed colorimetrically. To predict congestive heart failure (CHF), Cox proportional hazards models with time-varying covariates were constructed.Results: The hazard ratio for NT-proANP (per 1000 pmol/l increase) to predict future CHF was 6.7 (95% confidence interval, 3.6-12.5; p < 0.001). The median time to CHF for dogs with NT-proANP levels >1000 pmol/l was 11 months (95% confidence interval, 5.6-12.6 months), compared to 54 months (46 - infinity) for dogs with concentrations <= 1000 pmol/l (p < 0.001). Due to intra- and inter-individual variability, most corresponding analyses for NOx were insignificant but dogs reaching CHF had a lower mean NOx concentration than dogs not reaching CHF (23 vs. 28 mu mol/l, p = 0.016). Risk of CHF increased with increase in heart rate (>130 beats per minute) and grade of murmur (>= 3/6).Conclusions: The risk of CHF due to mitral regurgitation is increased in dogs with blood NT-proANP concentrations above 1000 pmol/l. Measurement of NT-proANP can be a valuable tool to identify dogs that may develop CHF within months. (C) 2014 Elsevier B.V. All rights reserved.
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| 6. |
- Häggström, Jens, et al.
(författare)
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Mitral valve morphology assessed by three-dimensional transthoracic echocardiography in healthy dogs and dogs with myxomatous mitral valve disease
- 2017
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 19, s. 113-123
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess differences in morphology of the mitral valve (MV) between healthy dogs and dogs affected by myxomatous mitral valve disease (MMVD) using real-time transthoracic three-dimensional echocardiography (RT3DE).Animals: Thirty-four were normal dogs and 79 dogs were affected by MMVD.Methods: Real-time transthoracic three-dimensional echocardiography mitral data sets were digitally recorded and analyzed using dedicated software. The following variables were obtained and compared between healthy dogs and dogs with MMVD at different stages: antero-posterior annulus diameter, anterolateral-posteromedial annulus diameter, commissural diameter, annulus height, annulus circumference, annulus area, anterior leaflet length, anterior leaflet area, posterior leaflet length, posterior leaflet area, non-planar angle, annulus sphericity index, tenting height, tenting area, tenting volume, the ratio of annulus height and commissural diameter.Results: Dogs with MMVD had a more circular MV annulus compared to healthy dogs as demonstrated by an increased annulus sphericity index (p=0.0179). Affected dogs had a less saddle-shaped MV manifest as a decreased annulus height to cornmissural width ratio. (p=0.0004). Tenting height (p<0.0001), area (p<0.0001), and volume (p<0.0001) were less in affected dogs.Conclusions: Real-time transthoracic three-dimensional echocardiography analysis demonstrated that dogs affected by MMVD had a more circular and less saddle shaped MV annulus, as well as reduced tenting height area and volume, compared to healthy dogs. Multiple variables differed between dogs at different stages of MMVD. Diagnostic and prognostic utility of these variables, and the significance of these changes in the pathogenesis and natural history of MMVD, require further attention. (C) 2017 Elsevier B.V. All rights reserved.
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| 7. |
- Häggström, Jens
(författare)
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Pharmacologic management of myxomatous mitral valve disease in dogs
- 2012
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 14, s. 165-184
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Forskningsöversikt (refereegranskat)abstract
- Myxomatous mitral valve disease (MMVD) causing mitral regurgitation is the most important disease of the heart in small animal cardiovascular medicine. Because MMVD is an example of a chronic disease that progresses from mild to severe over years, treatment strategies change with the stage of the disease. In this review the treatment options are compared and contrasted as they are discussed relative to the recently published ACVIM consensus statement regarding the treatment of MMVD. Results from clinical trials and evidence-based medicine are likely to provide significant improvements in the management of MMVD in the coming decades. (C) 2012 Elsevier B.V. All rights reserved.
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| 8. |
- Häggström, Jens
(författare)
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Prediction of clinically important acquired cardiac disease without an echocardiogram in large breed dogs using a combination of clinical, radiographic and electrocardiographic variables
- 2022
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 40, s. 126-141
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Large breed (LB) dogs develop dilated cardiomyopathy (DCM) and myxomatous mitral valve disease (MMVD). Echocardiography is required for a definitive diagnosis but is not always available. Our objective was to assess the clinical utility of thoracic radiographs alone and in combination with physical examination and electrocardiography findings for the prediction of clinically important DCM or MMVD in LB dogs. Animals: Four hundred fifty-five client-owned dogs >20 kg with concurrent thoracic radiographs and echocardiogram. Materials and methods: Medical records were reviewed and stored thoracic radio-graphs and echocardiographic images were measured to classify dogs as normal heart size (NHS), preclinical DCM, clinical DCM, preclinical MMVD (with cardiome-galy), clinical MMVD, or equivocal. Dogs with preclinical MMVD, without cardiome-galy, were classified as NHS. Vertebral heart size (VHS) and vertebral left atrial size (VLAS) were measured. Receiver operating characteristic curves and prediction models were derived. Results: Prevalence of MMVD (39 .3%) was higher than the prevalence of DCM (24.8%), though most MMVD dogs (67.0%) lacked cardiomegaly and were classified as NHS for analysis. The area under the curve for VHS to discriminate between NHS and clinical DCM/MMVD or preclinical DCM/MMVD was 0.861 and 0.712, respec-tively, while for VLAS, it was 0.891 and 0.722, respectively. Predictive models incor-porating physical examination and electrocardiography findings in addition to VHS/ VLAS increased area under the curve to 0.978 (NHS vs. clinical DCM/MMVD) and 0.829 (NHS vs. preclinical DCM/MMVD). Conclusions: Thoracic radiographs were useful for predicting clinically important DCM or MMVD in LB dogs, with improved discriminatory ability when physical exam-ination abnormalities and arrhythmias were accounted for.@ 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 9. |
- Häggström, Jens
(författare)
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Predictors of reoccurrence of congestive signs within 180 days after successful treatment of the first episode of congestive heart failure in dogs with myxomatous mitral valve disease
- 2021
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 34, s. 112-119
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Myxomatous mitral valve disease (MMVD) is the most com-mon cause of left-sided congestive heart failure in dogs. We sought to identify pre-dictors of first reoccurrence of congestive signs (CS) within 180 days in dogs with MMVD and clinically stable heart failure.Animals: A total of 445 dogs affected by stable American College of Veterinary In-ternal Medicine (ACVIM)-Stage-C MMVD were included, 106 in the reoccurrence group (RG) and 339 in no reoccurrence group (NRG). Patients were considered & ldquo;stable & rdquo; if medical treatment had been unchanged for at least 4 weeks since the first identification of CS.Methods: Medical records of dogs with stable ACVIM-Stage-C MMVD included in a registry of dogs affected by MMVD were reviewed. Follow-up was required for inclusion in this investigation. Logistic regression was used to identify clinical and echo cardiographic variables that independently predict first reoccurrence of CS. Results: Baseline left atrial-aortic ratio (p=0.022, OR: 1.89, 90% CI: 1.20-2.98), left ventricular internal diameter at end-diastole (LVIDd_N) (p=0.014, OR: 2.84, 90% CI: 1.41-5.77), peak velocity of early diastolic transmitral flow (p=0.049, OR: 1.81, 90% CI: 1.10-3. 00) and furosemide daily dosage (p=0.039, OR: 1.19, 90% CI: 1.04-1.37) were associated with reoccurrence of CS in univariable analyses. The LVIDd_N (p=0.014) remained significant in the multivariable analysis, but the area under the receiver operator characteristic curve was 0.57.Conclusion: This study failed to identify accurate predictors of reoccurrence of CS. However, dogs with larger value of LVIDd_N are more likely to have reoccurrence of CS within 180 days.(c)& nbsp;2021 Elsevier B.V. All rights reserved.
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| 10. |
- Häggström, Jens
(författare)
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Prospective evaluation of the combined value of physical examination and biomarker variables in screening for preclinical dilated cardiomyopathy in Doberman Pinschers
- 2022
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Ingår i: Journal of Veterinary Cardiology. - : Elsevier BV. - 1760-2734 .- 1875-0834. ; 40, s. 69-83
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Screening to assess likelihood of preclinical dilated cardi-omyopathy (PC-DCM) prior to advanced diagnostic tests in Doberman Pinschers (DP) is desirable. Objective: To investigate the combined value of physical examination (PE), N -term-inal pro B-type natriuretic peptide (NTproBNP) and cardiac troponin I (cTnI) for identifying PC-DCM in DP. Animals, materials and methods: All dogs underwent: PE, echocardiogram, 3-min ECG and cardiac biomarker measurement. Asymptomatic DP specialIntscript were classified based on 3-min ECG and echocardiogram as: No-DCM/MMVD or myxomatous mitral valve disease (MMVD), PC-DCM based on echocardiogram (PC-DCM-Echo), PC-DCM based on arrhythmias with a normal echocardiogram (PC-DCM-ECG), equivocal DCM (EQ-DCM), and MMVD. Receiver operator characteristic curves and prediction models were derived. Results: Heart murmurs and arrhythmias were rare and gallop sounds were absent in No-DCM/MMVD DP. Dogs > four years old and males had higher probabilities of PC-DCM-Echo. Prediction models incorporating PE variables with NTproBNP had an area under the curve (AUC) of 0.940 for distinguishing between PC-DCM-Echo and all other groups, which was similar to the AUC for NTproBNP (0.939) or cTnI (0.932) alone. Discrimination between No-DCM/MMVD and all other groups was simi-lar for NTproBNP (0.781) and cTnI (0.742) as individual tests, however, models com-bining PE variables and NTproBNP increased the AUC to 0.812. An NTproBNP cut-off of >548 pmol/L, was 100% sensitive and 77.3% specific for detecting PC-DCM-Echo. Conclusions: Both NTproBNP and cTnI had good utility as sole tests to discriminate PC-DCM-Echo DP from all others. Models differentiating No-DCM/MMVD DP from all other DP were improved by using PE and NTproBNP together. 2022 Elsevier B.V. All rights reserved.
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