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See detailPrevalence and Risk Factors for Various Cardiac Diseases in a Hospital-Based Population of 3434 Horses (1994-2011)
Leroux, Aurélia ULg; Detilleux, Johann ULg; Sandersen, Charlotte ULg et al

in Journal of Veterinary Internal Medicine (2013), 27(6), 1563-70

Background: Risk factors for several cardiac diseases have been suspected in horses, but few have been statistically demonstrated in a large equine population. Objectives: To describe risk factors for ... [more ▼]

Background: Risk factors for several cardiac diseases have been suspected in horses, but few have been statistically demonstrated in a large equine population. Objectives: To describe risk factors for various cardiac diseases in a hospital-based equine population. Animals: Files of 3434 horses admitted at the internal medicine department of the Liege Equine Teaching Hospital between 1994 and 2011were reviewed and of those, 284 were categorized as suffering from moderate to severe cardiac disease. Methods: Observational study. After calculating prevalence for each cardiac disease, we tested whether breed (chi-square test) or gender, age, body weight (BW) and other cardiac diseases (logistic regressions) were risk factors (p<0.05 significant). Results: Mitral regurgitation (MR, 4.4%), atrial fibrillation (AF, 2.3%), aortic regurgitation (AR, 2.1%) and tricuspid regurgitation (TR, 1.7%) were the most common cardiac abnormalities. Determinants were male gender and increasing age for AR (OR=2.03, CI=1.07-4.94), racehorses breed and middle-age for TR (OR=4.36; CI=1.10-17.24), and high BW for AF (OR=3.54; CI=1.67-7.49). MR was the major valvular disease associated with AF, pathological ventricular arrhythmia, pulmonary regurgitation (PR) and congestive heart failure (CHF). TR was also linked to AF, PR and CHF; AR was not linked to CHF. Conclusions and clinical importance: Several previously suspected risks factors of a variety of equine cardiac diseases are statistically confirmed in the studied hospital-based population. Similar observation could be suspected in a larger randomized population and should be taken into account in health and sport’s monitoring of horses presenting predisposing factors. [less ▲]

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See detailPrevalence and Risk Factors for Various Cardiac Diseases in a Hospital-Based Population of 3434 Horses (1994-2011)
Leroux, Aurélia ULg; Detilleux, Johann ULg; Sandersen, Charlotte ULg et al

in Journal of Veterinary Internal Medicine (2013), 27(6), 1563-70

Background: Risk factors for several cardiac diseases have been suspected in horses, but few have been statistically demonstrated in a large equine population. Objectives: To describe risk factors for ... [more ▼]

Background: Risk factors for several cardiac diseases have been suspected in horses, but few have been statistically demonstrated in a large equine population. Objectives: To describe risk factors for various cardiac diseases in a hospital-based equine population. Animals: Files of 3434 horses admitted at the internal medicine department of the Liege Equine Teaching Hospital between 1994 and 2011were reviewed and of those, 284 were categorized as suffering from moderate to severe cardiac disease. Methods: Observational study. After calculating prevalence for each cardiac disease, we tested whether breed (chi-square test) or gender, age, body weight (BW) and other cardiac diseases (logistic regressions) were risk factors (p<0.05 significant). Results: Mitral regurgitation (MR, 4.4%), atrial fibrillation (AF, 2.3%), aortic regurgitation (AR, 2.1%) and tricuspid regurgitation (TR, 1.7%) were the most common cardiac abnormalities. Determinants were male gender and increasing age for AR (OR=2.03, CI=1.07-4.94), racehorses breed and middle-age for TR (OR=4.36; CI=1.10-17.24), and high BW for AF (OR=3.54; CI=1.67-7.49). MR was the major valvular disease associated with AF, pathological ventricular arrhythmia, pulmonary regurgitation (PR) and congestive heart failure (CHF). TR was also linked to AF, PR and CHF; AR was not linked to CHF. Conclusions and clinical importance: Several previously suspected risks factors of a variety of equine cardiac diseases are statistically confirmed in the studied hospital-based population. Similar observation could be suspected in a larger randomized population and should be taken into account in health and sport’s monitoring of horses presenting predisposing factors. [less ▲]

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See detailEvaluation échocardiographique de la fonction cardiaque chez le cheval en coliques
Borde, Laura ULg

Doctoral thesis (2013)

Endotoxemia is a common complication of colic in adult horses and its outcome is mainly related to cardiovascular status. Endotoxic shock, like septic shock, involves hypovolemic, cardiogenic and ... [more ▼]

Endotoxemia is a common complication of colic in adult horses and its outcome is mainly related to cardiovascular status. Endotoxic shock, like septic shock, involves hypovolemic, cardiogenic and distributive components leading to tissue hypoperfusion with a high risk for multiple organ failure and an elevated mortality rate in equine and human intensive care units. Via the release of pro-inflammatory mediators, endotoxins induce a fall in systemic vascular resistance (SVR) and a drop of cardiac output (CO) resulting both from reduction in venous return and myocardial depression. First, CO is preserved thanks to a compensatory vasoconstriction and an increase in heart rate (HR), myocardial contractility and venous return. However, a loss of vascular responsiveness to catecholamines and a myocardial depression finally result in a drop of CO and SVR with a progressive hypotension despite a persistent tachycardia. The time point during the course of septic shock when hemodynamic monitoring is used has been proven to influence outcome, allowing early goal-directed therapy in humans. Unfortunately, hemodynamic monitoring in conscious horses is often limited due to animal size, working conditions and lack of patient cooperation. Therefore, such as in human patients, echocardiography could provide useful non invasive information about stroke volume (SV) and CO, systolic and diastolic function as well as fluid status. In human septic shock patients, this technique has emphasised a myocardial depression with both diastolic and systolic dysfunction reversible in survivors. Previous studies in horses focused on quantitative evaluation of hemodynamic parameters after an experimental endotoxin challenge. However, LV function had not been reported in naturally-occurring endotoxemia in horses. The purpose of the first prospective study was to assess the impact of clinically-occuring endotoxic shock on echocardiographic indices of LV systolic function in horses. Fifty horses admitted in clinic on emergency for colic were submitted to an echocardiographic exam on admission. A shock score from 1 to 4 was established for each horse based on clinical evaluation, non invasive systolic blood pressure and blood tests measurements. LV echocardiographic parameters were compared between the 4 groups according to the shock score (SS) (SS1: no or discrete signs of shock, n=11; SS2 : mild, n=17; SS3: moderate, n=12; SS4: severe, n=10) using a multivariable analysis. Significance was set at p < 0.05. Stroke volume, stroke index (SI), ejection time (ET), ejection time index corrected for HR (ETI), aortic velocity time integral (AoVTI), aortic flow acceleration time (TTP) and deceleration time (DTAo) were significantly lower, whereas aortic flow acceleration rate (dv/dtAo) was significantly higher in shocked horses than in SS1. CO was not significantly different between groups. Even if those results were difficult to interpret because of the shock-induced changes in loading conditions of the heart, they suggested that alterations in some indicators of systolic function can be quantified by Doppler echocardiography in horses with colic-induced endotoxemic shock. The aim of the second study was to non invasively assess the impact of colic-related endotoxic shock on equine diastolic cardiac function. Sixty-eight horses admitted in clinic on emergency with colic were included in this study. A similar SS was established for each horse. LV echocardiographic parameters were compared between the 4 groups according to the SS (SS1 n=14; SS2 n=16; SS3 n=27; SS4 n=12) using a multivariable analysis. Significance was set at p < 0.05. Deceleration rate of peak early LV filling velocity, peak late LV filling velocity and E/Em (peak early LV filling velocity (E) to peak early myocardial velocity (Em) ratio) were significantly higher whereas time to Em onset was significantly lower in high shock score groups compared with horses with no or mild signs of shock. The results of this second study could suggest a diastolic dysfunction with a rise of LV filling pressure ocurring with endotoxic shock in horses. Since E/Em has shown to be a very reliable predictor of mortality in human with septic shock, the results of this second study warranted further investigations. To assess the prognostic value of echocardiographic parameters of LV function in horses with endotoxic shock, 41 horses admitted for colic with clinical evidence of systemic inflammatory response syndrome associated to hyperlactatemia or hypotension underwent echocardiographic examination on admission. LV echocardiographic parameters were compared between nonsurvivors (n=29) and horses that survived to discharge (n=12). With comparable heart rate and LV preload estimate, LV SV, AoVTI, DTAo, ET and ETI of aortic flow and Em were lower in the nonsurviving than in the surviving horses while pre-ejection period to ejection time ratio (PEP/ET) of Doppler aortic flow and E/Em ratio were higher (p<0.05). A cut-off value of 0.26 for PEP/ET predicted mortality with 100% sensitivity and 42% specificity (area under the receiver operating characteristic curve (AUC): 0.71), whereas a cut-off value of 2.67 for E/Em predicted mortality with 100% sensitivity and 83% specificity (AUC: 0.89). The results of this third study suggested that echocardiography may provide prognostic information in colic horses with clinical evidence of endotoxic shock. Especially, PEP/ET and E/Em could be useful markers of systolic and diastolic dysfunction, respectively, to detect horses with a high risk of death requiring more intensive cardiovascular monitoring as it has been reported in human patients with septic shock. Finally, to assess LV function after preload restoration in colic horses, 5 horses were followed echocardiographically from admission to at least 24 hours after colic surgery in a preliminary study. Systolic dysfunction was detected in 4/5 horses and diastolic dysfunction assumed in 2/5 horses and suspected in the 3 other horses during hospitalisation. Moreover, echocardiography provided useful diagnosis informations about hemodynamic and fluid status suggesting that ultrasonographic monitoring of cardiovascular function could be of interest in equine intensive care. 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See detailRisks factors for valvular regurgitations in 3499 equids: a cross-sectional study.
Leroux, Aurélia ULg; Detilleux, Johann ULg; Sandersen, Charlotte ULg et al

in Proceedings of the 2013 ACVIM Forum (2013)

Risk factors for valvular regurgitations (VR) have been suspected in equids, but no extensive epidemiologic study has been performed in a large mixed equine population. Therefore, the aim of this study ... [more ▼]

Risk factors for valvular regurgitations (VR) have been suspected in equids, but no extensive epidemiologic study has been performed in a large mixed equine population. Therefore, the aim of this study was to statistically test risk factors for VR in a large population of equids. Hospital records were reviewed for 3.499 equids, admitted at the internal medicine department of the Liege Equine Teaching Hospital between 1994 and 2011, aged ≥2 years, and which underwent thorough cardiac clinical evaluation. Of this population, 495 cases had ECG and echocardiography performed because of a clinical suspicion of cardiac disease. Chi-square test or logistic regressions (as appropriate) were used to test if breed, gender, age, body weight (BW), and co-existence of various cardiac diseases were risk factors for each VR. Moreover, the risk of development of congestive heart failure (CHF) was tested for each VR. Significance was set at p<0.05. Most of the studied animals were warmbloods, and observed prevalences were 4.4% for mitral regurgitation (MR), 2.1% for aortic regurgitation (AR), 1.7% for tricuspid regurgitation (TR), and 1.0% for pulmonary regurgitation (PR). Significant risk factors were male gender and increasing age for AR (OR=2.03, CI=1.07-4.94), and racehorses breed group and middle-age for TR (OR=4.36; CI=1.10-17.24). No effect of age or BW was demonstrated for MR. MR was the major valvular disease associated with atrial fibrillation (AF), ventricular tachyarrhythmia, PR and CHF. TR was also linked to AF, PR and CHF; but AR was not linked to CHF. In conclusion, several previously suspected risks factors for VR were confirmed statistically in this study and should be taken into account in health and athletic monitoring of horses presenting predisposing factors. [less ▲]

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See detailRisk factors for atrial fibrillation and ventricular tachyarrhythmias in 3499 equids admitted at the liege university equine hospital between 1994 and 2011
Leroux, Aurélia ULg; Detilleux, Johann ULg; Sandersen, Charlotte ULg et al

in Proceedings of the 2013 ECEIM Congress (2013)

Risk factors for atrial fibrillation (AF) and pathological ventricular tachyarrhythmias (VTA) have been suspected in equids, however little epidemiologic data exists. The aim of this study was to ... [more ▼]

Risk factors for atrial fibrillation (AF) and pathological ventricular tachyarrhythmias (VTA) have been suspected in equids, however little epidemiologic data exists. The aim of this study was to determine risk factors for AF and VTA in a large equine population. Case files of 3499 equids admitted to the internal medicine department of the Liege University Equine Teaching Hospital between 1994 and 2011were reviewed. Amongst them, 495 horses with a suspicion of a cardiac abnormality underwent ECG and echocardiography. After calculation of prevalence of AF and VTA, we tested whether breed (chi-square test) or gender, age, body weight (BW) and presence of other cardiac diseases (logistic regressions) were risk factors (significance set at p<0.05). In the studied population, prevalence of AF was high (2.3%), whereas prevalence of VTA was low (0.7%). Warmbloods and standardbreds were significantly overrepresented in AF cases. High BW was a risk factor for AF (OR=3.54; CI=1.67-7.49), whereas age was not. No effect of breed, age or BW was demonstrated for VTA. AF was observed significantly more frequently in horses presenting with moderate to severe mitral regurgitation (MR), tricuspid regurgitation, and pulmonary regurgitation, and VTA was significantly more frequent in horses with MR. Several previously suspected but not statistically demonstrated risk factors of AF were confirmed in this study and horses presenting valvular disease could be at increased risk of developing AF and VTA. [less ▲]

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See detailRelationship between echocardiographic measurements and body size in horses.
Al Haidar, Ali; Leroux, Aurélia ULg; Borde, Laura ULg et al

in Journal of Equine Veterinary Science (2013), 33(2), 107-114

The objectives of this work were to evaluate the optimal body size variable, and to determine mathematical model that best fits echocardiographic measurements to body size in the equine species. 150 ... [more ▼]

The objectives of this work were to evaluate the optimal body size variable, and to determine mathematical model that best fits echocardiographic measurements to body size in the equine species. 150 horses of various breeds, aged 1 week to 17 years old, body weight (BW) 38 to 890 kg, and free from cardiac disease were used in this study. Based on their age (i.e. younger or older than 2 years), animals were separated into 2 groups. In each horse, the body weight (BW), height at withers (HT), thoracic circumference (TC) and the body length (BL) were measured, the body surface area (BSA) was calculated, and a standard two-dimensional and M-mode echocardiography was performed allowing classic cardiac measurements to be taken. Correlations between each echocardiographic measurement and each of the anthropometric variables were assessed via a Pearson’s product-moment analysis and using linear, logarithmic, and power regression analysis in all animals and within the 2 groups. The dimensional, but not the functional, echocardiographic measurements showed a close correlation with all body size variables, especially during growth. The relationship between cardiac measurements and body size was best described using power regression models with TC as the anthropometric variable, but the relationship was also very accurately described using BW, BSA, or BL. In the equine species, dimensional echocardiographic reference values should be established using power regression equations on TC. Such a correction for body size could increase the diagnostic value of echocardiography in equine cardiology. [less ▲]

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See detailEffect of breed, sex, age and body weight on Echocardiographic Measurements in the Equine Species
Al Haidar, Ali; Farnir, Frédéric ULg; Deleuze, Stefan ULg et al

in Research in Veterinary Science (2013), In press

Little is known about the effect of various animal's signalment variables on echocardiographic reference values in the equine species. This study was performed to evaluate the effect of sex, breed, age ... [more ▼]

Little is known about the effect of various animal's signalment variables on echocardiographic reference values in the equine species. This study was performed to evaluate the effect of sex, breed, age and body weight (BW) on echocardiographic measurements in the equine species. Echocardiography was performed on 212 ponies or horses of various breeds, aged from 1 day to 37 years old (mean ± SD: 7.8 ± 5.8 years), BW 38-890 kg (mean ± SD: 421 ± 133 Kg), and free of cardiac disease. Fifty of those animals aged from 2 months to 35 years old (mean ± SD: 11.6 ± 6.4 years old); BW 77-662 kg (mean ± SD: 436 ± 135 kg) were also examined using the pulsed-wave Doppler mode. Standard two-dimensional and M-mode echocardiography were performed on all animals. Standard pulsed-wave Doppler examination of each cardiac valve was performed on the 50 first examined animals. Data were analysed using a general linear model including the effect of sex, age, breed and BW after logarithmic transformation of the data. Therefore, the same analysis was performed separately on animals aged  2 years-old and on older animals. All dimensional echocardiographic measurements were significantly affected by BW and most of them were significantly affected by breed, but not by sex. Only the aortic and the pulmonary artery internal diameter were significantly affected by age. None of the Doppler measurements were significantly affected by the tested variables. In conclusion, in the equine species, dimensional echocardiographic reference values should be established using regression equations as a function of BW, which could increase the diagnostic value of this leading technique in equine cardiology. Breed could also have an effect on those measurements. [less ▲]

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See detailSuccessful treatment of equine sarcoids with cisplatin electrochemotherapy: a retrospective study of 48 cases.
Tamzali, Y; Borde, Laura ULg; Rols, MP et al

in Equine Veterinary Journal (2012), 44(2), 214-220

REASONS FOR PERFORMING STUDY: Sarcoids are the commonest form of equine skin tumour. Several therapeutic measures have been described but none is considered to be universally effective ... [more ▼]

REASONS FOR PERFORMING STUDY: Sarcoids are the commonest form of equine skin tumour. Several therapeutic measures have been described but none is considered to be universally effective. Electrochemotherapy (ECT) is a new anticancer therapy that utilises electrical field pulses to induce increased cell membrane permeability to antitumour hydrophilic drugs, such as cisplatin. The increased intracellular concentration of the drugs has a significant therapeutic benefit. The procedure has not been previously reported in a large number of horses. OBJECTIVE: To validate ECT as a novel alternative treatment for equine sarcoids. METHODS: A retrospective study evaluating the efficacy of cisplatin ECT in the treatment of equine sarcoids was performed. Electrochemotherapy treatments were applied under general anaesthesia at 2 week intervals with or without prior excision or debulking. Electric pulses were directly applied to the lesions following intra-tumoural injections of an aqueous solution of cisplatin. RESULTS: One-hundred-and-ninety-four sarcoids on 34 horses, 2 ponies, 11 donkeys and one mule were treated with ECT. The 4 year nonrecurrence rate was 97.9% for animals (47/48) and 99.5% (193/194) for tumours. When ECT was used as a single treatment, a significant influence of tumour size (ρ= 0.55) on the number of treatments required for cure was shown. When prior surgery was performed, there was a significant influence (P<0.001) of the excision quality (complete or incomplete) and the healing mode (closed or open wound) on the number of treatments. The most common adverse effect was a slight oedematous reaction for lesions located on thin skin regions. CONCLUSION AND CLINICAL RELEVANCE: Results demonstrate that ECT, with or without concurrent tumour debulking, is an effective alternative for treatment of equine sarcoids [less ▲]

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See detailThe diagnostic value of equine rectal and duodenal biopsies.
Tossens, Morgane; Borde, Laura ULg; Amory, Hélène ULg et al

in Journal of Veterinary Internal Medicine (2012), 26(2), 430-431

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See detailEtude rétrospective de 12 cas de défaut du septum interventriculaire chez le cheval
Leroux, Aurélia ULg; Borde, Laura ULg; Sandersen, Charlotte ULg et al

in In Proceedings of the 39ème journées annuelles de l'Association des Vétérinaires Equins Français (AVEF) (2011, December 05)

Introduction Le défaut du septum interventriculaire ou communication interventriculaire (CIV) est l’anomalie congénitale la plus fréquente chez le cheval. Le diagnostic et le pronostic de cette pathologie ... [more ▼]

Introduction Le défaut du septum interventriculaire ou communication interventriculaire (CIV) est l’anomalie congénitale la plus fréquente chez le cheval. Le diagnostic et le pronostic de cette pathologie sont réalisés au moyen de l’échocardiographie Doppler pulsé. Cette étude a pour but de décrire les cas observés entre 1998 et 2008 à la clinique équine de l’Université de Liège, mais aussi de déterminer leur devenir à long terme. Matériel et méthodes Sept chevaux présentant une CIV ont été présentés en clinique. Leur race, âge, sexe, symptômes, et le motif de la consultation ont été notés puis une échocardiographie Doppler pulsé a été effectuée. Un suivi téléphonique a aussi été mis en place en 2011 pour connaître leur évolution à long terme. Résultats Les 7 chevaux présentés avaient entre 1 mois et 11 ans. Six chevaux étaient des demi-sang et le septième était un poney islandais. Tous les chevaux présentaient un souffle bilatéral holo- ou pan-systolique de grade égale ou supérieur à 5/6, plus intense à droite en région tricuspide. Cinq chevaux étaient référés pour souffle sans symptôme associé tandis que les 2 autres présentaient des œdèmes, de l’intolérance à l’effort et de la dyspnée. A l’échocardiographie, toutes les CIV étaient localisées à la base du septum dans sa partie membraneuse. Cependant, pour le premier cheval, examiné en 1998, une communication atypique entre le ventricule gauche (VG) et l’oreillette droite (OD) fut observée. La taille des CIV variait entre 0,5 et 6,6cm et la vitesse du shunt, toujours dirigé de gauche à droite, était comprise entre 2,5 et 5,5 m/s. Le premier cheval, référé en clinique en 1998, était en insuffisance cardiaque très sévère et présentait une dilatation des 2 ventricules et des 2 oreillettes, une fibrillation auriculaire et une insuffisance mitrale et tricuspide sévères. Le 2ème cheval avec des signes d’insuffisance cardiaque était un poulain d’1 mois avec une CIV de grande taille (2,6 cm) associé à un début de dilatation du ventricule droit sans autre anomalie cardiaque. Enfin, 3 des 5 chevaux asymptomatiques présentaient différentes insuffisances valvulaires mais seulement légères à modérées et une sténose pulmonaire a été observé chez l’un d’entre eux. Discussion et conclusions Les résultats de cette étude sont en accord avec la littérature. Les CIV sont associées à un souffle bilatéral holo- ou pan-systolique important et sont majoritairement localisés dans la partie membraneuse du septum. Une vitesse élevée du shunt est associée à une CIV de petite taille et à un pronostic vital et sportif bon. Par contre, en cas de CIV associé à d’autres anomalies graves comme des insuffisances valvulaires sévères, le pronostic est sombre. [less ▲]

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See detailPronostic value of echocardiographic and Doppler parameters in colic horses with endotoxic shock: A preliminary study
Borde, Laura ULg; Amory, Hélène ULg; Leroux, Aurélia ULg et al

Conference (2011, February 05)

Endotoxemia is the first mortality cause in equine intensive care. In humans with septic shock, some echocardiographic indicators are used to predict the efficiency of fluid resuscitation and outcome ... [more ▼]

Endotoxemia is the first mortality cause in equine intensive care. In humans with septic shock, some echocardiographic indicators are used to predict the efficiency of fluid resuscitation and outcome, allowing an early-goal-directed therapy. Echocardiography has never been investigated for this indication in horses. The aim of this study was to assess the prognosis value of echocardiographic and Doppler parameters of left ventricular (LV) function in horses with severe endotoxic shock. Twenty-one horses admitted to the clinic for colic with clinical signs of severe endotoxic shock underwent Doppler echocardiographic examination. LV echocardiographic and Doppler parameters were compared between the survivors (n=6) and the non-survivors (n=15) horses using a multivariable ANOVA analysis. The pre-ejection period to ejection time ratio (PEP/ET) of the Doppler aortic flow was significantly higher in the non-survivors than in the survivors group. All other measured parameters (including heart rate and end-diastolic-volume) were not significantly different between the groups. Doppler parameters of left ventricular function are subject to high variability and low repeatability in horses. This might explain that most variables were not significantly different between the two groups. Moreover, the number of investigated horses was limited, especially in the survivors group. However, with comparable HR and LV preload, a higher PEP/ET suggested a more compromised systolic dysfunction in the non-survivors. PEP/ET is often considered to be one of the best indicators of systolic function in horses and its measurement might therefore be useful in indicating the need for inotropic support in the management of horses with endotoxic shock. [less ▲]

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See detailDoppler Echocardiographic follow up of three horses with congestive heart failure and treated with quinapril, digoxin, and diuretics
Leroux, Aurélia ULg; Sandersen, Charlotte ULg; Borde, Laura ULg et al

Poster (2011, February)

Angiotensin converting enzyme inhibitors are recommended therapy in human and canine patients with congestive heart failure (CHF), but little is known concerning their efficiency to treat horses with CHF ... [more ▼]

Angiotensin converting enzyme inhibitors are recommended therapy in human and canine patients with congestive heart failure (CHF), but little is known concerning their efficiency to treat horses with CHF. Enalapril has been shown to be poorly absorbed in horses and quinapril has been shown to decrease the severity of the insufficiency and to increase the stroke volume (SV) and the cardiac output (CO) in horses with mitral regurgitation (MR) without signs of CHF. The objective of this cases report was to evaluate the effect of quinapril associated with routine treatment in horses with CHF. Three horses with clinical, echocardiographic and electrocardiographic signs of severe MR, CHF and secondary atrial fibrillation were studied (Fig 1 to 3). None of them had been previously treated for those problems. According to the ACVIM classification system for management of canine CHF, they were therefore classified in class C. They were treated with quinapril 0.2mg/kg SID PO, digoxin 0.011mg/kg BID PO, and furosemide 1mg/kg BID IM. Standard echocardiographic and Doppler measurements were performed before treatment (T0), and 1 and 4 weeks after starting treatment (W1 and W4, respectively). All horses showed a transient clinical improvement (decrease of edemas and disappearance of the dyspnea) after 1 week of treatment, but clinical signs deteriorated within the following weeks in 2 horses that were euthanized for ethical reasons. The third horse kept a steady clinical status and was discharged with the treatment pursued at home. Evolution (in %) of main echocardiographic parameters at W1 and W4 compared to T0 values are showed in Table1. Large individual variations in response to the treatment were seen. Nevertheless, in all horses, a decrease of the Heart Rate (HR) was observed after 1 week of treatment, but the HR increased again after 1 month of treatment (Fig 4). On the contrary, no increase in SV or CO, and no decrease in LVIDd were seen in response to treatment (Fig 5). In the 2 horses that were euthanized, the fractional shortening (FS) and the pre-ejection to ejection time ratio (PEP/ET) decreased and the mitral E peak velocity increased with treatment, whereas they followed the opposite evolution in the surviving horse. No conclusion can be drawn from this study because of the limited number of studied cases. However, it would be interesting to extend it to additional cases and to less severely affected cases (i.e. horses classified in class C after initial treatment or class B horses). Negative chronotropic effect of digoxin was suggested after 1 week of treatment since a decrease of the HR was observed in all horses. However, this effect seemed to decrease after 1 month of treatment. Those preliminary results of echocardiography suggest that quinapril in association with digoxin and furosemide at the used dosage could be inefficient to reduce the left ventricular filling pressure and to improve the myocardial contractility in horses with severe CHF. This could however be due to the fact that the 3 studied horses were cases refractory to classic treatment (thus to be classified in class D). [less ▲]

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See detailRespiratory pathologies in foals
Frizot, Myriam; Amory, Hélène ULg; Borde, Laura ULg et al

Poster (2011, January 22)

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See detailCas de pneumonie interstitielle référés à l’université de Liège
Borde, Laura ULg; Araújo Pequito, Manuel; Molitor, Céline et al

in Pratique Vétérinaire Equine (2011), 43(171), 1-10

La pneumonie interstitielle est une maladie rare chez le cheval adulte. Une étude rétrospective propose de revenir sur 9 cas référés entre 1998 et 2009.

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See detailEchocardiographic assessment of left ventricular systolic function in colic horses
Borde, Laura ULg; Amory, Hélène ULg; Leroux, Aurélia ULg et al

in Journal of Equine Veterinary Science (2011), 31(8), 481-487

Background: Echocardiography has not been reported to study hemodynamic disturbances in colic horses. Objectives: To non invasively assess the impact of colic-related endotoxin shock on equine cardiac ... [more ▼]

Background: Echocardiography has not been reported to study hemodynamic disturbances in colic horses. Objectives: To non invasively assess the impact of colic-related endotoxin shock on equine cardiac function. Animals: Fifty horses admitted in clinic on emergency for colic. Methods: A shock score from 1 to 4 was established for each horse based on clinical evaluation, non invasive systolic blood pressure and blood tests measurements. Left ventricular echocardiographic and Doppler parameters were compared between the 4 groups according to the shock score (1 = no or discrete signs of shock, n=11; 2 = mild shock, n=17; 3 = moderate shock, n=12; 4 = severe shock, n=10) using a multivariable analysis. Horses with a score shock of 1 were considered as control. Significance was set at P < 0.05. Results: The stroke volume, stroke index, ejection time, ejection time index corrected for heart rate, aortic velocity time integral, aortic flow acceleration time and aortic flow deceleration time were significantly lower whereas acceleration rate of aortic flow ejection and heart rate were significantly higher in shocked horses than in controls. Cardiac output was not significantly different between groups. Conclusions and Clinical importance: Even if those results are difficult to interpret because of the shock-induced changes in loading conditions of the heart, they suggest that alterations in some indicators of systolic function can be quantified by Doppler echocardiography in horses with colic-induced endotoxemic shock. Ultrasonographic monitoring of cardiovascular function could thus be of interest in equine intensive care. [less ▲]

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See detailMyocardial depression as a component of endotoxic shock in horses: preliminary results of an echocardiographic study
Borde, Laura ULg; Amory, Hélène ULg; Leroux, Aurélia ULg et al

Conference (2010, October 16)

Cardiovascular consequences of septic shock are well described in humans but these hemodynamic disturbances have not yet been studied in endotoxic horses. The endotoxins act directly and indirectly to ... [more ▼]

Cardiovascular consequences of septic shock are well described in humans but these hemodynamic disturbances have not yet been studied in endotoxic horses. The endotoxins act directly and indirectly to cause a myocardial depression associated with a systemic hypotension responsible for a fall of both the cardiac output and the systemic vascular resistance in end-stage endotoxic shock. The hypothesis was that myocardial depression was a component of endotoxic shock in horses. In this way, fifty horses admitted in clinic with signs of endotoxic shock and 17 healthy control horses were submitted to a doppler echocardiographic exam to assess the impact of endotoxic shock on equine cardiac function. A shock score from 1 to 4, based on clinical evaluation, non invasive systolic blood pressure, and blood tests was attributed to each endotoxic horse. Echocardiographic and Doppler parameters were compared between the 5 groups using a multivariable ANOVA analysis. Score 1, 2, 3 and 4 groups included 11, 17, 12 and 10 horses, respectively. Some markers of systolic function included the ejection time (ET), ET corrected for HR and mean velocity of circumferential fibre shortening corrected for HR, the aortic velocity time integral and deceleration time, and the stroke volume were significantly lower, whereas the HR and the peak velocity of the late diastolic filling of the mitral Doppler flow and its velocity time integral were significantly higher in endotoxemic horses than in controls. Thanks to an increase in HR, the cardiac output was not significantly different between groups. Even if the tachycardia, the fall in preload and a probable decrease in afterload doubtless influence the observed changes, the results of this study suggest that a myocardial depression with both an impaired systolic and diastolic left ventricular function could be a component of endotoxic shock in horses. [less ▲]

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Peer Reviewed
See detailProspective study of hemodynamic disorders mesured by echocardiography and associated with endotoxemia in horses
Borde, Laura ULg; Amory, Hélène ULg; Leroux, Aurélia ULg et al

Conference (2010, September 11)

Endotoxemia is the first mortality cause in intensive care horses. In human, hemodynamic disturbances have been showed to be associated with septic shock whereas in horses, this facet of endotoxemia has ... [more ▼]

Endotoxemia is the first mortality cause in intensive care horses. In human, hemodynamic disturbances have been showed to be associated with septic shock whereas in horses, this facet of endotoxemia has not yet been studied. The aim of the study was to assess the impact of endotoxin shock on equine cardiac function. Fifty horses admitted in clinic with signs of endotoxic shock and 17 healthy control horses were submitted to a doppler echocardiographic exam. The endotoxemic horses were classified in 4 groups according to their shock score based on clinical evaluation (heart rate (HR) and respiratory rate), non invasive systolic blood pressure, and blood tests (Packed cell volume and lactates). Score 1, 2, 3 and 4 groups included 11, 17, 12 and 10 horses, respectively. Left ventricular (LV) echocardiographic and Doppler parameters were compared between the 5 groups using a multivariable ANOVA analysis. The LV internal diameter, ejection time, ejection time corrected for HR and mean velocity of circumferential fiber shortening corrected for HR, the aortic velocity time integral and deceleration time, and the stroke volume were significantly lower, whereas the HR and the peak velocity of the late diastolic filling of the mitral Doppler flow and its velocity time integral were significantly higher in grade 2 to 4 endotoxemic horses than in control horses. Because of the tachycardia compensating the lower stroke volume in endotoxemic horses, the cardiac output was not significantly different between groups. Despite the fact that the increase in HR, the fall in preload and a probable decrease in afterload doubtless played a role in the observed changes, the results of this study suggest an impaired systolic and diastolic LV function in horses with moderate to severe endotoxemia. Doppler echocardiographic monitoring of the cardiovascular function could thus be of interest in equine intensive care. [less ▲]

Detailed reference viewed: 48 (6 ULg)
Peer Reviewed
See detailA comparison between pulse contour analysis and Doppler echocardiographic measurements of cardiac output in awake horses
Guidi, E; Amory, Hélène ULg; Borde, Laura ULg et al

in In Proceedings of the 3rd Annual Congress of the European College of Equine Internal Medicine (ECEIM) (2009)

Detailed reference viewed: 5 (3 ULg)