Effect of breed, sex, age and body weight on Echocardiographic Measurements in the Equine Species

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 ▲]

Relationship between echocardiographic measurements and body size in horses.

in Journal of Equine Veterinary Science (2012)

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 ▲]

Etude rétrospective de 12 cas de défaut du septum interventriculaire chez le cheval

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 ▲]

Doppler Echocardiographic follow up of three horses with congestive heart failure and treated with quinapril, digoxin, and diuretics

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 ▲]

Cas de pneumonie interstitielle référés à l’université de Liège

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.

Myocardial depression as a component of endotoxic shock in horses: preliminary results of an echocardiographic study

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 ▲]

A retrospective study of Doppler echocardiographic findings in horses referred in a Belgian equine clinic.

Poster (2010, September)

A comparison between pulse contour analysis and Doppler echocardiographic measurements of cardiac output in awake horses

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

Cardiac output measurement by pulse contour analysis, lithium dilution and Doppler echocardiography in horses

in Proccedings of the Xth WCVA (2009)