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See detailAtrial Natriuretic Peptide in cardiac horses
Leroux, Aurélia ULg; Al-Haidar, Ali; Remy, Benoît ULg et al

in Voorjaarsdagen Proceedings (2014, April 17)

Background: Natriuretic peptides are cardiac biomarkers that have been shown to have high potential for diagnosis, prognosis, and guidance of treatment in human and small animal cardiology. However, their ... [more ▼]

Background: Natriuretic peptides are cardiac biomarkers that have been shown to have high potential for diagnosis, prognosis, and guidance of treatment in human and small animal cardiology. However, their diagnostic and prognosis value in the equine species has only been studied in a limited number of cases. Objective: To investigate the plasma atrial natriuretic peptide concentration (ANPPl) in a large group of horses with various degrees of valvular regurgitation (VR) and heart failure (HF). Animals: Ninety-one horses, admitted at the equine teaching hospital of the University of Liege, and with no, mild, moderate or severe VR and presenting various stages of HF, according to human and canine grading system (A: no VR, B1: asymptomatic VR without cardiac remodelling, B2: asymptomatic VR with cardiac remodelling, C: symptomatic VR). Methods: All horses underwent clinical and Doppler echocardiographic examination, which allowed determining the presence, nature, and severity of VR, and the HF stage. The ANPPl was measured using a commercially available human RIA test. The mean values of body weight, age, ANPPl and each echocardiographic parameter were compared between horses in stage A, B1, B2 or C of HF and between horses with no, mild, moderate or severe VR, using a one-way ANOVA test. Then, correlations between ANPPl and each echocardiographic parameter were assessed using a Pearson’s product-moment analysis. Results: Horses with severe and moderate VR had significantly higher ANPPl than horses with mild or no VR. ANPPl was significantly higher in horses at stage B2 and C of HF than horses at stage A and B1. Moreover, ANPPl was significantly correlated with most of the measured echocardiographic variables. This correlation was especially strong with the left atrial diameter and its percentage of dilation. Conclusions and Clinical Importance: Those results suggest that ANPPl in horses suffering from VR could have a high diagnostic value of HF, especially in horses with tricuspid or mitral insufficiency and with enlargement or dysfunction of the atria. [less ▲]

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See detailAtrial Natriuretic Peptide as an indicator of the severity of valvular regurgitation and heart failure in horses
Leroux, Aurélia ULg; Al Haidar, Ali; Remy, Benoît ULg et al

in Journal of Equine Veterinary Science (2014), in press

Natriuretic peptides are cardiac biomarkers, routinely used for diagnosis, prognosis, and guidance for treatment in human and small animal cardiology. However, their diagnostic and prognostic value in ... [more ▼]

Natriuretic peptides are cardiac biomarkers, routinely used for diagnosis, prognosis, and guidance for treatment in human and small animal cardiology. However, their diagnostic and prognostic value in horses has received little study. The aim of this study was to investigate the plasma atrial natriuretic concentration (ANPPl) in a large group of horses with various degrees of valvular regurgitation (VR) and congestive heart failure (CHF). Clinical examination and two-dimensional, time-motion mode and Doppler echocardiography were performed on 91 horses admitted to the Equine Teaching Hospital of Liege University, with either no, mild, moderate or severe VR and presenting various stages of CHF. ANPPl was measured using a commercially available human RIA test. Mean values of body weight, age, ANPPl and echocardiographic parameters were compared between horses with no, mild, moderate and severe VR and between horses in different CHF stages. Correlation and linear regression of ANPPl with each echocardiographic parameter and with the percentage of dilation of each of cardiac chambers were assessed. Horses with severe or moderate VR had significantly higher ANPPl than horses with mild or no VR. ANPPl was significantly higher in horses presenting CHF than in horses without CHF. ANPPl was significantly correlated with the left atrial diameter and its percentage of dilation. These results suggest a diagnostic value of ANPPl in horses with VR, especially with tricuspid or mitral insufficiency with dilation of the atria. [less ▲]

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See detailCarriage and acquisition rates of Clostridium difficile in hospitalized horses, including molecular characterization, multilocus sequence typing and antimicrobial susceptibility of bacterial isolates
Rodriguez Diaz, Cristina ULg; Taminiau, Bernard ULg; Brévers, Bastien et al

in Veterinary Microbiology (2014)

lostridium difficile has been identified as a significant agent of diarrhoea and enterocolitis in both foals and adult horses. Hospitalization, antibiotic therapy or changes in diet may contribute to the ... [more ▼]

lostridium difficile has been identified as a significant agent of diarrhoea and enterocolitis in both foals and adult horses. Hospitalization, antibiotic therapy or changes in diet may contribute to the development of C. difficile infection. Horses admitted to a care unit are therefore at greater risk of being colonized. The aim of this study was to investigate the carriage of C. difficile in hospitalized horses and the possible influence of some risk factors in colonization. During a seven-month period, faecal samples and data relating the clinical history of horses admitted to a veterinary teaching hospital were collected. C. difficile isolates were characterized through toxin profiles, cytotoxicity activity, PCR-ribotyping, antimicrobial resistance and multilocus sequence typing (MLST). Ten isolates were obtained with a total of seven different PCR-ribotypes, including PCR-ribotype 014. Five of them were identified as toxinogenic. A high resistance to gentamicin, clindamycin and ceftiofur was found. MLST revealed four different sequencing types (ST), which included ST11, ST26, ST2 and ST15, and phylogenetic analysis showed that most of the isolates clustered in the same lineage. Clinical history suggests that horses frequently harbour toxigenic and non-toxigenic C. difficile and that in most cases they are colonized regardless of the reason for hospitalization; the development of diarrhoea is more unusual. [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 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 detailL’insuffisance mitrale chez le cheval : revue de la littérature et comparaison avec la pathologie chez l’homme et chez le chien
Al Haidar, Ali; Leroux, Aurélia ULg; Amory, Hélène ULg

in Annales de Médecine Vétérinaire (2013), 157(1), 52-68

Abstract Mitral regurgitation (MR) is a one of the most common cardiac disease in the equine species. Furthermore, it is the valvular disease that presents the higher risk to be associated with reduced ... [more ▼]

Abstract Mitral regurgitation (MR) is a one of the most common cardiac disease in the equine species. Furthermore, it is the valvular disease that presents the higher risk to be associated with reduced athletic performance, to evolve into congestive heart failure and to become life threatening. The clinical diagnosis of MR depends mainly on the expertise of the veterinarian in cardiology and is above all based on cardiac auscultation. In all of the cases, the definitive diagnosis and the evaluation of the disease severity require performing a Doppler echocardiographic examination. Signs of left ventricular and/or left atrial overload, large regurgitation jet, pulmonary arterial hypertension or significant arrhythmias are negative prognosis factors. Clinical signs of congestive heart failure make the prognosis worse. Other echocardiographic parameters are used in human and dogs in order to determine the severity of the MR, but have been not validated in horses. Treatment of mitral regurgitation in the equine species is symptomatic and directed against the development of a congestive heart failure. A lot of drugs that are used in human or dogs are of limited value in horses for financial reasons and/or lack of pharmacokinetics and pharmacologic data in equine species. [less ▲]

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See detailIntérêt de l'épidémiologie et des modèles animaux expérimentaux dans l'étude des valvulopathies en cardiologie humaine et équine
Leroux, Aurélia ULg

Doctoral thesis (2013)

Valvular regurgitations are one of the most common causes of cardiac diseases in humans and in domestic animals. Clinical studies, epidemiological studies, and animal experimental models have been ... [more ▼]

Valvular regurgitations are one of the most common causes of cardiac diseases in humans and in domestic animals. Clinical studies, epidemiological studies, and animal experimental models have been developed to test new diagnostic and therapeutic techniques. Electrocardiography, Doppler echocardiography, angiography, magnetic resonance imaging (MRI) and computed tomography are currently used in clinical practice for diagnosis and prognosis. Medical management and, in humans, surgical treatments can increase life expectancy and improve quality of life of cardiac patients. In horses, cardiac clinical abnormalities including murmurs and arrhythmias are relatively common while the prevalence of clinically significant cardiac diseases is low. However, investigation of these with ECG and Doppler echocardiography is recommended as even mild cardiac abnormalities may lead to significant cardiac disease and cause poor performance in sport horses. To our knowledge, risk factors for several cardiac diseases have been suspected in equids. Few have been statistically demonstrated in a large equine population, since most studies about cardiac murmurs or arrhythmias concerned only racehorses. The first aim of this research work was to perform an epidemiological study in a large equine population to describe risk factors for various cardiac diseases. The prevalence of main cardiac diseases in the studied population was in accordance with previously described prevalence as mitral regurgitation (MR), atrial fibrillation (AF), aortic regurgitation (AR) and tricuspid regurgitation (TR) were the most frequently observed cardiac diseases. Various risk factors of these cardiac diseases were statistically demonstrated: Ageing and male gender appear to predispose to AR, TR appears to affect middle-aged patients, and AF was significantly more common in larger and heavier horses. Moreover MR was an important cardiac disease since it led to congestive heart failure (CHF) whereas AR was not a direct risk factor for CHF. Functional ischemic MR is one of the main human valvular diseases and is caused by ischemic cardiomyopathy with one or more prior myocardial infarctions involving most commonly the basal posterolateral myocardium of the left ventricle (LV). The therapeutic approach to functional MR is difficult and still controversy as regards the timing and the nature of the treatment. To our knowledge, no percutaneous large animal model of functional MR has been conceptualized. This model would be the first one to allow studying the dynamic component of functional MR. Therefore the second aim of this work was the development of an experimental animal model of functional ischemic MR. Goats appeared as good candidates for the model as they fulfill all requested conditions. They have a body and heart size comparable to that of humans and can be handled easily even during exercise tests. As few publications are available in this species, three first studies were designed to test the repeatability and to establish the reference values of measurements obtained using Two-Dimensional (2D), M-Mode, Pulsed-wave (PW) Doppler and 2D speckle tracking (2DST) echocardiography in unsedated standing adult goats. Standardized echocardiographic protocols were performed three times by the same observer at one day interval on 10 to 12 goats and the intra-observer inter-day repeatability and variability was calculated. 2D and M-Mode echocardiography showed a good inter-day repeatability and a low variability of the cardiac measurements, whereas PW Doppler measurements had a poor inter-day repeatability and a moderate variability. Caprine 2DST parameters demonstrated a poor but acceptable repeatability and a high variability and allowed determination of significant physiologic differences between measurements at rest and after exercise. Then the experimental model of functional ischemic mitral regurgitation induced by a percutaneous approach in goats was developed. This experimental study was conducted in two steps: first, the study of the goat coronary arteries anatomy to determine the best myocardial infarction location to induce ischemic MR in adult Saanen goats and, secondly, the development and the imaging characterization of the goat model of functional ischemic MR. The anatomic pattern of the coronary artery system of the goat was determined using casts made of auto polymerizing resin. Two coronary arteries branches were highlighted from the results of this anatomical study: the left marginal branch (LMB) and the posterior descending branch (PDB) of the left circumflex artery, which could supply the posterolateral wall of the LV. Then myocardial infarction was induced by microcoil embolization of LMB, PDB, or both, under fluoroscopic guidance. The results confirmed that LMB and PDB occlusion produced a large myocardial infarction and an immediate severe functional MR (n=3) unlike only LMB (n=2) or only PDB occlusion (n=2). Mortality rate of this model was high (56%), particularly when LMB and PDB were simultaneously occluded (87,5%). After the myocardial infarction, a complete follow-up was performed in each surviving goat using echocardiographic techniques previously described and MRI. 2DST techniques allowed quantifying LV dysfunction during acute ischemic MR. Quantification of functional MR was performed by Doppler techniques including measurements of the vena contracta width, the effective regurgitant orifice area and the regurgitant volume using the proximal isovelocity surface area method (PISA), and by 2D-echocardiographic technique analyzing the geometrical distortion of the mitral apparatus in mid-systole (tenting area and coaptation distance). Finally, MRI confirmed the location of myocardial ischemia and the presence of functional MR. These findings make this model an interesting alternative to study the pathophysiology of the functional ischemic MR, especially for its dynamic component yielding useful prognostic information. In conclusion, the two major aims of this research were met: the prevalence of various cardiac diseases and their risk factors in a large population of equids were described and an experimental model of functional ischemic mitral regurgitation induced by a percutaneous approach in goats was developed. This model of experimental ischemic MR could be useful to further study the pathophysiology of the functional ischemic MR, especially for its dynamic component and to maximize further treatment in problem patients. Our epidemiologic study confirmed that horses with cardiac murmurs or arrhythmias and presenting demonstrated risk factors, should routinely undergo ECG and Doppler echocardiography to diagnose and to evaluate the severity of any pathological cardiac abnormalities and to identify potential signs of evolution into CHF, including the presence of multiple cardiac diseases and enlargement of the cardiac chambers. [less ▲]

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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 detailRepeatability, variability and reference values of pulsed wave Doppler echocardiographic measurements in healthy Saanen goats.
Leroux, Aurélia ULg; Farnir, Frédéric ULg; Moonen, Marie ULg et al

in BMC Veterinary Research (2012), 8

Background Pulsed wave (PW) Doppler echocardiography has become a routine non invasive cardiac diagnostic tool in most species. However, evaluation of intracardiac blood flow requires reference values ... [more ▼]

Background Pulsed wave (PW) Doppler echocardiography has become a routine non invasive cardiac diagnostic tool in most species. However, evaluation of intracardiac blood flow requires reference values, which are poorly documented in goats. The aim of this study was to test the repeatability, the variability, and to establish the reference values of PW measurements in healthy adult Saanen goats. Using a standardised PW Doppler echocardiographic protocol, 10 healthy adult unsedated female Saanen goats were investigated three times at one day intervals by the same observer. Mitral, tricuspid, aortic and pulmonary flows were measured from a right parasternal view, and mitral and aortic flows were also measured from a left parasternal view. The difference between left and right side measurements and the intra-observer inter-day repeatability were tested and then the reference values of PW Doppler echocardiographic parameters in healthy adult female Saanen goats were established. Results As documented in other species, all caprine PW Doppler parameters demonstrated a poor inter-day repeatability and a moderate variability. Tricuspid and pulmonary flows were best evaluated on the right side whereas mitral and aortic flows were best obtained on the left side, and reference values are reported for healthy adult Saanen goats. Conclusions PW Doppler echocardiography allows the measurement of intracardiac blood flow indices in goats. The reference values establishment will help interpreting these indices of cardiac function in clinical cardiac cases and developing animal models for human cardiology research. [less ▲]

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See detailAnimal Models of Mitral Regurgitation Induced by Mitral Valve Chordae Tendineae Rupture.
Leroux, Aurélia ULg; Moonen, Marie ULg; Pierard, Luc ULg et al

in Journal of Heart Valve Disease (The) (2012), 21

Background – Mitral regurgitation (MR) is a common valvular disease throughout the world. Various diagnostic techniques have been developed to assess the causes and severity of MR, and the therapeutic ... [more ▼]

Background – Mitral regurgitation (MR) is a common valvular disease throughout the world. Various diagnostic techniques have been developed to assess the causes and severity of MR, and the therapeutic approaches to this disease have been widely documented. However, treatments for chronic MR remain controversial, and various animal models of chronic MR (including chordae tendineae rupture, rapid pacing and ischemia) have been developed to study the pathophysiology and therapeutic approaches to this disease. The objective of this paper is to review the animal MR models that have been developed using a mitral valve chordae tendineae rupture technique. Animal models – Dogs and sheep have been the animals most commonly used in MR models induced by mitral valve chordae tendineae rupture, mainly due to considerations of cardiac size. Chordae tendineae cutting is performed using closed or open chest techniques. In the closed chest model, long flexible grasping forceps are positioned percutaneously in order to tear the mitral valve chordae. In the open chest model, cardiopulmonary bypass is performed and either selected chordae are cut under direct visualization, or a non specified number of chordae are cut using a metal device inserted through the left ventricular apex. Whatever the model used, MR has been found to become chronic 3 to 6 months after the induction of MR by chordae rupture. The reported mortality and complication rates of these models are high. Conclusion – In the long term, experimental evolution of chronic MR is similar to the evolution occurring naturally in patients suffering from chronic MR. These models could thus be useful in understanding the disease better and in testing new therapeutic modalities. This review summarizes the physiological effects of each of these techniques and compares the advantages and disadvantages of each procedure. [less ▲]

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See detailTwo-dimensional and M-mode echocardiographic reference values in healthy adult Saanen goats
Leroux, Aurélia ULg; Moonen, Marie ULg; Farnir, Frédéric ULg et al

in Veterinary Record : Journal of the British Veterinary Association (2012), 170(6), 154

Echocardiography has become a routine non invasive cardiac diagnostic tool in most species. Accurate measurement of cardiac dimensions requires reference values, which are poorly documented in goats. The ... [more ▼]

Echocardiography has become a routine non invasive cardiac diagnostic tool in most species. Accurate measurement of cardiac dimensions requires reference values, which are poorly documented in goats. The aim of this study was to test the inter-day repeatability and to establish the reference values of two-dimensional (2D-) and time-motion (M-) mode echocardiographic variables in healthy adult Saanen goats. Six goats were investigated three times by the same observer at one day interval using a standardized 2D- and M-mode echocardiographic protocol. The intra-observer inter-day repeatability was tested using analysis of variance, calculation of the coefficient of variation and confidence intervals. A single echocardiographic examination was performed in 6 other goats, and values obtained in the 12 goats were used to establish the 2D- and M-mode echocardiographic reference values in healthy adult female Saanen goats. Statistical analysis revealed a good inter-day repeatability of the echocardiographic cardiac measurements. Echocardiographic reference values obtained in healthy adult Saanen goats seemed slightly higher than those reported in healthy Swedish domestic goats and were similar to those reported in healthy adult sheep. [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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Peer Reviewed
See detailTwo-Dimensional, M-Mode and Pulsed Wave Doppler Echocardiographic Reference Values in Healthy Adult Saanen Goats
Leroux, Aurélia ULg; Moonen, Marie ULg; Farnir, Frédéric ULg et al

Poster (2011, March 18)

Echocardiography has become a routine non invasive cardiac diagnostic tool in most species. Accurate measurement of cardiac dimensions requires reference values, which are poorly documented in goats ... [more ▼]

Echocardiography has become a routine non invasive cardiac diagnostic tool in most species. Accurate measurement of cardiac dimensions requires reference values, which are poorly documented in goats. Goats are animals easy to handle with a body and heart size comparable to humans’. This makes goats an attractive candidate for the development of animal models for human cardiology research. The aim of this study was to test the repeatability and to establish the reference values of bi-dimensional (2D-), time-motion (M-) mode and pulsed wave (PW) Doppler echocardiographic variables in adult goats. Six healthy female adult Saanen goats were investigated three times by the same observer at one day interval using a standardized 2D-, M-mode and PW Doppler echocardiographic protocol. Calculation of the coefficient of variation for each variable measured within day and depending on the day allowed to evaluate their degree of variability. A single echocardiographic examination was performed in 6 other goats by the same observer, and the obtained values were added to these obtained on the third day of the 6 first goats. Then the observed mean, the standard deviation and the range of these measurements were calculated to establish the reference values of echocardiographic parameters in unsedated adult healthy female Saanen goats. Statistical analysis revealed a good inter-day repeatability of the 2D- and M-mode echocardiographic cardiac measurements, but PW Doppler parameters presented moderate to high variability, as documented in other species. Echocardiographic reference values obtained in healthy adult Saanen goats were similar to those reported in healthy adult sheep and in healthy adult humans. [less ▲]

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Peer Reviewed
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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