BackgroundThe assessment of left atrial (LA) function by 2‐dimensional speckle tracking echocardiography (STE) holds important clinical implications in human medicine. Few similar data are available in dogs.ObjectivesTo assess LA function by STE in dogs with and without myxomatous mitral valve disease (MMVD), analyzing LA areas, systolic function, and strain.AnimalsOne hundred and fifty dogs were divided according to the American College of Veterinary Internal Medicine classification of heart failure: 23 dogs in class A, 52 in class B1, 36 in class B2, and 39 in class C + D.MethodsProspective observational study. Conventional morphologic and Doppler variables, LA areas, and STE‐based LA strain analysis were performed in all dogs and results were compared among groups. Correlation analysis was carried out between LA STE variables and other echocardiographic variables.ResultsVariability study showed good reproducibility for all the tested variables (coefficient of variation <16%). Left atrial areas, fractional area change, peak atrial longitudinal strain (PALS), peak atrial contraction strain, and contraction strain index (CSI) differed significantly between groups B2 and C + D and all the other groups (overall P < .001), whereas only PALS differed between groups B1 and A (P = .01). Left atrial areas increased with progression of the disease, whereas LA functional parameters decreased. Only CSI increased nonsignificantly from group A to group B1 and then progressively decreased. Thirty‐one significant correlations (P < .001, r > .3) were found between conventional left heart echocardiographic variables and LA areas and strain variables.Conclusions and Clinical ImportanceLeft atrial STE analysis provides useful information on atrial function in the dog, highlighting a progressive decline in atrial function with worsening of MMVD.
BackgroundThe prognostic relevance of left atrial (LA) morphological and functional variables, including those derived from speckle tracking echocardiography (STE), has been little investigated in veterinary medicine.ObjectivesTo assess the prognostic value of several echocardiographic variables, with a focus on LA morphological and functional variables in dogs with myxomatous mitral valve disease (MMVD).AnimalsOne‐hundred and fifteen dogs of different breeds with MMVD.MethodsProspective cohort study. Conventional morphologic and echo‐Doppler variables, LA areas and volumes, and STE‐based LA strain analysis were performed in all dogs. A survival analysis was performed to test for the best echocardiographic predictors of cardiac‐related death.ResultsMost of the tested variables, including all LA STE‐derived variables were univariate predictors of cardiac death in Cox proportional hazard analysis. Because of strong correlation between many variables, only left atrium to aorta ratio (LA/Ao > 1.7), mitral valve E wave velocity (MV E vel > 1.3 m/s), LA maximal volume (LAVmax > 3.53 mL/kg), peak atrial longitudinal strain (PALS < 30%), and contraction strain index (CSI per 1% increase) were entered in the univariate analysis, and all were predictors of cardiac death. However, only the MV E vel (hazard ratio [HR], 4.45; confidence interval [CI], 1.76‐11.24; P < .001) and LAVmax (HR, 2.32; CI, 1.10‐4.89; P = .024) remained statistically significant in the multivariable analysis.Conclusions and Clinical ImportanceThe assessment of LA dimension and function provides useful prognostic information in dogs with MMVD. Considering all the LA variables, LAVmax appears the strongest predictor of cardiac death, being superior to LA/Ao and STE‐derived variables.
Normal features of the ST segment are poorly characterised in dogs. This study aimed to describe ST segment characteristics in a population of healthy dogs.Materials and MethOds: Medical records were reviewed to identify healthy dogs that underwent an electrocardiogram. Several ST segment qualitative parameters were evaluated: presence/absence of deviation, type of deviation (depression/elevation) and morphological patterns of depression (horizontal, downsloping, upsloping and sagging) and elevation (horizontal, concave and convex). Moreover, the amplitude of ST segment depression/elevation was measured. The potential effect of sex, bodyweight, age and somatotype on the presence/absence of ST segment deviation was evaluated through binary logistic regression.results: One hundred and eighty dogs were enrolled. The deviation was evident in 43 of 180 dogs (23.9%), among which 36 showed depression and seven showed elevation. The median depression amplitude was 0.1 (range 0.05 to 0.3) mV. The mean elevation amplitude was 0.136 ±0.055 mV. Concerning depression morphology, the horizontal pattern was overrepresented, followed by the downsloping and upsloping ones.Concerning elevation morphology, all dogs showed a concave pattern. No meaningful effect of sex, bodyweight, age and somatotype on the presence/absence of ST segment deviation was documented. clinical significance: Normal features of canine ST segment were described and made available for clinical use.
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