Murmurs and arrhythmias are commonly detected in equine athletes. Assessing the relevance of these cardiovascular abnormalities in the performance horse can be challenging. Determining the impact of a cardiovascular disorder on performance, life expectancy, horse and rider or driver safety relative to the owner's future expectations is paramount. A comprehensive assessment of the cardiovascular abnormality detected is essential to determine its severity and achieve these aims. This consensus statement presents a general approach to the assessment of cardiovascular abnormalities, followed by a discussion of the common murmurs and arrhythmias. The description, diagnosis, evaluation, and prognosis are considered for each cardiovascular abnormality. The recommendations presented herein are based on available literature and a consensus of the panelists. While the majority of horses with cardiovascular abnormalities have a useful performance life, periodic reexaminations are indicated for those with clinically relevant cardiovascular disease. Horses with pulmonary hypertension, CHF, or complex ventricular arrhythmias should not be ridden or driven.
Results suggest that age must be taken into account when interpreting results of echocardiography in young Standardbred racehorses because significant cardiac enlargement takes place with age and training. A larger heart was found in horses that were racing, and size of the heart was correlated with athletic performance of the horse.
How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was 0.7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow remained unchanged. Cardiac output was reduced by 30%, CVP decreased to -1 +/- 2 mmHg (P < 0.01), and jugular flow ceased as the jugular cross-sectional area increased to 3.2 +/- 0.6 cm(2) (P < 0.01), corresponding to accumulation of approximately 1.2 l of blood in the veins. When the head was raised, the jugular veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head is lowered, blood accumulates in the vein, affecting MAP.
The purpose of this study was to assess the intraobserver variation of various echocardiographic measures in standardbred trotters. Serial echocardiographic examinations were carried out on eight standardbred mares by one ultrasonographer for 5 separate days. During each examination, five nonconsecutive cardiac cycles (frames) were recorded and an average obtained for each individual measure. Various echocardiographic measures were obtained by use of two-dimensional (2-D), M-mode, color flow Doppler and pulsed wave Doppler echocardiography. The total variation in the echocardiographic measurements was split into three levels: the variation between horses, the day-to-day variation within individual horses, and finally the variation within horse on the same day of examination (intercardiac cycle variation). The intraclass correlation coefficient (ICC) was calculated for each measure. The ICC represents the variability of the measurements because of differences between the horses. In general the 2-D, M-mode and color flow Doppler measures had higher ICC values (ICC from 0.63 to 0.95) than the pulsed wave Doppler measures (ICC from 0.24 to 0.46), and the former measures were more repeatable than the pulsed wave measures. Exceptions to that were left ventricular free wall in diastole, the pulmonary artery in systole and the left ventricular mass, which all had low repeatability (ICC from 0.22 to 0.49). The results were used to calculate the relative differences that must be detected to diagnose a statistically significant change between two measurements in an individual horse. Differences from 4.2% to 21.8% must be achieved to document significant changes between serial measurements. A general tendency is that the color flow and pulsed wave Doppler measures require a larger relative difference (11.4-21.8%) between the measures to point out statistically significant cardiac changes than the 2-D and M-mode measures (4.2-13.9%).
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