BackgroundRight ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH).Hypothesis/ObjectivesTo assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right‐sided congestive heart failure (R‐CHF).Animals89 dogs with PH and 74 healthy dogs.MethodsProspective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end‐diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively).ResultsRVEDA index was higher in dogs with moderate PH (10.8 cm2/m2; range, 6.2‐14.4 cm2/m2) and severe PH (12.4 cm2/m2; range, 7.7‐21.4 cm2/m2) than in those with mild PH (8.4 cm2/m2; range, 4.8‐11.6 cm2/m2) and control dogs (8.5 cm2/m2; range, 2.8‐11.6 cm2/m2; P < .001). RVEDA index was significantly higher in dogs with R‐CHF (13.7 cm2/m2; range, 11.0‐21.4 cm2/m2) than in dogs without R‐CHF (9.4 cm2/m2; range, 4.8‐17.1 cm2/m2; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R‐CHF.Conclusions and Clinical ImportanceThe RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R‐CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.
A good diagnostic accuracy of smartphone-based electrocardiography in the evaluation of heart rate, heart rhythm and ECG measurements has been reported in humans, dogs and cats. The aim of this study was to assess the feasibility of smartphone-based electrocardiography in horses. Fifty healthy adult horses were enrolled. Standard base-apex ECG and smartphone ECG were simultaneously recorded in each horse. All ECGs were reviewed by one blinded operator, who judged whether tracings were acceptable for interpretation and performed electrocardiographic measurements. Agreement between smartphone and standard base-apex ECG in the analysis of tracings was evaluated. Smartphone ECG tracings were interpretable in 48/50 (96%) cases. A perfect agreement between smartphone and standard ECG tracings was found in the assessment of heart rate. Heart rate automatically measured by the smartphone application was not reliable. In terms of electrocardiographic waves and interval duration, minimal differences of no clinical value were found between smartphone and standard ECG. Agreement was found for QRS complex polarity evaluation, but not for P wave polarity. Baseline artefacts were rare but significantly higher in the smartphone ECG tracings compared to standard ECG. The smartphone ECG can record single-lead ECG tracings of an adequate quality for interpretation in horses. The smartphone ECG could represent an additional tool for the electrocardiographic evaluation of horses, but is not a substitute for the standard base-apex ECG.
The diagnostic accuracy of a smartphone electrocardiograph (ECG) in evaluating heart rhythm and ECG measurements was evaluated in 166 dogs. A standard 6-lead ECG was acquired for 1 min in each dog. A smartphone ECG tracing was simultaneously recorded using a single-lead bipolar ECG recorder. All ECGs were reviewed by one blinded operator, who judged if tracings were acceptable for interpretation and assigned an electrocardiographic diagnosis. Agreement between smartphone and standard ECG in the interpretation of tracings was evaluated. Sensitivity and specificity for the detection of arrhythmia were calculated for the smartphone ECG. Smartphone ECG tracings were interpretable in 162/166 (97.6%) tracings. A perfect agreement between the smartphone and standard ECG was found in detecting bradycardia, tachycardia, ectopic beats and atrioventricular blocks. A very good agreement was found in detecting sinus rhythm versus non-sinus rhythm (100% sensitivity and 97.9% specificity). The smartphone ECG provided tracings that were adequate for analysis in most dogs, with an accurate assessment of heart rate, rhythm and common arrhythmias. The smartphone ECG represents an additional tool in the diagnosis of arrhythmias in dogs, but is not a substitute for a 6-lead ECG. Arrhythmias identified by the smartphone ECG should be followed up with a standard ECG before making clinical decisions. The study was not supported by a grant. Abbreviations: HR, heart rate; App HR, heart rate automatically measured by the 19 smartphone application; AVB, atrioventricular block; QTc, corrected QT interval. evaluating heart rhythm and ECG measurements in dogs. 24Design-Prospective, multicenter, single-blind study. 25Animals-166 client-owned dogs. 26Procedures-A standard 6-lead ECG was acquired for 1 minute in each dog. A smartphone 27 ECG tracing was simultaneously recorded using a single-lead bipolar ECG recorder. All was found in detecting arrhythmias, with a 100% sensitivity and 97.9% specificity. 36Conclusions and clinical relevance-The smartphone ECG provides tracings that are 37 adequate for analysis in most dogs with a reliable assessment of heart rate, heart rhythm,
Background There is good diagnostic accuracy of smartphone‐based ECG in the evaluation of heart rate (HR), heart rhythm, and ECG values for humans, horses, dogs, and cats. Objectives Assess feasibility and reliability of a smartphone ECG device to evaluate HR expressed as beats per minute and ECG values in cows. Animals Fifty‐five healthy Holstein Friesian cows. Methods Prospective observational study. A standard base‐apex ECG was acquired for 60 seconds in each cow. A smartphone ECG tracing was recorded simultaneously using a single‐lead bipolar ECG recorder. All ECGs were reviewed by 1 blinded investigator. The following ECG variables were assessed: HR, P wave duration, PR interval, QRS complex and QT interval (milliseconds), P wave, and QRS complex polarity. Agreement between standard and smartphone ECG was evaluated by Cohen's k test and the Bland‐Altman test. Results Smartphone ECG tracings were interpretable in 89% of the recordings. Minimal differences of no clinical relevance were found between standard and smartphone ECG tracings regarding HR and duration of ECG waves and interval. Good agreement found in the evaluation of QRS complex polarity (85%) but not for P wave polarity (k = 0.006). Artifacts were rare but of significantly higher frequency in smartphone ECG compared to standard ECG tracings (22% versus 0%; P = .005). Conclusions and Clinical Importance Good quality single‐lead ECG tracings can be recorded by smartphone device in healthy cows. Smartphone tracings are reliable for evaluation of HR and selective ECG variables. Smartphone ECG can represent an additional tool for ECG screening in cows.
Although echocardiography is the gold standard for the diagnosis of cardio-structural disease, thoracic radiography is a rapid, cost-effective, and widely accessible method for evaluating cardiac size in dogs. The vertebral heart score (VHS) and the vertebral left atrial size (VLAS) are established as objective measures of cardiomegaly on thoracic radiographs. However, several studies have shown significant variations in the VHS among different breeds. The Chihuahua is predisposed to both congenital and acquired cardiac diseases. The aim of this prospective, single-center, cross sectional study was thus to evaluate the VHS and the VLAS in healthy adult Chihuahua dogs. A total of 30 Chihuahuas were included. The VHS values in our sample population of Chihuahuas were 10.0 ± 0.6 (95% range, 8.9-11.0). This was significantly greater than the canine reference value of 9.7 ± 0.5 established by Buchanan and Bücheler (P = .002). The VLAS of Chihuahuas in our study was 1.8 ± 0.2 (95% range, 1.3-2.1). This was significantly lower than the values previously reported by Malcolm et al (2.07 ± 0.25; P = .0004). The VHS and the VLAS were not influenced by sex, body weight, short or long hair, and body condition score in normal Chihuahuas. Our results indicated that breed-specific reference values for radiographic VHS and VLAS are needed. In Chihuahuas, the values found in this study can be used as a normal reference in order to help avoid overinterpretation of cardiomegaly in these dogs.
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