Cardiac extracellular volume fraction in cats with preclinical hypertrophic cardiomyopathy

Fries, Ryan; Kadotani, Saki; Keating, Stephanie; Stack, J.

doi:10.1111/jvim.16067

Cited by 14 publications

(14 citation statements)

References 44 publications

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“… 19 A more recent study that utilized gadolinium to calculate extracellular volume fraction, an indirect measure of myocardial fibrosis, showed that cats with HCM had an increase in this variable, presumably due to myocardial fibrosis. 20 This presumption was strengthened by the fact that this variable correlated well with echocardiographic measures of diastolic dysfunction.…”

Section: Pathophysiologymentioning

confidence: 99%

The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy

Kittleson

Côté

2021

Journal of Feline Medicine and Surgery

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Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline cardiomyopathy observed clinically and may affect up to approximately 15% of the domestic cat population, primarily as a subclinical disease. Fortunately, severe HCM, leading to heart failure or arterial thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any breed, can be affected. A higher prevalence in male and domestic shorthair cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound. Substantial left atrial enlargement can often be identified radiographically in cats with severe HCM. Biomarkers should not be relied on solely to diagnose the disease. While severe feline HCM can usually be diagnosed via echocardiography alone, feline HCM with mild to moderate left ventricular (LV) wall thickening is a diagnosis of exclusion, which means there is no definitive test for HCM in these cats and so other disorders that can cause mild to moderate LV wall thickening (eg, hyperthyroidism, systemic hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is suspected in another, for most cats the cause is unknown. Systolic anterior motion of the mitral valve (SAM) is the most common cause of dynamic left ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common cause of a heart murmur with feline HCM. While severe DLVOTO is probably clinically significant and so should be treated, lesser degrees probably are not. Furthermore, since SAM can likely be induced in most cats with HCM, the distinction between HCM without obstruction and HCM with obstruction (HOCM) is of limited importance in cats. Diastolic dysfunction, and its consequences of abnormally increased atrial pressure leading to signs of heart failure, and sluggish atrial blood flow leading to ATE, is the primary abnormality that causes clinical signs and death in affected cats. Treatment (eg, loop diuretics) is aimed at controlling heart failure. Preventive treatment (eg, antithrombotic drugs) is aimed at reducing the risk of complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or near-normal life despite this disease. However, a substantial minority of cats develop overt clinical signs referable to heart failure or ATE that require treatment. For most cats with clinical signs caused by HCM, the long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few breeds, but, despite valiant efforts, the cause of HCM in the vast majority of cats remains unknown. No treatment currently exists that reverses or even slows the cardiomyopathic process in HCM, again despite valiant efforts. The search goes on.

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Section: Pathophysiologymentioning

confidence: 99%

The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy

Kittleson

Côté

2021

Journal of Feline Medicine and Surgery

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“…It has been speculated in humans that LA dysfunction might reflect early myocardial fibrosis, 30,40 which could be a marker for early HCM 40 . A recent study showed that LAFS% in cats with subclinical HCM was correlated with LV extracellular volume, a measure of interstitial fibrosis, but not with LVWT 41 . Abnormal collagen metabolism has been also suggested in Ragdoll cats carrying MYBPC3 R820W mutation without LVH, 42 and interstitial fibrosis has been described on histopathology in cats diagnosed antemortem with mild subclinical HCM 43 .…”

Section: Discussionmentioning

confidence: 99%

“…40 A recent study showed that LAFS% in cats with subclinical HCM was correlated with LV extracellular volume, a measure of interstitial fibrosis, but not with LVWT. 41 Abnormal collagen metabolism has been also suggested in Ragdoll cats carrying MYBPC3 R820W mutation without LVH, 42 and interstitial fibrosis has been described on histopathology in cats diagnosed antemortem with mild subclinical HCM. 43 Thus, our findings of LA dysfunction might, as in humans, reflect abnormal myocardial properties that precede overt HCM.…”

Section: Discussionmentioning

confidence: 99%

Natural history of hypertrophic cardiomyopathy in cats from rehoming centers: TheCatScan IIstudy

Matos

Payne

Seo

et al. 2022

Veterinary Internal Medicne

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Background The natural history of hypertrophic cardiomyopathy (HCM) in cats has been mainly studied in cats referred for suspected heart disease, which can skew the results towards cats with clinical signs. Few data are available on factors associated with development of HCM in cats. Hypotheses (1) Clinical variables can predict which cats will develop HCM; (2) HCM in cats not referred for suspected heart disease is associated with a low rate of cardiovascular events. Animals One hundred seven cats from rehoming centers without a history of clinical signs of cardiac or systemic disease at the time of adoption. Methods Prospective longitudinal study. After rehoming, shelter cats were reexamined for serial echocardiograms. Cox regression analysis was used to identify predictors of development of HCM in cats that were normal at baseline. Adverse cardiovascular events including heart failure, thromboembolism, or sudden death were recorded. Results Cats were monitored for a median of 5.6 [1.2‐9.2] years. At baseline, 68/107 cats were normal, 18/107 were equivocal and 21/107 had HCM. Nineteen cats developed HCM during the study period. The factors at baseline associated with increased hazard of developing HCM were lower left atrial fractional shortening, higher left ventricular fractional shortening, and higher body weight. Cardiovascular events were observed in 21% of cats with HCM. Conclusions and Clinical Importance Cardiovascular events were common in cats with HCM from a rehoming center study sample. Lower left atrial systolic function appears to precede overt HCM.

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“…Similarly in cats, reduction in MAPSE is associated with a worse prognosis 6 and cats with HCM have a reduced GLS, suggesting reduced overall longitudinal systolic function. 11,28 In humans, displacement of the aortic root is used to assess longitudinal systolic function. This is referred to as systolic aortic root motion (SARM), aortic root systolic excursion (ARSE) and anterior aortic plane systolic excursion (AAPSE).…”

Section: Discussionmentioning

confidence: 99%

Aortic annular plane systolic excursion in cats with hypertrophic cardiomyopathy

Dutton,

Spalla,

Seo

et al. 2023

Veterinary Internal Medicne

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BackgroundImpairment of left ventricular (LV) longitudinal function is an early marker of systolic dysfunction in hypertrophic cardiomyopathy (HCM). Aortic annular plane systolic excursion (AAPSE) is a measure of LV longitudinal function in people that has not been evaluated in cats.HypothesisAortic annular plane systolic excursion is lower in cats with HCM compared to control cats, and cats in stage C have the lowest AAPSE.AnimalsOne hundred seventy‐five cats: 60 normal, 61 HCM stage B and 54 HCM stage C cats.MaterialsMulticenter retrospective case‐control study. Electronic medical records from 4 referral hospitals were reviewed for cats diagnosed with HCM and normal cats. HCM was defined as LV wall thickness ≥6 mm and normal cats ≤5 mm. M‐mode bisecting the aorta in right parasternal short‐axis view was used to measure AAPSE.ResultsAortic annular plane systolic excursion was lower in HCM cats compared to normal cats (3.9 ± 0.9 mm versus 4.6 ± 0.9 mm, P < .001) and was lowest in HCM stage C (2.4 ± 0.6 mm, P < .001). An AAPSE <2.9 mm gave a sensitivity of 83% (95% CI 71%‐91%) and specificity of 92% (95% CI 82%‐97%) to differentiate HCM stage C from stage B. AAPSE correlated with mitral annular plane systolic excursion (r = .6 [.4‐.7], P < .001), and atrial fractional shortening (r = .6 [.5‐.7], P < .001), but showed no correlation with LV fractional shortening.Conclusions and Clinical ImportanceAortic annular plane systolic excursion is an easily acquired echocardiographic variable and might be a new measurement of LV systolic performance in cats with HCM.

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Cardiac extracellular volume fraction in cats with preclinical hypertrophic cardiomyopathy

Cited by 14 publications

References 44 publications

The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy

The Feline Cardiomyopathies: 2. Hypertrophic cardiomyopathy

Natural history of hypertrophic cardiomyopathy in cats from rehoming centers: TheCatScan IIstudy

Aortic annular plane systolic excursion in cats with hypertrophic cardiomyopathy

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