Diagnostic performance of P wave duration in the identification of left atrial enlargement in dogs

Savarino, Paolo; Borgarelli, Michele; Tarducci, Alberto; Crosara, S.; Bello, Nora M.; Margiocco, Marco L.

doi:10.1111/j.1748-5827.2012.01200.x

Cited by 17 publications

(19 citation statements)

References 26 publications

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“…To the authors’ knowledge, this is the first study investigating the diagnostic performance of P wave-related measurements, measured using an image manipulation software, to detect LAE in dogs with DMVD. In a previous report [ 26 ] the diagnostic accuracy of ECG, was analyzed measuring a single wave parameter (P wave duration) and using a metal caliper system. The prediction of LAE using the P wave area, Macruz index and mean electrical axis, has not been studied previously in veterinary medicine.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of electrocardiographic P wave related parameters in the assessment of left atrial size in dogs with degenerative mitral valve disease

Soto-Bustos

Caro-Vadillo

Martinez-de-Merlo

et al. 2017

The Journal of Veterinary Medical Science

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The purpose of this research was to compare the accuracy of newly described P wave-related parameters (P wave area, Macruz index and mean electrical axis) with classical P wave-related parameters (voltage and duration of P wave) for the assessment of left atrial (LA) size in dogs with degenerative mitral valve disease. One hundred forty-six dogs (37 healthy control dogs and 109 dogs with degenerative mitral valve disease) were prospectively studied. Two-dimensional echocardiography examinations and a 6-lead ECG were performed prospectively in all dogs. Echocardiography parameters, including determination of the ratios LA diameter/aortic root diameter and LA area/aortic root area, were compared to P wave-related parameters: P wave area, Macruz index, mean electrical axis voltage and duration of P wave. The results showed that P wave-related parameters (classical and newly described) had low sensitivity (range=52.3 to 77%; median=60%) and low to moderate specificity (range=47.2 to 82.5%; median 56.3%) for the prediction of left atrial enlargement. The areas under the curve of P wave-related parameters were moderate to low due to poor sensitivity. In conclusion, newly P wave-related parameters do not increase the diagnostic capacity of ECG as a predictor of left atrial enlargement in dogs with degenerative mitral valve disease.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of electrocardiographic P wave related parameters in the assessment of left atrial size in dogs with degenerative mitral valve disease

Soto-Bustos

Caro-Vadillo

Martinez-de-Merlo

et al. 2017

The Journal of Veterinary Medical Science

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“…One can speculate about what might have been different. If, for instance, electrocardiography had been invented after echocardiography I doubt that as much effort would have been expended over the years attempting to establish reliable electrocardiographic indicators of cardiac chamber enlargement, a technique which has increasingly been recognised as unreliable as better methods of measurement of heart size have developed (Savarino and others 2012). …”

Section: Dawning Of New Methodsmentioning

confidence: 99%

Veterinary cardiology: a journey through time

Boswood

2013

Veterinary Record

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“…Apesar de ser considerada constante em cães hígidos, os valores de onda P devem ser avaliados com cuidado, pois detém baixa sensibilidade diagnós-tica do aumento atrial comparado ao ecocardiograma [23]. Os maiores valores do intervalo PR em ambos os grupos podem ser decorrentes da diminuição da frequência cardíaca.…”

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Seric Concentration of Troponin I and Electrocardiographic Tracing in Dogs Submitted to Long-Term Sedation during 24 Hours

Regalin

Gehrcke

Comassetto

et al. 2017

Acta Scientiae. Vet.

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Background: General anesthetics and sedatives are commonly used for long-term sedation in veterinary medicine; however, they can lead to cardiac suppression. Cardiac troponin I is a biomarker used to detect myocardial pathology, monitor treatment, and assess outcomes in veterinary patients. The aim of this study was to evaluate the serum concentration of troponin I (cTnI), the electrocardiographic (ECG) tracing, and the ventricular stroke work index in dogs undergoing two long-term sedation protocols over 24 h. Materials, Methods & Results: Twelve healthy mongrel dogs with an average weight of 13.2 ± 2.3 Kg were admitted for this study. Twenty-four h before the experiment began (M-24), venous blood samples were collected for chemiluminescent cTnI evaluation and ECG data were obtained, specifically heart rate (HR); P, PR, QRS and T wave duration; P, R, T wave amplitude; and ST segment depression. On the day of the experiment, the animals were anaesthetized with propofol and isoflurane, and instrumented. After instrumentation, right and left ventricular stroke work index (RVSWI and LVSWI respectively) and intrapulmonary shunt (Qs/Qt) were performed as baseline parameters. The isoflurane was then discontinued and the animals randomly allocated to two groups (n = 6 each): Midazolam and fentanyl group (GMF), in which the animals received a bolus and continuous rate infusion (CRI) of midazolam (0.5 mg/kg and 0.5 mg/kg/h) and fentanyl (5 µg/kg and 10 µg/kg/h) or ketamine and morphine group (GKM), in which the animals received a bolus and CRI of ketamine (1 mg/kg and 0.6 mg/kg/h) and morphine (0.5 mg/kg and 0.26 mg/kg/h). Both groups also received propofol as a bolus and CRI (3 mg/kg and 0.3 mg/ kg/min) over 24 h. The ECG and cTnI parameters were evaluated at 6, 12, and 24 h during CRI (M6, M12, and M24) and 12 and 24 h after the end of infusion (T12 and T24). The hemodynamic parameters RVSWI, LVSWI, and Qs/Qt were evaluated every 2 h until the end of CRI. There was a non-significant increase in cTnI from M6 in both groups; however, a significant increase was only observed in GMF between M-24 and T12. During sedation, HR decreased an average of 46% in GKM and 51% in GMF compared to M-24. The QT interval (milliseconds) increased in both groups after CRI started, returning to baseline values at T24. There were no differences in P, QRS, and T wave amplitude or ST segment depression in either group. Discussion: The serum concentration of cTnI increased in GMF at T12, more probably due to hemodynamic changes during sedation rather than myocardial lesions, since the increase was relatively mild. A greater hemodynamic change was observed in GMF, with a greater increase in RVSWI compared to baseline than GKM, which may reflect an increase in cardiac effort and possibly cTnI release; however, in both groups, the cTnI values remained within the acceptable values for the species. Bradycardia was reported during long-term sedation, which may be due to the synergism between opioids as a result of vagal stimulation, central s...

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Diagnostic performance of P wave duration in the identification of left atrial enlargement in dogs

Cited by 17 publications

References 26 publications

Diagnostic accuracy of electrocardiographic P wave related parameters in the assessment of left atrial size in dogs with degenerative mitral valve disease

Diagnostic accuracy of electrocardiographic P wave related parameters in the assessment of left atrial size in dogs with degenerative mitral valve disease

Veterinary cardiology: a journey through time

Seric Concentration of Troponin I and Electrocardiographic Tracing in Dogs Submitted to Long-Term Sedation during 24 Hours

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