Electrocardiographic Findings and Cardiac Troponin I Assay in Dogs with SIRS Diagnosis

Abstract

Several studies performed in humans have demonstrated that the onset of systemic inflammatory response syndrome (SIRS) represents a high risk condition to develop myocardial damage and arrhythmias. Therefore, we also hypothesized cardiac involment for dogs affected by SIRS. To assess this hypothesis, 24 dogs with a diagnosis of SIRS (13 entire males, 7 entire females, and 4 spayed females) with an age ranging from 4 to 11 years (mean 5.6 years) and an average weight of 24 kg (range from 5 to 47 kg) were enrolled. The dogs were divided into two groups according to their prognosis: Survivors (G1) and not survivors (G2), composed by 13 and 11 dogs, respectively. Moreover, healthy dogs were included as the control group (CTR). All the dogs with a history of cardiac or renal disease were excluded. At the inclusion, each patient underwent a physical examination and a complete cell count, and a biochemistry panel (including electrolyte profile) was performed; moreover, the blood cardiac Troponin I (cTnI) was measured. For each clinical variable indicative of SIRS, a score between 0 (absence) and 1 (presence) was applied. Furthermore, an electrocardiographic examination was recorded. Seventeen out of 24 (70.8%) dogs with SIRS showed arrhythmias, of which n. 6 belonged to the G1, while n. 11 belonged to the G2. Most represented findings were sinus tachycardia (7/17; 41.1%), followed by monomorphic premature ventricular beats (6/17; 35.3%), less common were first-degree atrioventricular block (2/17; 11.7%) and sinus bradycardia 1/17; 5.8%). Notably, in G1 dogs, only sinus tachycardia and premature ventricular beats were observed. G2 dogs presented a number of total and banded leukocytes significantly higher than those of G1 (p = 0.002 and 0.049), in the same manner, the clinical score suggestive of SIRS (3 vs. 2.1) was significantly higher in G2 than in G1 dogs (p = 0.01). Moreover, a significantly higher value of cTnI was observed in the G2 group compared to the G1 group (p = 0.006). Data presented here suggested a cardiac involvement in dogs with SIRS, analogously to humans, that may significantly influence the patient’s prognosis.

Effect of early stepwise cardiopulmonary rehabilitation on function and quality of life in sepsis patients

“…cTnI is considered the most sensitive specific marker of myocardial injury and can assess the degree of myocardial injury in patients with sepsis[ 23 , 24 ]. In addition, BNP levels also increase markedly with myocardial damage[ 25 , 26 ].…”

Cardiac Troponin I and Electrocardiographic Evaluation in Hospitalized Cats with Systemic Inflammatory Response Syndrome

“…The cTnI assay is applied in human intensive care units as a prognostic marker of myocardial injury, both in human patients with structural cardiac disease [ 39 , 40 ] and in human patients with noncardiac disorder that secondarily involves the heart [ 15 ]. In veterinary medicine, a high serum concentration of cTnI is reported as a negative prognostic marker of death in dogs affected with SIRS [ 42 , 43 , 44 ]. Significantly higher levels of cTnI have been assayed also in cats with hypertrophic cardiomyopathy [ 45 , 46 , 47 ] and no specific primary cardiac diseases such as hyperthyroidism [ 48 ], renal disease [ 23 ], critical illness [ 48 , 49 ], and hypertension [ 50 ].…”

“…Although in the population studied, other potential causes of cTnI increase cannot be excluded, the cTnI value should be considered as a sensitive biomarker of cardiac involvement in cats with SIRS, as well as in dogs [ 43 , 44 ] and humans [ 15 , 21 , 40 ]. Given that these guidelines were recognized based on cats with sepsis, it is reasonable to infer that the increase in cTnI recorded in the present study suggests a possible cardiac involvement during SIRS.…”