Topics in Cardiology, An Issue of Veterinary Clinics: Small Animal Practice

Jonathan A. Abbott

Description

A comprehensive review of cardiology for the small animal practitioner! Articles will focus on advanced techniques in echocardiography, use of natiuretic peptides in the management of canine patients with heart disease, use of natiuretic peptides in the management of feline patients with heart disease, current use of pimobendan in canine patients with heart disease, canine mitral valve disease, infective endocarditis, interventional catheterization for congenital heart disease, pulmonary hypertension, feline hypertrophic cardiomyopathy, feline arrhythmias, surgery for cardiac disease, gene therapy for cardiac disease, and much more!

Sujets

• Smal Animal
• Veterinary Medicine
• Medical
• Médecine

Informations

• Publié par: Saunders
• Date de parution: 30 juillet 2010
• Nombre de lectures: 0
• EAN13: 9781455700790
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Veterinary Clinics of North America: Small Animal Practice , Vol. 40, No. 4, July 2010
ISSN: 0195-5616
doi: 10.1016/S0195-5616(10)00072-0

Contributors
Veterinary Clinics of North America: Small Animal Practice
Topics in Cardiology
Jonathan A. Abbott
Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Duck Pond Drive, Blacksburg, VA 24061-0442, USA
ISSN  0195-5616
Volume 40 • Number 4 • July 2010

Contents
Cover
Contributors
Forthcoming Issues
Erratum
Preface
Advanced Techniques in Echocardiography in Small Animals
The Use of NT-proBNP Assay in the Management of Canine Patients with Heart Disease
Natriuretic Peptides: The Feline Experience
Current Use of Pimobendan in Canine Patients with Heart Disease
Minimally Invasive Per-Catheter Occlusion and Dilation Procedures for Congenital Cardiovascular Abnormalities in Dogs
Surgery for Cardiac Disease in Small Animals: Current Techniques
Pulmonary Hypertension in Dogs: Diagnosis and Therapy
Feline Arrhythmias: An Update
Canine Degenerative Myxomatous Mitral Valve Disease: Natural History, Clinical Presentation and Therapy
Infective Endocarditis in Dogs: Diagnosis and Therapy
Feline Hypertrophic Cardiomyopathy: An Update
Genetics of Cardiac Disease in the Small Animal Patient
Status of Therapeutic Gene Transfer to Treat Canine Dilated Cardiomyopathy in Dogs
Index
Veterinary Clinics of North America: Small Animal Practice , Vol. 40, No. 4, July 2010
ISSN: 0195-5616
doi: 10.1016/S0195-5616(10)00074-4

Forthcoming Issues
Veterinary Clinics of North America: Small Animal Practice , Vol. 40, No. 4, July 2010
ISSN: 0195-5616
doi: 10.1016/j.cvsm.2009.09.003

Erratum
The editor of Veterinary Clinics of North America: Small Animal Practice would like to confirm the retraction of “Idiopathic Granulomatous and Necrotizing Inflammatory Disorders of the Canine Central Nervous System,” by Scott J. Schatzberg from the January 2010 issue (Vol. 40(1): 101-120) at the request of the editor and author. This article was a duplication of a paper that had already appeared in the Journal of Small Animal Practice , Published Online: October 8, 2009 9:28AM; DOI: 10.1111/j.1748-5827.2009.00823.x. The author would like to apologize for this administrative error.
Veterinary Clinics of North America: Small Animal Practice , Vol. 40, No. 4, July 2010
ISSN: 0195-5616
doi: 10.1016/j.cvsm.2010.04.005

Preface
Topics in Cardiology

Jonathan A. Abbott, DVM
Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Duck Pond Drive, Blacksburg, VA 24061-0442, USA
E-mail address: [e-mail]

Jonathan A. Abbott, DVM Guest Editor
Six years ago, it was my privilege to provide guest editorial direction when an issue of the Veterinary Clinics of North America: Small Animal Practice addressed topics in cardiology. There have been notable advances since I last contributed to this series: the practice of veterinary echocardiography has continued to evolve; we are beginning to realize the diagnostic potential of biomarkers, such as the natriuretic peptides; recent discoveries have improved understanding of recognized diseases; and new therapeutic approaches have been developed.
As in 2004, this issue addresses a broad range of subjects in an attempt to provide an overview of current topics in veterinary cardiology. The initial articles outline progress in cardiovascular diagnosis. The current role of the natriuretic peptides is assessed and recent advances in the practice of echocardiography are reviewed. Subsequent articles address current issues in cardiovascular therapy: recent clinical data regarding the use of the pimobendan are reviewed; the growing field of interventional catheterization is addressed as is the role of surgical techniques in the management of small animal cardiovascular disease. In a series of updates, current issues in the diagnostic and therapeutic management of specific disorders and syndromes are addressed. Finally, the subject of genetics is addressed in two separate reviews that relate, respectively, to heritability of disease and therapy.
I was fortunate that talented clinical scientists generously provided their expertise—I wish to acknowledge these authors and express sincere thanks for their willingness to contribute to this issue. I am certain, however, that it is the readership that will be the true beneficiary of their efforts. Readers are fortunate that prominent experts were willing to share their views on such vital and exciting topics in veterinary cardiology.
Veterinary Clinics of North America: Small Animal Practice , Vol. 40, No. 4, July 2010
ISSN: 0195-5616
doi: 10.1016/j.cvsm.2010.03.007

Advanced Techniques in Echocardiography in Small Animals

Valérie Chetboul, DVM, PhD
Unité de Cardiologie d’Alfort, UMR INSERM-ENVA U955, Ecole Nationale Vétérinaire d’Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort Cedex, France
E-mail address: [e-mail]

Abstract
Transthoracic echocardiography has become a major imaging tool for the diagnosis and management of canine and feline cardiovascular diseases. During the last decade, more recent advances in ultrasound technology with the introduction of newer imaging modalities, such as tissue Doppler imaging, strain and strain rate imaging, and 2-dimensional speckle tracking echocardiography, have provided new parameters to assess myocardial performance, including regional myocardial velocities and deformation, ventricular twist, and mechanical synchrony. An outline of these 4 recent ultrasound techniques, their impact on the understanding of right and left ventricular function in small animals, and their application in research and clinical settings are given in this article.

Keywords
• Tissue Doppler • Speckle tracking • Strain • Strain rate • Tissue tracking
Over the last 30 years, standard transthoracic echocardiography has become a major imaging tool for the diagnosis and management of canine and feline cardiovascular diseases. In the late 1980s miniaturization of transducer components allowed the development of transesophageal echocardiography, which is used for analyzing specific abnormalities (congenital heart diseases, thrombosis, cardiac tumors) and for monitoring surgical and interventional procedures. 1 - 3 During the last decade, more recent advances in ultrasound technology with the introduction of newer imaging modalities, such as tissue Doppler imaging (TDI), strain (St) and strain rate (SR) imaging, and 2-dimensional (2D) speckle tracking echocardiography (STE), have provided new parameters to assess myocardial performance, including regional myocardial velocities and deformation, ventricular twist, and mechanical synchrony. An outline of these 4 recent ultrasound techniques, their impact on the understanding of right and left ventricular function in small animals, and their application in research and clinical settings are given in this article.

Tissue Doppler imaging
TDI is a recently developed echocardiographic technique that enables global and regional myocardial function to be quantified from measurements of myocardial velocities in real time. 4
Isaaz and colleagues 5 were the first (in 1989) to record the left ventricular free wall (LVFW) velocities in human patients using the pulsed-wave Doppler mode of standard ultrasound equipment. The wall filter was set at 100 Hz to record the low myocardial velocities (<10 cm/s). Several years later, the first software was developed for quantifying myocardial velocities using color Doppler imaging. 6 Since then, TDI has been more and more investigated in human and veterinary cardiology, providing information on myocardial function, and also improving our understanding of cardiac physiopathology.

Technical Characteristics
Standard spectral and color Doppler instrumentation detects high-frequency, low-amplitude Doppler signals reflected from rapidly moving red blood cells, and filters out low-frequency, high-amplitude Doppler signals that arise from the myocardium. With the TDI technique, modifications of high-pass frequency and amplitude filter settings are needed to allow Doppler signals from myocardial motion to be processed and displayed. 7
Three TDI modes are available. 4, 7 The pulsed-wave TDI mode provides information on myocardial movements through a single sample volume, which is placed within the myocardial wall ( Fig 1 A). With color M-mode TDI ( Fig. 1 B), myocardial velocities are analyzed along a selected single scan line, which is directed by the operator in the same manner as for conventional transventricular M-mode; this method is used to analyze the radial motion of the interventricular septum (IVS) or the LVFW. Using 2D color TDI mode ( Fig. 1 C), real-time color Doppler is superimposed on the gray-scale of 2D mode images. Specific software is then used to quantify velocities throughout the cardiac cycle in myocardial segments of various sizes ( Fig. 2 ). One of the main advantages of 2D color TDI mode over the 2 others is its ability to simultaneously quantify velocities in several segments within 1, 2, or 3 myocardial walls, thereby allowing assessment of intra- and interventricular synchrony (see Fig. 2 ; Figs. 3 and 4 ). 8

Fig. 1 The 3 TDI modes. ( A ) The pulsed-wave TDI mode provides information on myocardial movements through a single sample volume, which is placed within the myocardial wall thickness (here in the left ventricular free wall [LVFW], using the right parasternal transventricular short-axis view). When the myocardium moves toward the transducer, myocardial velocities are positive (above the baseline), and when it moves away from the transducer, myocardial velocities are negative (below the baseline). S