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Specialty Revision > Cardiology (Literature) > Flashcards

Cardiology (Literature) Flashcards

1
Q
  • What level does cTnI typically not exceed in:
    1. Primary cardiac disease
    2. Congestive heart failure
A
  1. 1 ng/mL
  2. 2 ng/ mL

Also: there is a lot of overlap in these concentrations with healthy animals.

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2
Q

How many times more likely are unwell dogs with increased troponin to die?

A

Up to 4x

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3
Q

What is the target heart rate for AF rate control and what is the impact of survival in dogs with AF in MMVD with CHF?

A

<160bpm
Controlling the rate below this value improved MST from 61 to 171 days.

https://paperpile.com/app/p/761e7ba5-e91e-0de6-901e-58aefc0cd843

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4
Q

What proportion of dogs with AVB having pacemaker implantation may have a change (progression/regression) of the original rhythm at follow up?

A

Around 1/3

https://paperpile.com/app/p/2ecf3351-85a9-0b33-bfc2-d6055055e825

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5
Q

What was the OR of Dance CKCS having a murmur following introduction of a breeding program aimed at reducing incidence of cardiac disease?

A

0.27 (73% reduction in risk).

https://paperpile.com/app/p/1d7af771-a9c1-0d63-9440-c603638fe8a6

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6
Q

What is right ventricular tei index and what is its relevance to MMVD?

A

RVTX = IVCT+IVRT/Ejection Time
It has been shown to independently predict death from MMVD within a year in one study.

n.b it seems that the higher the index the better the RV function if you think about how the values might change to indicate dysfunction.
https://paperpile.com/app/p/b9660945-e531-0843-82d3-b183aa1a7a8f

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7
Q

What implant has been shown to be suitable for treatment of PDA via. femoral artery catheterisation in small dogs?

A

Amplatzer vascular plug-4. (AVP-4). This was placed in several dogs with a femoral artery diameter <2mm. A complication that did occur was embolisation of the device.

https://paperpile.com/app/p/fb6361c2-855a-0483-aa61-67767d6e28c4

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8
Q

What survival times have been reported for dogs undergoing stenting for non-haemangiosarcoma heart-base masses that are obstructing the CVC?

A

5 - 37 months. (3 dogs only)

https://paperpile.com/app/p/b1ddeab1-f832-054e-b81d-73f79afd2aea

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9
Q

What increase in LA:Ao in cats with RCM phenotype was associated with what increase in HR of death?

A

0.5 increase in LA:Ao associated with 2.5x increased HR of cardiac death

https://paperpile.com/app/p/cc7221b7-273f-012e-a363-265131d35589

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10
Q

What is the usefulness of POC and ELISA testing of NT-proBNP on plasma or pleural effusion for differentiating casues of pleural effusion?

A

POC or ELISA good on plasma and the ELISA on pleural effusion but POC not so good on pleural effusion (with lower sensitivity).

Good diagnostic accuracy in determining cardiac vs. non-cardiac pleural effusion for ELISA:
- Plasma: Sensitivity 95.2%, specificity 82.4%
- Pleural fluid: Sensitivity 100%, Specificity 76.5%

POC Test:
- Plasma: Sensitivity 95.2% and specificity 87.5%
- Pleural fluid: Sensitivity 100%, specificity 64.7%

Conclusion is that using plasma for the ELISA or POC test is useful but only plasma for the POC test.

https://paperpile.com/app/p/8e5f090e-1907-0780-bcac-cf19d3d47b0a

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11
Q

What echocardiographic measurement may be most useful to obtain in the diagnosis of pulmonary hypertension if a TR velocity cannot be obtained?

A

right pulmonary artery distensibiliy index (RPAD)

https://paperpile.com/app/p/a781e586-143c-00e8-9e75-4a182ea47b29

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12
Q

Which drugs have been shown to be effective in monotherapy at delaying CHF or sudden death in Irish Wolfhounds with DCM, AF or both?

A

Pimobendan treated dogs had a longer time to primary endpoint (CHF or SD) which was 1,991 days, compared to methyldigoxin (1,263 days) or benazapril (997 days).

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13
Q

What echocardiographic technique may be most appropriate for assessing cardiac contractlity in dogs with PDA?

A

Speckle tracking echocardiography

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14
Q

Effects of PDA percutaneous closure on systolic function - what are the echocardiographic manifestations of this.

A

The effect of closure of PDA on systolic function is that it generally reduces systolic function. Specifically this may manifest as a reduced end-diastoic volume index and fractional shortening. Strain and strain rate are note affected.

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15
Q

Predictors of sudden cardiac death in Doberman’s with DCM and probability od SCD with increase in LVEDV/BSA?

A
  • Left ventricular volume overload as assessed by left ventricular end-diastolic volume indexxed to BWT (LVEDVBSA) was the best variable
  • Ventricular tachycardia
  • Increased cTnI
  • Fastest rate of VPCs >260 bpm

8.5-fold (CI 0.95 = 0.8–35.3) for every 50 mL/m²-unit increment in LVEDV/BSA

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16
Q

What drug may be used to reduce heart rate of cats undergoing echocardiography to help facilitate assessment of diastolic function?

A

Timolol maleate reduces heart rate by 25bpm on average and seperates e/a waves in 62% of cats that have it administered.

https://paperpile.com/app/p/04aea4f7-34df-0d64-99a9-2b5854020146

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17
Q

In general, what is the relationship between serum leptin and adiponectin in dogs with MMVD?

A
  • Dogs with MMVD have higher leptin and lower adiponecin than healthy dogs
  • ISACHC class 3 dogs have higher leptin than class 1 or 2
  • ISACHC class 3 dogs had higher adiponectin than dogs with class 1
  • ISACHC class 1 dogs had lower adiponectin than healthy controls

https://paperpile.com/app/p/13a97ad9-4ccf-026c-8c56-4fa6309dcde8

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17
Q

In general, what is the relationship between serum leptin and adiponectin in dogs with MMVD?

A
  • Dogs with MMVD have higher leptin and lower adiponecin than healthy dogs
  • ISACHC class 3 dogs have higher leptin than class 1 or 2
  • ISACHC class 3 dogs had higher adiponectin than dogs with class 1
  • ISACHC class 1 dogs had lower adiponectin than healthy controls
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18
Q

What happens to echocardiographic measurements in cats with increasing bodyweight?

A

They pretty much all increase. However, HR decreases

https://paperpile.com/app/p/e984665f-1312-0aee-98e5-d2fc14f1bd95

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19
Q

What is the relationship between IRIS stages and ACVIM heart failure class?

A

They are associated. Dogs with CKD and MMVD have a shorter survival time than dogs with MMVD only.

https://paperpile.com/app/p/6e52ec50-7cd5-0b6e-b66e-7515334f85f7

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20
Q

What is the relationship between MYBPC3 A31P mutation in cats and platelet activity?

A

These cats seem to have a higher platelet activation which can be attenuated with clopidogrel. This study evaluated cats without evidence of HCM which is interesting.

https://paperpile.com/app/p/4a2966b1-fa62-0a72-bb71-fb5ce9a31ab6

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21
Q

What is the relationship between blood pressure and potassium concentrations in cats?

A

Cats with tiger blood pressure at diagnosis of hypertension seem to have lower potassium concentrations?

https://paperpile.com/app/p/3b92ef10-4bc5-02a4-9969-3af78903a50c

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22
Q

What factors influence the ability of amlodipine to decreased blood pressure in cats?

A

Blood pressure at diagnosis
Plasma amlodipine concentration
Not bodyweight

https://paperpile.com/app/p/3b92ef10-4bc5-02a4-9969-3af78903a50c

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23
Q

HR for entry to CHF of dogs with MMVD treated with pimobendan compared to untreated

A

0.64

https://paperpile.com/app/p/d2b5744a-e13a-0e74-a43f-e0e41745b75e

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24
What factors are associated with an increased risk of higher blood pressures in apparently healthy cats? (5 points)
Age Male Increased nervousness Neutering History of being a stray
25
What is the association between stages of MMVD and markers of oxidative stress (malondialdehydye, oxidised LDLs and vitamin E)?
None, although these markers were all positively associated with serum cholesterol concentrations https://paperpile.com/app/p/a834b208-60ea-0ab4-ad6d-51b0fdf98d91
26
Successfullness of balloon valvuloplasty in dogs with tricuspid stenosis?
- Overall initial success was 75% (3/4 dogs in which procedure was completed - Procedure completed in 4/5 dogs - 2/4 dogs had sustained clinical improvement (2/4) but the remainder experience recurrance of clinical signs https://paperpile.com/app/p/8c7be2fc-ec16-07bb-8e18-4083b2cf9c93
27
What is the relationship between LA strain measured by speckle tracking echocardiography in dogs with MMVD and disease stage? Which indices best predicts CHF?
LA strain markers lower in dogs with C/D compared to B1/B2. Longitudinal left atrial strain was the best predictor of the presence or history of CHF https://paperpile.com/app/p/f162e515-8114-0978-8bf6-c27db9eb6ee3
28
Is NTproBNP useful in distinguishing innocent from pathologic murmurs in young dogs? What disease is this not useful in?
Yes, exept for dogs with pulmonic stenosis. https://paperpile.com/app/p/7458c46a-6401-041f-ad6c-3d3d7c47a9e4
29
What phonocardiogram findings may predict an innocent compared to a murmur associated with congenital crdiac disease in young dogs?
Innocent murmurs have a shorter murmur-to-systole ratio and lower murmur-to-systole amplitude on phonocardiography https://paperpile.com/app/p/7458c46a-6401-041f-ad6c-3d3d7c47a9e4
30
What is the relationship of RV size and function in cats with HCM?
RV size increased and function decreased in cats with HCM and CHF or pleural effusion. however, only RVFWd increased in cats with subclinical HCM https://paperpile.com/app/p/a4c01b0f-aeb5-0e1a-af6f-0d5e2e19d618
31
Relationship of proBNP for cats with CHF and survival
Greater percentage decrease in NT-proBNP associated with longer survival. https://paperpile.com/app/p/f4f9616c-1705-0e7d-af2f-3aa07856472e
32
What tye of shunting is expected in older dogs with a PDDA?
Left to right https://paperpile.com/app/p/0f3f9529-07bc-0988-8b8f-74c7ef5dd3fb
33
Sensitivity, specificity, PPV and NPV of lung ultrasound for detection of pulmonary oedema in dogs with MMVD.
- Lung ultrasound predicted pulmonary oedema with a sensitivirty of 90% and specificity of 93% - PPV 85.7% and NPV 95.2% https://paperpile.com/app/p/55aeaf05-3935-0159-a527-ef77386a752a
34
Sensitivity and specificity of POC proBNP ELISA on serum of cats for differentiation of cardiac disease vs. non-cardiac disease
-Sensitivity of POC ELISA 65.4% and specificity of 100% for diffentiation of cats with cardiac disease vs. those without
35
Effect of MR severityt and LVIDSn in predicting cardiac death in CKCS
- Increased MR in male dogs predicted cardiac death but the same was found in females - LVIDSn increases also predictive of HR of cardiac death https://paperpile.com/app/p/e2dea591-80f5-0f77-902a-bf17953f0ab2
36
Risk reduction of torasemide in MMVD in reaching end point of cardiac death
2 fold reduction https://paperpile.com/app/p/d60d7fbd-1052-0fd6-ab26-bbabb3441e71
37
Median time to resolution of LVH with TMT
3.3 months
38
Time for LVIDDN to reduce in dogs with MMVD
35 days
39
HR of mortality for every 10pbm increase in HR for dogs with AFib
35%
40
Percentage of cats that develop CHF/ATE and rate of cardiovascular death in cats that are initially asymptomatic for HCM
- 30.5% - 27.9%
41
MST for dogs with 'advanced' heart failure
281 days, higher frusemide doses associated with improved survival
42
What is the effect of sotolol on systolic function?
Mild reduction in systolic function
43
Which sie are accessory pathways more commonly found in?
Right sides (91.7% dogs
44
Percentage of dogs with accessory pahtways that develop tachycardia induced cardiomyopathy
46.1%
45
Success rate of radiofrequency catheter ablation of accessory pathways
98.8%
46
What number of b-lines support a diagnosis of CHF in cats and how useful is the LA:Ao/pericardial effusion
>1 site with >3 b-lines LA:Ao was 97% sensitive and 100% specific (performed the best) Pericardial effusion very specific but poorly sensitive (around 60%)
47
What effect does sacubitril/valsartan have on dogs with B2 MMVD?
It increases urinary aldosterone:creatinine compared to placebo
48
How much does telmisartan reduce blood pressure by in hypertensive cats?
19.2mmHg by day 14 and 24.6mmHg by day 28 of treatment
49
What effects did synthetic canine BNP1-32 have on dogs with MMVD?
Nothin
50
What is the more common form of RCM in cats?
Myocardial form (90%) rather than endomyocardial fibrosis form (10%)
51
Negative prognostic indicators for cats with RCM
Biatrial enlargement Arrythmias LA:Ao Presence of severe LA enlargement
52
How many dogs will cardiovert frrom OAIOVR when administered lidocaine?
84%
53
What clinical presentation and clinicopathologic alterations are more likely in dogs with cardiac cachexia and CHF?
Arrythmia Increased chloride concentration Lower BCS Lower HCT, Hb and albumin
54
Effectiveness of benazapril in cats with heart disease
None
55
What is the difference in MST between cats with preclinical HCM and healthy cats?
No difference in MST but preclinical HCM cats had shorter all cause survival
56
What is the effect of short term oral steroid administration to cats on cardiac function, blood pressure, blood glucose and NT-proBNP?
Does not significantly affect NT-proBNP, blood pressure or blood glucose Does increased LAD and LVIDD
57
What presenting signs are assocaited with cardiac cachexia in cats with heart failure?
More likely to have pleural effusion, increased BUn and increased neutrophil concentrations Cachexic animals had a shorter survival time
58
What percentage of dogs with PHT will die in 1 month and within 6 months when treated with sildenafil?
32% within 1 month, 50% within 6 months
59
What clinical factors change in the run up to CHF in dogs?
RR increases, vetebral heart sum increases Rectal temperature and bodyweight decrease
60
What cardiac measurement is more common in dogs with PHT that is due to causes that are not secondary to left heart disease?
TAPSE is decreased
61
What echocardiographic/clinical factors are associated with shorter survival times in dogs with PHT?
Right atrial area and presence of right sided CHF
62
Is torasemide better than frusemide?
Dogs treated with torasemide have a longer time to endpoint and are less than 1/2 as likely to die than dogs that recieve frusemide
63
What is the most common comorbidity in dogs that have ATE
PLN - occurs in around 50% cases. This is follwed by neoplasia, corticosteroids, endocrine disease and infectious causes
64
What factor is correlated with survival to discharge in dogs with ATE?
Ambulatory status
65
Prevalence of hypertension and severe hypertension in dogs with HAC
82% prevalence 46% dogs will have NIBP >180mmHg
66
What clinicopathologic changes seem to occur more commonly in HAC dogs with hypertension? What was associated with a decreased risk of hypertension in this population?
Thrombocytosis, reduced potassium and UPC >0.5 Dogs with concurrent DM have a reduced risk of hypertension
67
What dietary intervention may improve echocardiographic and biomarker levels in cats with HCM?
Restricted starch wih added omega 3s
68
What is true of the presentation of heart failure in cats with OTO?
They are less likely to have pleural effusion and more likely to have pulmonary oedema
69
What is the prevalence of AFib in dogs with MMVD?
2.7%
70
What are the risk factors for development of Afib in dogs with MMVD?
LA:Ao Transmitral velocity Increased bodyweight Reduced FS
71
Should ramipril be used alongside frusemide and pimobendan in dogs with MMVD?
No - no impact on survival
72
On average how much higher does petMAP blood pressure device measure compared to high definition oscillometry?
14mmHg
73
Pimobendan has been shown to be safe in cats with heart failure evenwhen they have DLOVTO but is there any benefit to long term therapy?
None proen
74
In dogs, treated with telmisartan and an ACEi, whati s the benefit of combination therapy on blood pressure and UPC compared to sole therapy with an ACEi?
13mmHG blood pressure reduction 2.5 reduction in UPC Comapred to ACEi alone
75
Whgat is the most common electrolyte abnormality in dogs with heart failure?
Hypochloraemia
76
What is the sensitivity and specificity of NT=proBNP in serum for screening healthy cats for HCM?
Sensitivity 43% and spcificity 96% Screening only cats with a heart murmur increases sensitivity to 71%
77
Which adjunctive therapy is possibly beneficial in dogs with heart disease? - Benazapril alone - Ramipril - Benazapril and ramipril - Benazaprl and spironolactone
d - lower precentage of dogs seem to reach cardiac endpoint and have a reduced risk of death or progression of cardiac disease compared to giving benazapril alone
78
How could cTnI be used in infective endocarditis?
It is higher in IE compared to dogs with MMVD and those with immune mediated disease. However, it does not predict survival and had poor sensitivity for predicting IE.
79
Which electrolyte may help predict survival in dogs with cardiac disease that are treated with ACEi?
Higher potassium at evaluation following institution of an ACEi
80
What are the predictors of SCD in dogs with AFib?
Increased LA Younger age at diagnosis Presence of syncope
81
What parameter may not be well assessed by the use of a smartphone based ECG device?
Polarity of depolarisation in cats
82
Which breeds is ToF more common in?
Terrier breeds
83
What is the most common clinical signs of ToF?
Syncope (52%)
84
What prognostic factor is there for dogs with ToF?
Quiter murmur or no heart murmur had significantly shorter survival than animals wiht a louder murmur
85
Which disease process may lung ultrasound not distinguish well from CHF?
Interstital or alveolar disease
86
What thoraic radiographic measure may predict left atrial size?
Vetebral left atrial size (≥2.3)
87
What clinical difference was there between dogs treated for PDA with an occluder vs. surgical ligation
Important point is that survival was similar between groups with oerall survival to discharge 99%. 10% surgically treated dogs had complications GA time was longer in the occluder group
88
Which genetic varient seems to be relatively common in Dobermans with DCM?
TTN
89
MST for dogs undergoing LA decompression in the management of MMVD?
195 days
90
What are the four compobnents of the MINE score for MMVD and what score prediscts cardiac death?
- LA:Ao - E-wave velocity - LVIDD - FS% >8 predicts cardiac death

Specialty Revision (13 decks)

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