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2015 to 2019 journals > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the significance of atrial fibrillation for dogs with MMVD and CHF, over 15kg

A

Jung JVIM 2015: AFIb dogs had a shorter MST (142 vs 234) and increased risk of cardiac related death. Rate control improved MST. Combination treatment significantly decreased HR and prolonged MST compared to diltiazem alone

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2
Q

Can cardiac troponin I b used as a prognostic indicator in SIRS?

A

Hamacher JVIM 2015: Negative prognostic indicator at admission, no further information from sequential monitoring

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3
Q

What are the three troponin subunits and what is its function?

A

I, C and T. This complex controls cardiomyocyte contraction. T secures to the thin filament. I is inhibitory and C binds calcium when contraction is initiated

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4
Q

Can proBNP measurement be affected by strenuous exercise in dogs?

A

Hunt JVIM 2018: Yes

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5
Q

What are microRNA and what might they be useful for?

A

JVIM 2020 upregulation in one microRNA with doxorubicin, preceding troponin. Potential biomarker. MicroRNA bind RNA and prevent signal translation. They are also very stable

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6
Q

What is the MOA and indication for fenoldopam?

A

dopamine-1 agonist action, fenoldopam causes renal arterial vasodilation, natriuresis, and increased GFR in normal dogs. Anti-hypertensive

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7
Q

What drugs could be indicated for a hypertensive emergency and what is their MOA?

A

Fenoldopam - dopamine 1 agonist
Hydralazine (0.5-2 mg/kg PO q12h) has a rapid onset of action and can be used for rapid reduction of BP in both cats and dogs; direct acting smooth muscle relaxant. Inhibits calcium release within the muscle

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8
Q

What is the difference between coccygeal and radial artery doppler blood pressure measurement in cats?

A

JAVMA 2017: Coccygeal not affected by age or muscle condition. Radial affected by muscle condition. Mean systolic coccygeal pressures higher than radial (+19mm), though this is not consistent. Paper recommended coccygeal measurement and MCS monitoring
JFMS 2018; Also found significantly higher systolic BP in the tail. Obesity increased difference between. This study critiqued JAVMA 2017 saying cannot preference coccygeal over radial, as precision of radial is still high and no studies to support difference being pathological

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9
Q

Are there any biomarkers which are useful diagnostic tests for hypertension in cats? Are any biomarkers associated with hypertension in cats?

A

Bijsmans JVIM 2017: No. VEGF was higher in hypertensive cats with ocular TOD and was independently predictive of hypertension. CTnI was also independently predictive of hypertension. Based on ROC none useful as a diagnostic test though.

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10
Q

What is the effect on NT-proBNP when treating hypertension in cats? What about troponin and VEGF?

A

Bijsmans JVIM 2017. NT-ProBNP decreased with treatment of hypertension. Troponin and VEGF did not

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11
Q

What factors influence the required amlodipine dose for a hypertensive cat?

A

Bijsmans JVIM 2016: pre-treatment blood pressure

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12
Q

What is the frequency of hypertension developing in dogs treated with toceranib?

A

Tjostheim JVIM 2016; 37% of treated dogs developed SBP ≥ 160 mmHg

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12
Q

What is the frequency of hypertension developing in dogs treated with toceranib?

A

Tjostheim JVIM 2016; 37% of treated dogs developed SBP ≥ 160 mmHg

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13
Q

What is the effect of telmisartan on blood pressure in hypertensive cats?

A

Glaus JVIM 2018: Evaluated telmisartan in cats with SBP between 160-200mmHg. Was effective at reducing BP by 19.2mm at 2 weeks and 24.6mm at 4 weeks. 52% of cats treated were <150 at 4 weeks
Coleman JVIM 2018: at 4 weeks reduced SBP by 23.9mmHg and effect persisted over 6 months

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14
Q

What trend is seen with Vitamin D concentrations in dogs with degenerative valvular disease?

A

Serum 25(Oh)D concentrations are significantly lower in B2 compared to B1. No significant difference between B2 and C/D

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15
Q

How do leptin and adiponectin change with MMDV.

A

Kim JVIM 2016. Lepin high and adiponectin low compared to healthy dogs. ISACHC Class 3 (severe HF) dogs had high leptin concentrations, as well as adiponectin, compared to Class 1 dogs

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16
Q

What serum factor and signalment characteristics can affect markers of oxidative stress in dogs with MMVD?

A

Reimann JVIM 2017. OxLDL, Vitamin E, Y-tocopherol are affected by sex, BCS, neuter status and cholesterol. Could not be used for clinical stage of MMVD in this study

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17
Q

What is angiotensin converting enzyme 2 and what is its purpose?

A

Angiotensin-converting enzyme 2 (ACE2) is a homologue of angiotensin-converting enzyme (ACE) and produces angiotensin peptides (APs), such as angiotensin 1-9 and 1-7 that are vasodilatory and natriuretic, and act to counterbalance angiotensin II
Larouche JVIM 2019: In CHF, ACE-2 and beneficial products AG 1-7 are increased

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18
Q

What are the actions of Angiotensin 2? What receptor does it act on?

A

acts on angiotensin receptor type 1 and causes potent vasoconstric- tion, sodium and water conservation, aldosterone release, and myocar- dial remodeling

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19
Q

What is TMAO? What is its significance in heart disease?

A

Karlin JVIM 2018; an oxidised product of trimethylamine, which is produced by GI bacteria when they metabolise choline. Was found to be increased in dogs with CHF secondary to DMVD compared to subclinical dogs and healthy controls

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20
Q

What is speckle tracking echocardiography?

A

Toaldo JVIM 2017; 2D method using speckle tracking to calculate regional myocardial deformation and therefore function. In this study showed that LA function reduces with progression of MMVD. It was found to be feasible and reproducible.

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21
Q

What echocardiographic variable has prognostic significance in dogs with MMVD?

A

Toaldo JVIM 2017; several in an univariate analysis. In multivariate just the MV E wave velocity. An increase in MV E vel is an indirect measure of mitral regurgitation severity, reflecting worsening pressure differences between the LA and LV with increasing regurgitant volumes.
Nakamura JVIM 2016: Right ventricular Tei-index has a strong correlation with the prognosis for dogs with MMVD. The most significant independent predictor of death was RVTX in this study. La:Ao was also predictive
The Tei index (TX), also known as the myocardial performance index, is an index of global myocardial function, including systolic and diastolic performance. It is calculated by dual pulsed wave doppler

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22
Q

What is the impact of disease class and pulmonary hypertension on right heart function in MMVD?

A 
Toaldo JVIM2016:  not able to identify a significant deterioration of RV systolic or diastolic function with the progression of severity class in dogs with naturally occurring MMVD and different degrees of PH.
Chapel JVIM 2018: RV systolic function was increased in B2 MMVD but then decreased in stage C.
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23
Q

What can the pulmonary vein to artery ratio be used to predict?

A

Merveille JVIM 2015: CHF in MMVD. The presence of CHF could be best predicted by measuring PV/PA in 2D echocardiography cut-off, 1.7

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24
Q

What tissue doppler echocardiographic finding can be used to predict CHF in MMVD?

A

Kim JVIM 2015: TDI-derived E/Em sept which evaluates diastolic function could be an important predictor of CHF in dogs with MMVD and it may overcome the limitation of load-dependent conventional echocardiography.

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25
Q

What echo findings can be used to predict cardiac death later in life in CKCS?

A

Reimann JVIM 2017. Moderate to severe MR, even if intermittent, and increased LVIDSN in dogs <3 years of age were associated with cardiac death later in life in CKCS. Males had higher all cause mortality with MR.

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26
Q

How to the MV differ between healthy CKCS and other breeds?

A

Manicotti JVIM 2018: CKCSs having a flatter MV with reduced tenting, compared to the MV of other breeds.

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27
Q

In the EPIC study, what was the effect of Pimobendan vs Placebo?

A

Median time to primary endpoint was 1228 days (95% CI: 856–NA) in the pimobendan group and 766 days (95% CI: 667–875) in the placebo group (+15 months)
Dogs in the pimobendan group lived longer (median survival time was 1059 days (95% CI: 952–NA) in the pimobendan group and 902 days (95% CI: 747–1061) in the placebo group) (P = .012)
Dogs receiving pimobendan had approximately two-thirds the risk of reaching the primary end- point compared with dogs on placebo

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28
Q

TEST study; how did torsemide compare to frusemide?

A

The present trial demonstrates that torasemide q24h is noninferior to furosemide q12h when considering a composite clinical score endpoint (% treatment success; clinical and TXR pulmonary oedema). Torasemide was associated with a 2-fold reduction in the risk of reaching the secondary composite cardiac endpoint “spontaneous cardiac death, euthanasia for HF, or CHF class worsening” over a 3-month period

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29
Q

Does treatment for CHF reduce NT pro-BNP?

A

Hezzell JVIM 2018: A pre defined treatment algorithm in response to BNP measurements was able to reduce BNP in stable MMVD dogs with CHF

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30
Q

What is the MOA of sacubitril/valsartan? What is its effect in Stage B2 MMVD dogs (clue; decreased what in urine)?

A

ARB/NEP inhibitor. NEP (Neprilysin) cleaves natriuretic peptides that are meant to protect against RAAS activation. It can decrease urinary aldosterone/creatinine ratios

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31
Q

In the second part of EPIC, what pathological variables did Pimobendan affect, and what did this predict?

A

Pimobendan reduced heart size in dogs with B2 MMVD and this was associated with increased time to CHF and cardiac related death. LV end systolic dimension was associated with therapeutic benefit. At the onset of CHF, groups were similar.

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32
Q

What is the effect of a single dose of BNP1-32 on dogs with Stage C MMVD

A

BNP1-32 was well tolerated, and after subcutaneous dosing, it was well absorbed and resulted in an increase in UEcGMP (mediator of activity); however, there were no measurable effects on biological outcomes (UOP, BP, HR, FENa/K, and plasma aldosterone concentra- tion) in this study.

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33
Q

What is the dose-response relationship for ACEi in dogs with cardiac disease?

A

Ward JVIM 2021: q 12 hour dosing and higher potassium at the first revisit was predictive of 2 year survival

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34
Q

How do you measure LA size on x-rays? Does this correlate with La Ao?

A

Malcolm JAVMA 2018; Measure from carina to the caudal aspect of the LA where intersects with the CVC. Measure vertebra forward from T4. >2.3 predictive of LA enlargement. Useful measurement based on this study

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34
Q

How do you measure LA size on x-rays? Does this correlate with La Ao?

A

Malcolm JAVMA 2018; Measure from carina to the caudal aspect of the LA where intersects with the CVC. Measure vertebra forward from T4. >2.3 predictive of LA enlargement. Useful measurement based on this study

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35
Q

What are the pathologic changes seen in the LA and LV with MMVD?

A

Lee JVIM 2015: LA degenerates more severely, fatty change, immune cell infiltration and fibrosis. LB hypertrophied. LV end diastolic dimension/ejection fraction was associated with fatty replacement and vacuolisation.

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36
Q

What is the prevalence and risk factors for degenerative mitral valve disease in dogs in primary care in England?

A

Estimated prevalence 0.36% of diagnosed MMVD. Males, insured, <20kg, geriatric, CKCS, Chihuahua,, Whippet, Poodle

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37
Q

Can a breeding scheme reduce the risk of MMVD in CKCS?

A

Birkegard JVIM 2016; yes, breeding scheme over 8-10 year period reduced risk by 73%

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38
Q

What is the prognosis after diagnosis of “advanced” heart failure.

A

Beaumier JVIM 2018. median duration between the diagnosis of stage C and advanced heart failure was 163 days, and the median survival time after the diagnosis of advanced heart failure was 281 days. Higher frusemide dose and non hospitalisation were associated with longer survival. 81% of dogs had an increased BUN and 76% of dogs with hypochloremia at some point during treatment.

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39
Q

What factors were associated with disease progression from Stage B MMVD in a UK study?

A

Mattin JVIM 2018; Plasma NT-proBNP, heart rate, heart murmur intensity, presence of a cough, being a Cavalier King Charles Spaniel, and being prescribed pimobendan were associated with clinical progression to initiation of treatment with a potent diuretic or cardiac-related death

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40
Q

What clinical and radiographic changes occur in dogs with MMVD before they develop CHF?

A

Vertebral heart sum increased earliest. Heart rate, RR, and RRR also increased. Rectal temperature and BW decreased. Increases in RR and RRR were most extreme and occurred immediately before CHF

41
Q

What is the utility of NTproBNP for discriminating cardiac from non cardiac respiratory distress in dogs?

A

A cut off of >2,447 discriminated CHF from non cardiac respiratory distress with a Sn of 81% and Sp 73%

42
Q

Is there a correlation between cPLI and La/Ao and severity of heart failure?

A

Han JVIM 2015; Yes, there was a close association (r: 0.597 and 0.530) respectively

43
Q

What are the renal biochemical and RAAS differences between healthy Greyhounds and healthy non-Greyhounds

A

Martinez JVIM 2017. Serum creatinine, sodium and SDMA were higher in Greyhounds. Greyhounds higher blood pressure and albuminuria. Renin activity and ACE activity similar between groups but aldosterone concentrations were lower. Interpretation: Lower aldosterone is in response to high Na and blood pressure, suggesting AG II effects predominate over aldosterone

44
Q

What is the association between BCS and MCS and survival in dogs with CHF?

A

Ineson JVIM 2018; Catchexia was associated with shorter survival. Obesity and underweight at diagnosis were also associated (note; some obese dogs were sarcopenia). Azotaemia and tachyarrythmia also had prognostic significance in this study

45
Q

What is the impact of pulmonary hypertension on dogs with Stage B2 or C MMVD?

A

The median survival time for dogs without PH was 758 days (95% CI 527–848) and for those with PH, 456 days (95% CI 360–567). PH presence wasn’t an independent predictor of survival, but TRPG > 55 mmHg remained an independent negative predictor of survival.

46
Q

What echo features can predict PH/increased tricuspid regurgitation velocity?
Separately, are there any echo variables that can predict RHS CHF from pulmonary hypertension?

A

Tidholm JVIM 2015. La/Ao, Pulmonary artery accelerationtime/deceleration time, increased right ventricular internal diameter in diastole

Vezzosi JVIM 2018: Right atrial surface area can be used to predict RHS CHF in dogs with pulmonary hypertension and is predicted by the severity of tricuspid regurgitation. The most accurate cutoff value of the RAA index to identify R-CHF was >12.3 cm2/m2 (sensitivity, 100%; specificity, 89.5%).

The RVEDA (right ventricular end diastolic area) index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R-CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.

47
Q

Can sedation affect Tricuspid regurgitation velocity?

A

Rhinehart JVIM 2017: Yes, 78% of dogs had a significant increase after sedation

48
Q

What is the association between hypothyroidism and DCM in Dobermans?

A

Beier JVIM 2015:Dobermans with DCM had a 2.26 higher risk of being affected by hypothyroidism. However, treatment of hypothyroidism did not affect the outcome, so this did not support a role for hypothyroidism in the progression of DCM.

49
Q

What are some predictors of sudden cardiac death in Dobermans with DCM?

A

Volume overload of the left ventricle (increased left ventricular end diastolic volume > 91.3ml.m2) ** single best variable.
Increased cTnI, ventricular tachycardia, rate of VPCs >260 beats per minute were also predictive

50
Q

What is the Sn/Sp of conventional cTnI in dobermans with DCM? How about the high sensitivity assay?

A

Kluser JVIM 2018: Using a conventional cTnI assay, a cutoff value of >0.22 ng/mL has a sensitivity of 79.5% and a specificity of 84.4% to detect all DCM disease stages.

For Dobermans without CHF, a high sensitivity cTnI troponin assay had a sensitivity of 79% and specificity of 73% with a cut off of > 0.113ng/ml (compared with conventional, Sn 78 and Sp 72).
Sensitivity slightly higher for all dogs, including CHF dogs - Sn 81% Sp 73%

51
Q

What pathogens were detected in the endocardial biopsies of dogs with unexplained rhythm disorders, as compared to congenital heart disease

A

The most common pathogens in dogs with UMRD were canine distemper virus, canine coronavirus, canine parvovirus 2, and Bartonella spp. 57% of dogs tested positive to 1+ pathogen. Positive association but causation not found

52
Q

What is the typical character of a physiologic murmur in a puppy? Is NT-proBNP useful to differentiate?

A

Systolic, left heart base, up to 2/6 intensity
JVIM Marinus 2017: Plasma NT-proBNP concentrations within the reference range do not rule out a congenital cardiac anomaly. Murmurs longer than 80% of the systole are most likely abnormal, whereas murmurs shorter than that could be either innocent or pathologic.

53
Q

What is the prognostic significance of chronic renal disease in chronic MMVD?

A

Martinelli JVIM 2016: Survival time is reduced. A significant correlation was found between ACVIM class and IRIS stage. Anaemia was not associated with worsening of heart function.

54
Q

What echocardiographic variables are affected by body weight in cats?

A

Ao, LV end diastolic, LV free wall thickness, LA dimensions

55
Q

What is the diagnostic accuracy of POCUS for diagnosing CHF in cats with respiratory distress? How does this compare to NT pro BNP

A

Ward JVIM 2018: POCUS 78% Sn and 83% Sp. LA enlargement 97% Sn and Sp 100%. NT pro BNP 93.9% Sn, 72% Sp.

56
Q

What is the significance of red blood cell distribution width in cats with CHF?

A

Roderick JFMS 2017: RDW increased in CHF compared to those without , median higher in cats with UCM compared to other CM

57
Q

What is the difference in ambulatory ECG findings between asymptomatic HCM cats and healthy cats?

A

JFMS 2017: No difference in heart rate or number of VPC/APCs

58
Q

In the REVEAL study, what was the risk of CHF and ATE in cats with HCM/HOCM? Was their a difference between the two? What % of cats reached 9-15 years?

A

CHF or ATE in 30.5%, cardiovascular death 27.9%. No difference between HCM and HOCM. 10% of cats reached 9-15 years.

59
Q

What is MAPSE and TAPSE? How are they affected by HCM and CHF in cats?

A

JVIM 2017. Mitral annular plane systolic excursion (MAPSE) and the right-sided counterpart tricuspid annular plane systolic excursion (TAPSE) are M-mode-derived indices of systolic longitudinal displacement of the atrioventricular annular plane. MAPSE and TAPSE can therefore be considered as markers of ventricular long-axis function. The results of our study indicated that cats with HCM have lower MAPSE and TAPSE values as com- pared to healthy control cats. Furthermore, cats with CHF showed the lowest values of MAPSE and TAPSE.

60
Q

What is speckle tracking echocardiography? What changes can be seen in HCM cats?

A

JVIM 2019: quantification of myocardial deformation - therefore function. Cats with HCM had decreased systolic long axis deformation with this modality and radial deformation, but overall preserved circumfer- ential deformation.

61
Q

What are the key differences between cats with transient myocardial thickening and persistent HCM?

A

JVIM 2018: Cats were younger (2 vs 8 years), more commonly had antecedent events (15/21 vs 6/21). Reduction in La/Ao occurred over a mean interval of 3 months. All cats survived and cardiac medications were discontinued in 20/21

62
Q

What is the prevalence of cardiac catchexia in cats, based on MCS? What other factors is it associated with? Does it have a prognostic impact?

A

JVIM 2019: 41.6% prevalence. Associated with older age, pleural effusion, lower HCT, higher neutrophils, higher BUN, lower BCS. Survival time shorter than for those without

63
Q

What is the MST for RCM cats?

A

JFMS 2018: 69 days overall, but 64 days if clinical (without 466 days)
JVIM 2019: Median (min-max) median survival time from diagnosis was 436 days (2-3710). LA enlargement was associated with decreased survival. Risk of cardiac death increased by 2.5 for every 0.5 LA/AO increase

64
Q

How can thermography be used to diagnose FATE and what is the Sn/Sp?

A

JFMS 2018: a minimum difference of 2.4°C between ipsilateral affected and non-affected limbs has an excellent specificity and high sensitivity for the diagnosis of FATE (Sn 80-90% and Sp 100%, PPV 100%, NPV 75-80%)

65
Q

What was the reported differences in cats treated with TPA vs standard of care therapy for FATE?

A

JFMS 2019: No statistically significant difference in short term survival, clinical improvement, repercussion injury or AKI between groups. TPA group presented within 3 hours of onset of FATE. Study may have been underpowered

66
Q

What was the major findings of the FAT CAT trial?

A

clopidogrel was shown to be superior to aspirin with a CATE recurrence rate of 49% (vs 75%) and 1-year recurrence rate of 36% (vs 64%). Clopidogrel was also associated with longer median time to CATE event (443 days) compared with aspirin (192 days)

67
Q

What is the potential use of ophthalmic 0.5% timolol maleate for echocardiography in cats?

A

JVIM 2016: Causes a significant reduction in HR (25bpm). Caused separation of the E and A waves that were fused before application in 62% of cats. No bradyarrythmias but 2 developed 1st degree AV block. Caused resolution of a dynamic outflow obstruction in 6 cats.

68
Q

Has there been proven benefit to benazepril administration to cats with heart disease?

A

JVIM 2019. Was well tolerated but no benefit found (no difference with placebo in time to treatment failure or QOL scores). However, heterogenous group of cats, multiple diseases and included asymptomatic cats.

69
Q

What was the effect of steroids (median 2mg/kg/day, range 1-3.3mg/kg/day) on NTproBNP and LA size in cats?

A

JVIM 2019: Significant increase in La and LV size. Suspected due to mineralocorticoid effects due to BG remaining stable, as was blood pressure. Absolute values of NT pro BP were the same in the group, but 60^ of individual cats had an increase in BNP of greater than 60%

70
Q

What is the Sn and Sp of cTnI in differentiating healthy cats from asymptomatic HCM? What about predicting heart failure?

A

cTnI with a cut off of 0.163 = Sn 62 and Sp 100% for normal/asymptomatic. 0.234 = Sn95, Sp 77.8% for asking heart failure

71
Q

How does the second generation ELISA and a POC test for pro BNP perform to differentiate cardiac from non cardiac pleural effusion in cats? On serum and fluid itself

A 
JVIM 2016 ELISA; 
Plasma Sn 95, Sp 82
Effusion: Sn 100, Sp 76
POC 
Plasma:  Sn 95, Sp 87
Pleural: Sn 100, Sp 64
Overall, POC on pleural fluid was not considered able to distinguish
72
Q

What was the performance of a POC NT pro BNP ELISA in JVIM 2017 in differentiating healthy cats with cats with various cardiac diseases (structural and AV block)

A

JVIM 2017: Sn 65, Sp 100%. Conclusion was that a negative result could not exclude cardiac disease

73
Q

Can NT pro BNP predict prognosis in cats with CHF?

A

JVIM 2017: Cats with a larger decrease from admission to discharge, without CHF at revisit, had longer survival times. CHF at re evaluation and difficulty administering medications were associated with poorer prognosis

74
Q

What is the effect of Pimobendan on Dobermans with pre-clinical DCM?

A

Dobermanns with preclinical DCM at presentation had times to primary end- point (sudden death or CHF) of 441 days, which was shown to increase to 718 days in dogs receiving pimobendan

75
Q

What are the ACVIM MMVD consensus definitions for a Stage B2 MMVD dog

A

B2 definitions (ideally fulfil all) :
Murmur 3/6+
La/Ao 1.6 +
normalised LVIDd 1.7+
VHS 10.5+ (breed adjusted); or if not doing echo 11.5+
VLAS (radiographic measurement of LA size) 3+ vertebra if no echo

76
Q

What are some ways of measuring cardiac output? which are considered less affected by systemic vascular resistance?

A

JVIM 2016: Transpulomnary thermodilution and pulmonary artery thermodilution; change in blood temperature noted either in a peripheral artery (femoral) or pulmonary artery after injection of a cold indicator, are used to estimate CO. Comparable.
Calibrated pulse contour analysis uses analysis of the systolic portion of the arterial pressure waveform.
Pulse contour analysis is affected by peripheral vascular resistance which limits clinical utility

77
Q

What is a proposed vessel measurement that could be used for volume status in dogs? Where is this measured?

A

JVIM 2018: CVC to Ao ratio, measured at the right hepatic intercostal view and longitudinal right paralumbar view. Good inter observer agreement, needed validation in hypovolaemic dogs

78
Q

What are the differences in post operative outcomes for dogs having thoracotomy or thorascopy for treatment of PRAA?

A

JAVMA 2016 No difference in post operative complications. No difference in surgery length. No difference tube in place. Median hospitalisation 1 day for thorascopy and 2 days for thoracotomy

79
Q

Based on one case report, what would be the indication for pulmonary artery banding in a cat with a VSD?

A

JAVMA 2019; CHF or pulmonary to systemic flow ratio of >3 (reduced to 1.5 in this study post band and symptoms resolved)

80
Q

What are the complication rates reported with transvenous pacemakers? What factor was reported to impact complications?

A

JVIM 2015: Major complications in 18% = lead dislodgement, infection, pacing failure. Incidence of complications higher when placed OOH, particularly infections. MST was 27 months and did not differ between when the pacemaker was placed

81
Q

Name a treatment option for tricuspid stenosis. What breed is this reported in? What are the risks of treatment?

A

JVIM 2017: Baloon valvuloplasty. Labradors, presented for syncope, RHS CHF and exercise intolerance. Most had clinical improvement but CSx recurred in 2/5 and one dog was euthanised due to progressive RHS CHF

82
Q

What is the more accurate way of calibrating an angiographic image for size?

A

JVIM 2018: Oesophageal pigtail marker. Radioopqaue table ruler under estimated by 10%

83
Q

What is a notable complication in cats treated for PDA? Is there a proven survival benefit to correction?

A

JAVMA 2016: Laryngeal paralysis was a notable complication, due to nerve damage. No difference in MST between treated and untreated cats in this study, but a small cohort and 75% of untreated cats died of CHF

84
Q

What is the difference in complication rates between surgically ligated PDA and ductal occluders?

A

JAVMA 2018: 10% major complication rate in surgical group compared to 0% in occluder group. Survival to discharge was comparable.

85
Q

What is the expected echo changes post PDA closure?

A

JVIM 2015: Reduced La/Ao, reduced LVIDd, static LVIDs. Reduction in FS%. Reduced strain values, LV dyssynchrony. Strain analysis was found to be load dependent.

86
Q

What marker of systolic function is the same between open PDA dogs and normal dogs? What is different?

A

JVIM 2016: ejection fraction and fractional shortening were the same, speckle tracking showed subtle differences in systolic function

87
Q

Post attenuation, PDA dogs can have reductions in EF and FS, thought to be due to loss of preload. What other marker of systolic function can be used that is not as affected by this?

A

JVIM 2016: Speckle tracking echo. This was found to show stable systolic function (normal S and SR values) post

88
Q

Is pulmonary hypertension a contraindication to PDA closure?

A

No - JVIM 2017, pulmonary hypertension was not seen in this study but still associated with L to R shunts. Adult dogs in this study and improvement was seen with PDA closure, even when clinical

89
Q

Does PDA size correlate with body weight?

A

JVIM 2017: Poor correlation, not recommended to base choice of occluder on weight. in small patients the femoral artery size can limit the size of the device used

90
Q

What is the most common PDA shape and how is it best diagnosed?

A

JVIM 3018: Transoesophageal echo (3D) - oval shape

91
Q

what PDA anatomical type is most commonly reported in GSD? why is transoesophageal echocardiography recommended?

A

JVIM 2019: Type II anatomy was most common. three dogs had unusual anatomy in this study and median minimal ductal diameter was larger than in a mixed dog population, hence the echo recommendation

92
Q

What drug (Pimobendan, digoxin or benazepril) was associated with delaying CHF or death in Irish Wolfhounds with either Afib or DCM?

A

Pimobendan. Reached endpoint in 1991 days vs digoxin 1263 days and benazepril 997 days.

93
Q

What is the prognostic implication of heart rate in dogs with AFib (how much will an increase in HR by 10bpm increase mortality and what threshold was used for two group comparison?)

A

JVIM 2018: for every 10bpm increase, all cause mortality increased by 35%. MST was 1037 days for dogs with HR <125, but 105 days for HR 125+. Mean HR was independently associated with all cause and cardiovascular mortality

94
Q

what is pentamidine analogue (MOA)? What was it evaluated in and what was the outcome?

A

JVIM 2018: Inhibitor of the inward rectifier K+ current, which is important for depolarisation and maintaining resting membrane potential. In experimental Afib models this channel is upregulated, so this drug was proposed to be effective for Afib. Evaluated in large breed dogs with Afib: none cardioverted to sinus rhythm. Side effects: VPC, respiratory distress with laryngeal stridor, muscular weakness and twitching

95
Q

What % of dogs with pacemakers have regression to more normal rhythms, including sinus rhythm?

A

JVIM 2016: 13% of dogs regressed (meaning 87% progressed or remained static). Most dogs therefore had chronic structural change. the dogs that improved could have had myocarditis

96
Q

What dog breed is commonly affected by AV accessory pathways? What is the outcome after radiofrequency catheter ablation?

A

JVIM 2018: Labradors 47%. CSx: Lethargy and GI signs, also tachycardia induced cardiomyopathy in 46%. Catheter ablation eliminated AP conduction long term in 98.8% of dogs

97
Q

Which atrial tachycardia may lignocaine be efficacious for? in what % of dogs did cardioversion take place?

A

JVIM 2019: Orthrodromic AV reciprocating tachycardias. 84% converted.

98
Q

What is the effect of sotalol on echo features of ventricular function on dogs with ventricular arrhythmias.

A

JVIM 2018: Mild decreases in all indices except TAPSE; only LVIDs (normalised) and EF were significantly different. No adverse events, even in dogs with LA enlargement or systolic dysfunction..

99
Q

What is the median VPC/24 hour in healthy salukis?

A

JAVMA 2018: 2

100
Q

The mutation KCNQ1 was associated with what ECG abnormality in a family of Springer Spaniels

A

JVIM 2015; QT prolongation

101
Q

What echocardiographic variable is prognostically significant in Boxers in ARVC? What VPC # threshold was associated with this variable?

A

JVIM 2015: TAPSE (tricuspid annular plane systolic excursion); lower in dogs with 50+ VPCs, and TAPSE <15.1 was associated with shorter cardiac survival

2015 to 2019 journals (13 decks)

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