A Workplace-Based Intervention to Improve Awareness, Knowledge, and Utilization of Breast, Cervical, and Colorectal Cancer Screenings Among Latino Service and Manual Labor Employees in Utah.

In the United States, Latinos are more likely to be uninsured and diagnosed with later stage cancer than non-Hispanic whites. Promotoras (lay health educators) help improve cancer knowledge and facilitate access to cancer screenings. We tested a promotora led workplace-based intervention to improve knowledge of and adherence to breast, cervical, and colorectal cancer screening among Latino employees in service or manual labor jobs. Latinos 18 and older from Salt Lake County, Utah were enrolled from January 2015 to February 2016. N = 265 completed pre- and post-intervention surveys that measured knowledge of and adherence to breast, cervical, and colorectal cancer screenings. Demographic, economic, and cancer factors of participants who completed the intervention were compared to those who were incomplete. Changes in knowledge and adherence were calculated using McNemar's tests. Logistic regression compared outcomes by select demographic, economic and cancer factors. More participants were older, spoke Non-English languages, were single/widow(er)s, worked part-time, and had an immediate family member with cancer compared to those who did not complete the study (all p < 0.05). Knowledge of the age to begin cancer screenings increased significantly from baseline to follow-up for cervical (65.1-77.7%), breast (67.2-81.7%), and colorectal cancer (49.8-80.7%), all p ≤ 0.001. Knowledge of the frequency of cervical (34.0-46.5%) and colorectal (72.1-84.5%) screening increased from baseline to follow-up, both p < 0.001. Adherence to fecal immunochemical tests (FIT) for colorectal cancer increased from baseline to follow-up (13.8-56.9%, p < 0.001). Promotora led workplace-based interventions can strengthen community capacity for educating and supporting Latino employees in preventing breast, cervical, and colorectal cancer.

Extracellular Vesicles: Evolutionarily Conserved Mediators of Intercellular Communication.

Extracellular vesicles (EV) are sub-micron circulating vesicles found in all bodily fluids and in all species so far tested. They have also recently been identified in seawater and it has further been shown that they are released from microorganisms and may participate in interspecies communication in the gut. EV are typically composed of a lipid bilayer formed from the plasma membrane and which encases a cargo that can include genetic material, proteins, and lipids. At least two different processes of formation and release have been described in mammalian cells. The exosome population (50 to 150nm size) are produced via a lyso-endosomal pathway, while microvesicles (100 to 1000nm) are formed by budding of the plasma membrane in a calcium dependent process. Both pathways are highly regulated and appear to be conserved amongst different species. EV release has been shown to be upregulated in a number of human chronic diseases including cardiovascular disease, metabolic disorders, obesity, and cancer; evaluation of their presence in veterinary samples may aid diagnosis in the future. This review will provide insight into the formation of EV and their detection in bodily fluids from different veterinary species and how they may provide a novel addition to the veterinary toolkit of the future.

Longitudinal assessment of systolic anterior motion of the mitral valve in cats with hypertrophic cardiomyopathy.

BACKGROUND: The proportion of cats with hypertrophic cardiomyopathy (HCM) that lose systolic anterior motion of the mitral valve (SAM) in the long term is unknown. HYPOTHESIS/OBJECTIVES: Cats with HCM will lose SAM in the long term. Loss of SAM will be associated with greater age, longer scan-interval, and altered left ventricular (LV) dimensions. ANIMALS: Sixty unsedated cats with HCM, not receiving beta blockers or pimobendan. METHODS: A retrospective cohort study from 2 referral centers. Cats were eligible if they had been diagnosed with HCM and had a repeat echocardiogram ≥1 year later. Clinical and echocardiographic data of the left heart variables were collected. RESULTS: Thirty-eight cats had SAM at the initial scan. After a median follow-up time of 2.1 years (range: 1.0-5.9), 7 cats had lost SAM (18%) and 5 cats (23%) gained SAM. On follow-up, cats with SAM at the initial scan had a larger left atrium (P = .037), lower left atrial fractional shortening (P = .014), greater LV internal diameter in end-systole (P = .002), and lower LV fractional shortening (P < .001). Four cats with SAM developed congestive heart failure. There were no new cases of congestive heart failure or change in left heart variables in cats without SAM at the initial scan. The gain or loss of SAM was not associated with age or time between scans. CONCLUSIONS AND CLINICAL IMPORTANCE: Similar proportions of cats gained or lost SAM. Cats with SAM at baseline had more evidence of disease progression than cats without SAM.

Prevalence of Hypertrophic Cardiomyopathy and ALMS1 Variant in Sphynx Cats in New Zealand.

Recently, hypertrophic cardiomyopathy (HCM) in Sphynx cats has been associated with a variant in the gene encoding Alström syndrome protein 1 (ALMS1). The primary aims of this study were to describe the prevalence of HCM in Sphynx cats in New Zealand, and to assess the association between HCM and the ALMS1 variant in this population. In this prospective study, 55 apparently healthy Sphynx cats from registered Sphynx breeders and pet owners in New Zealand were screened by a cardiologist. A total of 42 of these cats had a repeat cardiac examination after median 1.8 years (range: 1.6-2.2). The frequency of the ALMS1 variant was 70.9% (11 homozygous and 28 heterozygous). At the median age of 5.8 years (range: 2.4-13.1), the prevalence of HCM was 40% (20 out of 55 cats). Three cats with HCM died during the study with congestive heart failure. All three cats had focal but extensive myocardial ischemia or infarction at necropsy. The ALMS1 variant was not associated with the HCM diagnosis. In summary, HCM was common in the studied cohort, suggesting Sphynx cats are predisposed to this disease. While the ALMS1 variant was also frequently detected, it was not associated with HCM in this population.

Automated echocardiographic left ventricular dimension assessment in dogs using artificial intelligence: Development and validation.

BACKGROUND: Artificial intelligence (AI) could improve accuracy and reproducibility of echocardiographic measurements in dogs. HYPOTHESIS: A neural network can be trained to measure echocardiographic left ventricular (LV) linear dimensions in dogs. ANIMALS: Training dataset: 1398 frames from 461 canine echocardiograms from a single specialist center. VALIDATION: 50 additional echocardiograms from the same center. METHODS: Training dataset: a right parasternal 4-chamber long axis frame from each study, labeled by 1 of 18 echocardiographers, marking anterior and posterior points of the septum and free wall. VALIDATION DATASET: End-diastolic and end-systolic frames from 50 studies, annotated twice (blindly) by 13 experts, producing 26 measurements of each site from each frame. The neural network also made these measurements. We quantified its accuracy as the deviation from the expert consensus, using the individual-expert deviation from consensus as context for acceptable variation. The deviation of the AI measurement away from the expert consensus was assessed on each individual frame and compared with the root-mean-square-variation of the individual expert opinions away from that consensus. RESULTS: For the septum in end-diastole, individual expert opinions deviated by 0.12 cm from the consensus, while the AI deviated by 0.11 cm (P = .61). For LVD, the corresponding values were 0.20 cm for experts and 0.13 cm for AI (P = .65); for the free wall, experts 0.20 cm, AI 0.13 cm (P < .01). In end-systole, there were no differences between individual expert and AI performances. CONCLUSIONS AND CLINICAL IMPORTANCE: An artificial intelligence network can be trained to adequately measure linear LV dimensions, with performance indistinguishable from that of experts.

Echocardiographic values for normal conditioned and unconditioned North American whippets.

BACKGROUND: Echocardiographic reference intervals have not been reported for North American whippets, or for whippets that have undergone pet-level athletic training. OBJECTIVES: To develop normal echocardiographic reference intervals for North American whippets and investigate differences in echocardiographic parameters based on athletic conditioning in pet whippets engaged in competitive sports. ANIMALS: One-hundred healthy North American whippets. METHODS: Dogs were examined at national shows between 2005 and 2009. Echocardiographic reference intervals were constructed and the effect of athletic conditioning on parameters of structure and function was assessed. RESULTS: Two dimensional, M-mode, Doppler and tissue Doppler reference ranges for healthy North American whippets are presented. Measures of left ventricular (LV) chamber diameter were larger in conditioned whippets (N = 25) and remained significantly larger than in unconditioned whippets (N = 16) when normalized for weight using allometric equations. Calculated LV mass was higher in conditioned dogs than in unconditioned dogs, and this difference persisted when LV mass was normalized by weight. Mitral E velocity was higher in conditioned dogs than in unconditioned dogs, whereas E/A and measures related to systolic function were not different. CONCLUSIONS AND CLINICAL IMPORTANCE: Pet whippets in peak athletic condition have larger hearts than do less conditioned whippets, but measures of systolic function are similar. Whippet pet athletes may show eccentric LV hypertrophy at peak condition. Normal values for cardiac size and function in North American whippets might be considered abnormal if population-specific whippet reference intervals are not used in analysis.

Exploration of Mediators Associated with Myocardial Remodelling in Feline Hypertrophic Cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) affects both humans and cats and exhibits considerable interspecies similarities that are exemplified by underlying pathological processes and clinical presentation to the extent that developments in the human field may have direct relevance to the feline disease. Characteristic changes on histological examination include cardiomyocyte hypertrophy and interstitial and replacement fibrosis. Clinically, HCM is characterised by significant diastolic dysfunction due to a reduction in ventricular compliance and relaxation associated with extracellular matrix (ECM) remodelling and the development of ventricular hypertrophy. Studies in rodent models and human HCM patients have identified key protein mediators implicated in these pathological changes, including lumican, lysyl oxidase and TGF-ß isoforms. We therefore sought to quantify and describe the cellular location of these mediators in the left ventricular myocardium of cats with HCM and investigate their relationship with the quantity and structural composition of the ECM. We identified increased myocardial content of lumican, LOX and TGF-ß2 mainly attributed to their increased expression within cardiomyocytes in HCM cats compared to control cats. Furthermore, we found strong correlations between the expressions of these mediators that is compatible with their role as important components of cellular pathways promoting remodelling of the left ventricular myocardium. Fibrosis and hypertrophy are important pathological changes in feline HCM, and a greater understanding of the mechanisms driving this pathology may facilitate the identification of potential therapies.

Natural history of hypertrophic cardiomyopathy in cats from rehoming centers: The CatScan II study.

BACKGROUND: The natural history of hypertrophic cardiomyopathy (HCM) in cats has been mainly studied in cats referred for suspected heart disease, which can skew the results towards cats with clinical signs. Few data are available on factors associated with development of HCM in cats. HYPOTHESES: (1) Clinical variables can predict which cats will develop HCM; (2) HCM in cats not referred for suspected heart disease is associated with a low rate of cardiovascular events. ANIMALS: One hundred seven cats from rehoming centers without a history of clinical signs of cardiac or systemic disease at the time of adoption. METHODS: Prospective longitudinal study. After rehoming, shelter cats were reexamined for serial echocardiograms. Cox regression analysis was used to identify predictors of development of HCM in cats that were normal at baseline. Adverse cardiovascular events including heart failure, thromboembolism, or sudden death were recorded. RESULTS: Cats were monitored for a median of 5.6 [1.2-9.2] years. At baseline, 68/107 cats were normal, 18/107 were equivocal and 21/107 had HCM. Nineteen cats developed HCM during the study period. The factors at baseline associated with increased hazard of developing HCM were lower left atrial fractional shortening, higher left ventricular fractional shortening, and higher body weight. Cardiovascular events were observed in 21% of cats with HCM. CONCLUSIONS AND CLINICAL IMPORTANCE: Cardiovascular events were common in cats with HCM from a rehoming center study sample. Lower left atrial systolic function appears to precede overt HCM.

Rhythm disturbances associated with lidocaine administration in four dogs with supraventricular tachyarrhythmias.

OBJECTIVE: To describe arrhythmias associated with administration of lidocaine in dogs treated for supraventricular tachyarrhythmias. CASE SUMMARIES: Four dogs with recent-onset supraventricular tachyarrhythmias: 3 dogs had atrial fibrillation (AF), and 1 had focal atrial tachycardia (FAT), which was thought to be AF at the time of assessment. The substrate of the supraventricular tachyarrhythmia was considered to be due to primary cardiomyopathy in 1 dog, high vagal tone in 2 dogs, and the change in hemodynamics from heavy sedation in 1 dog. Pharmacological cardioversion using lidocaine was only successful in the 2 dogs with vagally mediated AF. In these 2 cases, lidocaine administration resulted in a paroxysmal atrial flutter that was self-limiting and quickly led to sinus rhythm within 10 seconds in 1 dog but did not change over a 5-minute interval and required additional boluses in another dog. In the latter case, the dog showed severe bradycardia for 17.5 seconds prior to achieving sinus rhythm. The 2 unsuccessful cases both developed ventricular arrhythmias shortly after the lidocaine administration, with 1 case degenerating into ventricular fibrillation and cardiac arrest. NEW OR UNIQUE INFORMATION PROVIDED: Arrhythmias associated with lidocaine should be considered when treating dogs with supraventricular tachyarrhythmia.

Retrospective evaluation of hypertrophic cardiomyopathy in 68 dogs.

BACKGROUND: There is a lack of clinical data on hypertrophic cardiomyopathy (HCM) in dogs. HYPOTHESIS/OBJECTIVES: To investigate signalment, clinical signs, diagnostic findings, and survival in dogs with HCM. ANIMALS: Sixty-eight client-owned dogs. METHODS: Retrospective multicenter study. Medical records were searched between 2003 and 2015. The diagnosis of left ventricular (LV) hypertrophy was made by echocardiographic examination. RESULTS: Three hundred and forty-five dogs with LV hypertrophy were identified, of which 277 were excluded. The remaining 68 dogs were 0.3 to 14 years old and predominantly <10 kg (85%), and without a sex predilection. Twenty-four % were Shih Tzu and 24% terrier breeds. Most (80%) had a systolic heart murmur. Owner-determined exercise intolerance (37%) and syncope (18%) were most commonly reported signs. The majority (84%) of dogs had symmetrical LV hypertrophy, whereas asymmetrical septal and LV free wall hypertrophy was observed in 9% and 6% of dogs, respectively. Isolated basal interventricular septal hypertrophy was not observed. Commonly recorded were systolic anterior motion of the mitral valve (60%) and LV diastolic dysfunction (89% of dogs where diastolic function was evaluated). Six dogs died unexpectedly, and 3 developed congestive heart failure. Known survival times were between 1 day and 114 months after diagnosis. CONCLUSIONS AND CLINICAL IMPORTANCE: Hypertrophic cardiomyopathy in dogs should be considered as a differential diagnosis if LV hypertrophy is identified. Small breed dogs are overrepresented, and it is uncommon for dogs with HCM to develop CHF although sudden death can occur.

Cardiac auscultation skills in final year veterinary students and recent veterinary graduates, referral hospital veterinary surgeons and veterinary cardiologists or cardiology residents.

BACKGROUND: Cardiac auscultation is an important part of the physical examination. This study evaluated cardiac auscultation skills in veterinary students and compared their abilities to recent veterinary graduates, referral hospital veterinary surgeons and veterinary cardiologists or cardiology residents. In addition it compared their self-predicted quiz scores to their actual scores, evaluating if they could accurately predict their own performance level. METHODS: A digital recording device was used to record auscultation sounds from 12 different patients with a diagnosis confirmed by a board-certified veterinary cardiologist. The sound files and associated phonocardiograms were uploaded to a video sharing website. A cloud-based online multiple-choice quiz was generated and shared with final year veterinary students, recent veterinary graduates, referral hospital veterinary surgeons and veterinary cardiologists or cardiology residents. RESULTS: There were 128 participants: 51 final year veterinary students, 62 recent veterinary graduates, and 10 referral hospital veterinary surgeons and five veterinary cardiologists or cardiology residents. No difference was found between the cardiac auscultation skills of recent veterinary graduates and final year veterinary students. Veterinary students' self-predicted scores were lower than actual scores. CONCLUSIONS: Recent veterinary graduates did not perform better than final year veterinary students in this study, suggesting that auscultation skills do not continue to improve in the first few years after graduation. Efforts should be made to maximise students' learning in cardiac auscultation skills. Veterinary students show a lack of confidence in cardiac auscultation skills.

Left heart dimensions in anemic cats and dogs before and after blood transfusion.

BACKGROUND: Whether anemic cats and dogs with increased left heart dimensions are at higher risk of transfusion-associated circulatory overload, and the effect of blood transfusion on left heart dimensions in naturally occurring anemia is unknown. HYPOTHESIS/OBJECTIVES: To evaluate the effect of blood transfusion on left heart dimensions in clinically relevant anemia. ANIMALS: Twenty dogs and 20 cats presenting to a university veterinary teaching hospital. METHODS: In this prospective observational study, anemic dogs and cats requiring blood transfusion were included. Packed cell volume (PCV), total solids, and echocardiography were performed before and within 24 hours of blood transfusion. Signalment, bodyweight, disease process, transfusion duration and volume, and prior treatments were recorded. Nonparametric statistics were reported as median [range]. Post hoc Bonferroni correction set significance at P < .006. RESULTS: After transfusion, PCV increased in cats (12% [6-16] to 18% [10-33], P = .001) and dogs (14% [7-24] to 25% [9-37], P = .001), heart rate decreased in dogs (104 bpm [86-166] to 87 bpm [56-138], P < .001), and fractional shortening decreased in cats (57.1% [36.0-84.7] to 41.0% [28.1-69.6], P = .002) and dogs (33.79% [19.33-62.79] to 31.89% [19.06-51.47], P = .006). Left ventricular internal diameter in systole increased in cats (6.5 mm [2.7-9.8] to 7.9 mm [5.3-11.1], P = .001). Normalized left ventricular internal diameter in diastole (1.48 [1.25-1.79] to 1.57 [1.33-2.00], P = .001) and systole (0.87 [0.58-1.19] to 1.00 [0.74-1.36], P = .001) increased in dogs. Incidence of volume overload did not differ before (14/20 cats, 70%; 9/20 dogs, 45%) or after (12/20 cats, 60%; 11/20 dogs, 55%) transfusion (P = .64). CONCLUSIONS AND CLINICAL IMPORTANCE: Blood transfusion is well tolerated when signs of volume overload are present before transfusion.

Cyber-dating abuse in young adult couples: Relations with sexist attitudes and violence justification, smartphone usage and impulsivity.

Technologies have become important for interaction in couples. However, in some cases, controlling and aggressive behaviors can occur in the context of virtual interactions in couples; this is known as cyber-dating abuse (CDA). Identifying factors linked to CDA, as perpetrator and victim, are relevant for its prevention; therefore, more research is needed in this novel field of study. To contribute to the literature, our first goal was to analyze the associations among certain risk factors for CDA perpetration and victimization of, i.e., sexist attitudes and violence justification, problematic smartphone usage and impulsivity; sex and age were also considered. The second goal was to study whether there were differences in direct aggression and control, from the perpetrator and victim perspectives, with consideration of the above-mentioned risk factors. Third, differences in the diverse range of control behaviors and direct aggression between women and men were explored. To this end, 697 young adults (aged between 18 and 35 years; 548 women) completed self-report questionnaires that allowed assessment of the above-mentioned variables. The results showed that, among the wide range of CDA behaviors, indirect ones such as control behaviors were the most common. The highest level of control was strongly associated with the inability to manage behaviors under certain emotional states, especially negative ones, along with problematic smartphone usage. Sex differences were also observed: men displayed more sexist attitudes and violence justification, and perceived that they were more controlled by their partners. Regarding CDA behaviors, men and women showed differences in control (e.g. men considered themselves to be more controlled in terms of location and status updates), and direct aggression (e.g. men used more insults and humiliations than women). The results were discussed in terms of the importance of better understanding these risk factors to attenuate the increasing prevalence of CDA in relationships.

Immunohistological Evaluation of Von Willebrand Factor in the Left Atrial Endocardium and Atrial Thrombi from Cats with Cardiomyopathy.

Aortic thromboembolism (ATE) occurs in cats with cardiomyopathy and often results in euthanasia due to poor prognosis. However, the underlying predisposing mechanisms leading to left atrial (LA) thrombus formation are not fully characterised. von Willebrand Factor (vWF) is a marker of endothelium and shows increased expression following endothelial injury. In people with poor LA function and LA remodelling, vWF has been implicated in the development of LA thrombosis. In this study we have shown (1) the expression of endocardial vWF protein detected using immunohistofluorescence was elevated in cats with cardiomyopathy, LA enlargement (LAE) and clinical signs compared to cats with subclinical cardiomyopathy and control cats; (2) vWF was present at the periphery of microthrombi and macrothrombi within the LA where they come into contact with the LA endocardium and (3) vWF was integral to the structure of the macrothrombi retrieved from the atria. These results provide evidence for damage of the endocardial endothelium in the remodelled LA and support a role for endocardial vWF as a pro-thrombotic substrate potentially contributing to the development of ATE in cats with underlying cardiomyopathy and LAE. Results from this naturally occurring feline model may inform research into human thrombogenesis.

Effects of pimobendan in cats with hypertrophic cardiomyopathy and recent congestive heart failure: Results of a prospective, double-blind, randomized, nonpivotal, exploratory field study.

BACKGROUND: The benefits of pimobendan in the treatment of congestive heart failure (CHF) in cats with hypertrophic cardiomyopathy (HCM) have not been evaluated prospectively. HYPOTHESIS/OBJECTIVES: To investigate the effects of pimobendan in cats with HCM and recent CHF and to identify possible endpoints for a pivotal study. We hypothesized that pimobendan would be well-tolerated and associated with improved outcome. ANIMALS: Eighty-three cats with HCM and recently controlled CHF: 30 with and 53 without left ventricular outflow tract obstruction. METHODS: Prospective randomized placebo-controlled double-blind multicenter nonpivotal field study. Cats received either pimobendan (0.30 mg/kg q12h, n = 43), placebo (n = 39), or no medication (n = 1) together with furosemide (<10 mg/kg/d) with or without clopidogrel. The primary endpoint was a successful outcome (ie, completing the 180-day study period without a dose escalation of furosemide). RESULTS: The proportion of cats in the full analysis set population with a successful outcome was not different between treatment groups (P = .75). For nonobstructive cats, the success rate was 32% in pimobendan-treated cats versus 18.2% in the placebo group (odds ratio [OR], 2.12; 95% confidence interval [CI], 0.54-8.34). For obstructive cats, the success rate was 28.6% and 60% in the pimobendan and placebo groups, respectively (OR, 0.27; 95% CI, 0.06-1.26). No difference was found between treatments for the secondary endpoints of time to furosemide dose escalation or death (P = .89). Results were similar in the per-protocol sets. Adverse events in both treatment groups were similar. CONCLUSIONS AND CLINICAL IMPORTANCE: In this study of cats with HCM and recent CHF, no benefit of pimobendan on 180-day outcome was identified.

Evaluation of a flow-mediated vasodilation measurement technique in healthy dogs.

OBJECTIVE: To evaluate the between- and within-dog repeatability of a flow-mediated vasodilation (FMD) measurement technique in healthy dogs. ANIMALS: 43 male and female dogs of various breeds (weight range, 6.9 to 31.7 kg; age range, 11 months to 11 years). PROCEDURES: 5 dogs were used to refine the technique; other dogs were classified as large (>15 kg) or small (≥15 kg) before use in the main study. In each dog, a brachial artery was occluded for 5 minutes by inflating a blood pressure cuff (applied pressure was more than 50 mm Hg greater than that required to occlude flow). Two-dimensional ultrasonographic images of the artery were recorded during a 30-second period prior to cuff inflation (baseline) and during a 3-minute period after cuff deflation by each of 2 sonographers. Relative percentage increases in luminal size from baseline (ie, FMD) were calculated. Independent contributing factors to FMD (eg, body weight, age, and room temperature) were assessed. RESULTS: Median FMD was significantly greater in small dogs (77%; range, 0% to 19.3%) than it was in large dogs (2.2%; range, -2.2% to 10.6%); values were significantly greater in dogs<6 years old, compared with dogs>6 years old. Weight was the only independent contributing factor for FMD. Coefficients of variation for between- and within-dog repeatability were 99.7% and 62.8%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Application of the FMD measurement technique used in humans appears to be feasible in dogs and may provide a means of assessing canine endothelial function, although between and within-dog variations were large.

Investigation of optimal sample preparation conditions with potassium triiodide and optimal imaging settings for microfocus computed tomography of excised cat hearts.

OBJECTIVE: To determine optimal sample preparation conditions with potassium triiodide (I2KI) and optimal imaging settings for microfocus CT (micro-CT) of excised cat hearts. SAMPLE: 7 excised hearts (weight range, 10 to 17.6 g) obtained from healthy adult cats after euthanasia by IV injection of pentobarbital sodium. PROCEDURES: Following excision, the hearts were preserved in 10% formaldehyde solution. Six hearts were immersed in 1.25% I2KI solution (n = 3) or 2.5% I2KI solution (3) for a 12-day period. Micro-CT images were acquired at time 0 (prior to iodination) then approximately every 24 and 48 hours thereafter to determine optimal sample preparation conditions (ie, immersion time and concentration of I2KI solution). Identified optimal conditions were then used to prepare the seventh heart for imaging; changes in voltage, current, exposure time, and gain on image quality were evaluated to determine optimal settings (ie, maximal signal-to-noise and contrast-to-noise ratios). Images were obtained at a voxel resolution of 30 µm. A detailed morphological assessment of the main cardiac structures of the seventh heart was then performed. RESULTS: Immersion in 2.5% I2KI solution for 48 hours was optimal for sample preparation. The optimal imaging conditions included a tube voltage of 100 kV, current of 150 µA, and exposure time of 354 milliseconds; scan duration was 12 minutes. CONCLUSIONS AND CLINICAL RELEVANCE: Results provided an optimal micro-CT imaging protocol for excised cat hearts prepared with I2KI solution that could serve as a basis for future studies of micro-CT for high resolution 3-D imaging of cat hearts.

Biomarker changes with systolic anterior motion of the mitral valve in cats with hypertrophic cardiomyopathy.

BACKGROUND: N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) are biomarkers commonly evaluated in cats with suspected heart disease. Many cats with hypertrophic cardiomyopathy (HCM) have systolic anterior motion of the mitral valve (SAM), but its influence on circulating NT-proBNP or cTnI concentrations is currently unknown. HYPOTHESIS/OBJECTIVES: Cats with HCM and SAM (HCMSAM+ ) have higher NT-proBNP and cTnI concentrations than do cats with HCM but without SAM (HCMSAM- ). ANIMALS: One hundred forty cats with HCM: 70 with SAM and 70 without SAM. METHODS: Retrospective case-to-case study. Cats were recruited if diagnosed with HCM by echocardiography and results were available for NT-proBNP or cTnI concentrations or both. Cats with SAM were matched to those without SAM for clinical presentation, left atrial (LA) size and left ventricular (LV) fractional shortening. RESULTS: A total of 119 NT-proBNP and 123 cTnI results were available. The HCMSAM+ cats had higher median concentrations than did HCMSAM- cats for NT-proBNP (729 pmoL/L; interquartile range [IQR], 275-1467 versus 65 pmoL/L; IQR, 25-271; P < .001) and cTnI (0.27 ng/mL; IQR, 0.10-0.81 versus 0.07 ng/mL; IQR, 0.01-0.43; P = .002). In general linear models for both NT-proBNP and cTnI, the independent explanatory variables were SAM, congestive heart failure, maximal LV wall thickness, and LA size. CONCLUSIONS AND CLINICAL IMPORTANCE: For cats with HCM and equivalent LA size and LV systolic function, those with SAM had higher NT-proBNP and cTnI concentrations than did those without SAM. Presence of SAM should be considered when interpreting biomarker concentrations in cats with HCM.

ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats.

Cardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are well-tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death. Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk of life-threatening complications and those at higher risk. Based on the available literature, we offer recommendations for the approach to diagnosis and staging of cardiomyopathies, as well as for management at each stage.

Micro-computed tomography (micro-CT) for the assessment of myocardial disarray, fibrosis and ventricular mass in a feline model of hypertrophic cardiomyopathy.

Micro-computed tomography (micro-CT) is a high-resolution imaging modality that provides accurate tissue characterization. Hypertrophic cardiomyopathy (HCM) occurs as a spontaneous disease in cats, and is characterized by myocardial hypertrophy, disarray and fibrosis, as in humans. While hypertrophy/mass (LVM) can be objectively measured, fibrosis and myocyte disarray are difficult to assess. We evaluated the accuracy of micro-CT for detection and quantification of myocardial disarray and fibrosis by direct comparison with histopathology. 29 cat hearts (12 normal and 17 HCM hearts) underwent micro-CT and pathologic examination. Myocyte orientation was assessed using structure tensor analysis by determination of helical angle (HA), fractional anisotropy (FA) and myocardial disarray index (MDI). Fibrosis was segmented and quantified based on comparison of gray-scale values in normal and fibrotic myocardium. LVM was obtained by determining myocardial volume. Myocardial segments with low FA, low MDI and disruption of normal HA transmural profile on micro-CT were associated with myocardial disarray on histopathology. FA was consistently lower in HCM than normal hearts. Assessment of fibrosis on micro-CT closely matched the histopathologic evaluation. LVM determined by micro-CT was higher in HCM than normal hearts. Micro-CT can be used to detect and quantify myocardial disarray and fibrosis and determine myocardial mass in HCM.