Outcomes of transcatheter closure of patent ductus arteriosus in 22 small-breed dogs using the Amplatzer™ Vascular Plug 4

Journal of Veterinary Cardiology · 2026-02-05

Comparison of low- and high-pressure balloon valvuloplasty in dogs with severe pulmonary valve stenosis

Journal of Veterinary Cardiology · 2025-11-13

INTRODUCTION/OBJECTIVES: Balloon valvuloplasty (BVP) is considered a standard treatment for severe pulmonary valve stenosis (PS) in dogs. The efficacy and safety of low-pressure (LP) and high-pressure (HP) balloon catheters for BVP have not been compared. It was hypothesized there would be no difference in pressure gradient reduction between HP and LP, while cardiac troponin I would be higher with HP than with LP immediately following BVP. ANIMALS, MATERIALS AND METHODS: ) and aorta-to-pulmonary artery velocity time integral ratio at baseline, 18-24 h following BVP, and at the initial follow-up. Serum cardiac troponin I was measured at each time point. RESULTS: No differences were found between groups in sex, age, weight, or PS severity at any time point (baseline, 18-24 h post BVP, and follow-up; all P>0.9). Only three dogs had annular hypoplasia. Cardiac troponin values did not differ between LP and HP groups at any stage (P>0.1). Complication rates were also comparable (P=0.201). STUDY LIMITATIONS: The limited sample size may have reduced statistical power to detect modest yet clinically relevant differences. Small and homogeneous sample, lack of standardized HP catheters, inconsistent atenolol use, and variable follow-up timing may have influenced results. CONCLUSIONS: No significant difference between LP and HP catheters was observed in PS severity reduction or myocardial injury. High-pressure catheters offer no added benefit over LP catheters for treating severe PS in dogs without annular hypoplasia.

Comparison of adenosine, dobutamine and bicycle exercise on intracoronary physiological indices in patients with myocardial bridges

European Heart Journal · 2024-10-01

Abstract Background We have recently demonstrated that patients with angina and nonobstructive coronary arteries (ANOCA) with myocardial bridges (MBs) exhibit maladaptive exercise physiology, due to abnormal wave energies arising at the tunnelled segment (1). Intracoronary pressure-derived indices in response to dobutamine and adenosine are used to identify an ischaemic substrate in these patients in clinical practice (2). However, it remains unknown if the changes induced by dobutamine and adenosine are comparable with physical exercise. Methods Patients with ANOCA and a MB in the left anterior descending artery underwent simultaneous acquisition of intracoronary pressure and flow sequentially during rest, supine bicycle exercise and intravenous adenosine and dobutamine infusion. We compared coronary perfusion efficiency (accelerating energy/total energy flux) and changes in specific wave energies in response to these three stressors. Results Twenty-five patients were enrolled (36% females, 59±9 years old). Patients had a high symptom burden (88% CCS II-IV) and myocardial bridge muscle index (79±30). Fractional flow reserve and coronary flow reserve were 0.86±0.05 and 2.5±0.5. Microvascular resistances during adenosine, dobutamine and exercise were 2.0±0.7, 3.4±1.4 and 4.3±1.3 mmHg.cm-1.s-1 respectively (p<0.001). There was a reduction in coronary perfusion efficiency in response to adenosine (64±8% to 51±12%), dobutamine (65±9% to 53±13%) and exercise (66±10% to 56±9%) (all p<0.001), with no between stressor differences in delta perfusion efficiency (ANOVA p=0.641). However, the impact of each stressor on the wave energy arising from the tunnelled segment was different whereas no such difference (between stressors) was observed in the wave energies arising from the microcirculation. There was no difference in tunnelled-segment derived delta wave energies between dobutamine and exercise (Figure 1). Conclusions Adenosine, dobutamine and exercise have different effects on coronary microvascular resistance and cardiac coronary coupling in patients with myocardial bridges. Our findings provide novel mechanistic insights into the pathophysiology of ANOCA in combination with MB, and suggest that dobutamine (but not adenosine) could be used as a surrogate for physical exercise during intracoronary physiological assessment.Figure 1.

Therapy with clopidogrel or rivaroxaban has equivalent impacts on recurrence of thromboembolism and survival in cats following cardiogenic thromboembolism: the SUPERCAT study

Journal of the American Veterinary Medical Association · 2024-12-18 · 6 citations

OBJECTIVE: To assess the impact of clopidogrel or rivaroxaban administration on recurrence of arterial thromboembolism (ATE) in cats that have recovered from cardiogenic ATE. METHODS: This multicenter prospective double-masked protocol enrolled 45 cats that had recovered from cardiogenic ATE and were randomized to receive either clopidogrel (18.75 mg/cat, PO; n = 19) or rivaroxaban (2.5 mg/cat, PO; 26) as sole anticoagulant therapy for up to 2 years after the initial ATE. Primary outcome measures included recurrent ATE or death from any cause. In addition to bimonthly internet-based surveys of animal quality of life, echocardiograms were performed by veterinary cardiologists at 2, 6, 12, and 18 months after initial ATE. RESULTS: 17 cats experienced ATE recurrence: 7 of 19 (37%) in the clopidogrel group and 10 of 26 (39%) in the rivaroxaban group. Three cats in each group survived for the entire 2-year study without recurrence. In the clopidogrel group, median (95% CI) time to ATE recurrence was 663 days (150 to not calculable) and in the rivaroxaban group, 513 days (242 to not calculable). Median time from enrollment to death from cardiac or noncardiac causes was also not different between treatment groups. CONCLUSIONS: Single-agent antithrombotic therapy with rivaroxaban in cats recovered from cardiogenic embolism delayed recurrence of ATE for a similar time period as single-agent therapy with clopidogrel. CLINICAL RELEVANCE: In cats that have recovered from cardiogenic ATE, either rivaroxaban or clopidogrel may be used for single-agent thromboprophylaxis to delay ATE recurrence.

Habitual Physical Activity Does Not Prevent Long COVID

Medicine & Science in Sports & Exercise · 2023-09-01

PURPOSE: Physical activity’s role in prevention of excess body mass may be an important means of facilitating recovery after COVID-19. Independent of exercise’s effect on body mass, moderate habitual physical activity (PA) directly stimulates the immune system while a sedentary lifestyle increases risk of viral infections. Thus, habitual PA may be an effective and modifiable lifestyle behavior that improves immune response and lessens COVID-19 disease severity. Therefore, in this study we sought to determine the role of pre-infection habitual (pre-dx) PA in moderating long-term sequelae of COVID-19. METHODS: Invitations were emailed to 21,933 adults who were SARS-CoV-2 positive in a large healthcare system between March, 2020 and February, 2021. Participants (n = 492) completed a medical history and a Physical Activity History (PAH) questionnaire regarding PA during the 3-months pre-dx. Monthly thereafter they were emailed questionnaires regarding any on-going symptoms and the PAH survey. Long COVID (LC) was defined as the presence of COVID-related symptoms at 9 mos post-diagnosis. Logistic regressions were used to assess if PA pre-dx was protective against LC. Covariates were BMI, age, hospitalization (yes/no), and comorbidities that were different (p < 0.05) between those that did or did not have LC. RESULTS: Forty percent of subjects had LC at 9 mos: 34% of men and 44% of women, p = 0.022. PA pre-dx did not protect against LC (p = 0.299), however PA at 9 mos was significantly lower in the LC group (p < 0.001). The following factors increased the odds ratio (OR) of LC: higher BMI (p = 0.001; OR = 1.049, 95% CI = 1.019-1.081 per unit BMI), hospitalization (p = 0.008; OR = 1.756, 95% CI = 1.161-2.656), and diabetes (p = 0.021; OR = 3.134, 95% CI = 1.186-8.278). CONCLUSIONS: Since LC markedly limited PA and pre-dx PA did not protect against LC, individuals with a high pre-dx PA had difficulty returning to baseline PA levels. BMI and diabetes, known to be modulated by PA, greatly increased the odds of LC. Health professionals should be aware that symptoms commonly linger even 9 mos after COVID, particularly for women, and limit PA.

Pacemaker-lead-associated thrombosis in dogs: a multicenter retrospective study

Journal of Veterinary Cardiology · 2023-06-28 · 3 citations

Transvenous correction of patent ductus arteriosus in two toy-breed dogs with the Amplatzer™ Vascular Plug 4

Journal of Veterinary Cardiology · 2022 · 5 citations

• Medicine
• Cardiology
• Internal medicine

Concussion Incidence In Equestrians: A Self-report Survey

Medicine & Science in Sports & Exercise · 2021-07-12

PURPOSE: Equestrians are at high risk of concussion (CONC): per hospital records 45% of sports-related traumatic brain injury (TBI) in adults were related to horseback riding, dwarfing other causes. The second-leading cause of sports-related TBI was falls or hits from contact sports. However, little is known about incidence of CONC in equestrians who were not seen by medical professionals and it is likely that CONC rates are under-reported. Our purpose was to survey equestrians about their history of concussive-like injuries. METHODS: Subjects were recruited via email and social media using a snowball technique. Participants were provided with a definition of CONC and then completed a survey of their equestrian experience and CONC history. Incidence was expressed per 1000 hours of riding exposure. RESULTS: 205 subjects (198 women) reported an average of 26.5 ± 14.4 years of riding experience. A total of 708 CONC were reported, with the majority (563, 80%) occurring while riding a horse. CONC incidence while riding was 0.47 ± 1.15 per 1000 hours, with riders reporting a mean of 2.75 ± 4.48 CONC (range of 0-50); 88% were due to falls. Only 30 equestrians (15%) reported never having been concussed. Of those who were concussed at some point, the average number of CONC was 4.07 ± 5.60. The most common mechanisms were due to bucking (23%) and while jumping (22%). Riders reported wearing a helmet at the time of injury 84% of the time. Only 45% of riders indicated that they had reported a CONC to a health professional, while 33% indicated that they had not reported their CONC symptoms to anyone. CONCLUSIONS: Our data confirm that equestrians have a high CONC risk, per self-report, as expected when athletes collide with the ground with great force due to height and speed. For example, the all-injury incidence for skiing has been reported as 0.6/1000 hours, and for motorcycling as 0.14/1000 hours. The incidence reported by equestrians for CONC alone is similar or greater than the all-injury rate of those activities, respectively. Equestrians are at high risk of CONC relative to other activities. The high number (20%) of CONC occurring while not riding highlight the need for good safety practices not only while riding but also while handling horses.

Transarterial correction of patent ductus arteriosus in small dogs with the Amplatz™ Vascular Plug 4: A pilot study

Journal of Veterinary Cardiology · 2021 · 12 citations

• Medicine
• Cardiology
• Surgery

Identification of multilevel right-to-left shunting in a dog using nuclear scintigraphy imaging

Journal of Veterinary Cardiology · 2020 · 1 citations

• Medicine
• Radiology
• Cardiology