Cardiac Arrhythmias in Standardbreds During and After Racing—Possible Association Between Heart Size, Valvular Regurgitations, and Arrhythmias

Buhl, Rikke; Petersen, Ellen; Lindholm, Maria; Bak, Lars; Nostell, Katarina

doi:10.1016/j.jevs.2012.09.009

Cited by 45 publications

(56 citation statements)

References 37 publications

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“…The limited number of horses examined in this study is not sufficient to provide prevalence or frequency estimates for the general population. However, in agreement with previous studies in other types of horses [4–6, 8], the results suggest that SVPCs are relatively common in endurance horses. As stated in the Introduction, the appropriate clinical question is therefore related more to the frequency of premature beats in a given time period or under specific circumstances (e.g.…”

Section: Discussionsupporting

confidence: 93%

“…Both supraventricular and ventricular premature beats have raised concerns in equine cardiology as potential initiators of atrial fibrillation [2] and fatal ventricular arrhythmias [3]. In recent years, studies have therefore investigated the occurrence of premature beats in healthy horses [4–8], horses with poor performance [9, 10], and in both clinical [11, 12] and experimental settings [13]. These studies provide valuable information on the prevalence of premature beats, although a comparison of the results is problematic due to different study designs.…”

Section: Introductionmentioning

confidence: 99%

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Appropriate threshold levels of cardiac beat-to-beat variation in semi-automatic analysis of equine ECG recordings

et al. 2016

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BackgroundAlthough premature beats are a matter of concern in horses, the interpretation of equine ECG recordings is complicated by a lack of standardized analysis criteria and a limited knowledge of the normal beat-to-beat variation of equine cardiac rhythm. The purpose of this study was to determine the appropriate threshold levels of maximum acceptable deviation of RR intervals in equine ECG analysis, and to evaluate a novel two-step timing algorithm by quantifying the frequency of arrhythmias in a cohort of healthy adult endurance horses.ResultsBeat-to-beat variation differed considerably with heart rate (HR), and an adaptable model consisting of three different HR ranges with separate threshold levels of maximum acceptable RR deviation was consequently defined. For resting HRs <60 beats/min (bpm) the threshold level of RR deviation was set at 20%, for HRs in the intermediate range between 60 and 100 bpm the threshold was 10%, and for exercising HRs >100 bpm, the threshold level was 4%. Supraventricular premature beats represented the most prevalent arrhythmia category with varying frequencies in seven horses at rest (median 7, range 2–86) and six horses during exercise (median 2, range 1–24).ConclusionsBeat-to-beat variation of equine cardiac rhythm varies according to HR, and threshold levels in equine ECG analysis should be adjusted accordingly. Standardization of the analysis criteria will enable comparisons of studies and follow-up examinations of patients. A small number of supraventricular premature beats appears to be a normal finding in endurance horses. Further studies are required to validate the findings and determine the clinical significance of premature beats in horses.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Appropriate threshold levels of cardiac beat-to-beat variation in semi-automatic analysis of equine ECG recordings

et al. 2016

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“…Seven research studies in horses have evaluated cTn concentrations in normal horses after nonendurance exercise. None of these studies identified significant increases in cTn concentrations partly as a consequence of the study population sizes (15, 28, 6, 24, 26, and 15 horses, respectively) but also as a result of the use of older generation, conventional sensitivity assays that have a higher LoD . We identified significant increases in cTn, using the hscTnT assay, in horses after high‐intensity, short‐duration racing exercise.…”

Section: Discussionmentioning

confidence: 73%

24‐Hour Kinetics of Cardiac Troponin‐T Using a “High‐Sensitivity” Assay in Thoroughbred Chuckwagon Racing Geldings after Race and Associated Clinical Sampling Guidelines

Shields

Seiden‐Long

Massie

et al. 2017

Veterinary Internal Medicne

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BackgroundA “high‐sensitivity” cardiac troponin‐T (hscTnT) assay recently has been validated for use in horses and is a specific biomarker of myocardial damage. Postexercise release kinetics of cTnT utilizing the hscTnT assay have yet to be established in horses.ObjectivesTo determine: (1) cTnT release kinetics in racing Thoroughbreds after a high‐intensity 5/8th mile Chuckwagon race; (2) the effects of age on pre‐ and postrace cTnT concentrations; and (3) sampling guidelines for clinicians evaluating horses presenting after exercise.AnimalsSamples were obtained from 38 Thoroughbred geldings aged 5–16 years before racing and immediately, 2, 3, 4, 6, 12, and 24 hour postrace.MethodsProspective, observational study with convenience sampling. A fifth‐generation hscTnT assay was used for plasma sample analysis, and concentrations were compared at all time‐points. Correlations were determined between cTnT concentrations and age. Biochemistry analysis was performed to assess rhabdomyolysis, renal failure, and exercise‐induced dehydration.ResultsAll horses with measureable cTnT concentrations had significant postexercise increases in cTnT with a median peak (8.0 ng/L) at 3‐hour postrace. All horses had peak postexercise cTnT concentrations 2‐ to 6‐hour postrace ≤ the 99th percentile upper reference limit of 23.2 ng/L, after which all cTnT concentrations decreased until returning to baseline by 12–24 hours. There was no correlation over time between cTnT concentrations and age.Conclusions and Clinical ImportanceIn racing Thoroughbreds completing short‐duration, high‐intensity Chuckwagon races, cTnT concentrations are expected to be increased 2‐ to 6‐hour postrace and to decrease by 12–24 hours while remaining ≤23.2 ng/L throughout. This study contributes to establishing guidelines for clinical use of the hscTnT assay in exercising horses.

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“…; Buhl et al . ). Isolated VPCs have also been reported, albeit less commonly, in 3–4.5% of racehorses during strenuous exercise (Ryan et al .…”

Section: Cardiac Arrhythmiasmentioning

confidence: 97%

“…; Buhl et al . ) and 19–28% showing one or more VPC (Lindholm et al . ; Physick‐Sheard and McGurrin ; Buhl et al .…”

Section: Cardiac Arrhythmiasmentioning

confidence: 99%

Evaluation of heart rate and rhythm during exercise

Allen

Young²,

Franklin

2015

Equine Veterinary Education

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Summary Heart rate and rhythm can readily be monitored during exercise. Although there is considerable variation depending on the athletic discipline, exercise can be considered to be one of the most physiologically demanding times for the cardiovascular system. Assessment of heart rate during exercise typically provides information regarding fitness and the intensity of exercise, and on some occasions may provide an early indication of disease. Cardiac causes of poor performance occur relatively infrequently in comparison with disorders of the musculoskeletal and respiratory systems. Nevertheless, exercise induces cardiac hypertrophy, which predisposes athletes to valvular regurgitation and arrhythmias. Consequently cardiac murmurs and arrhythmias are frequently present in equine athletes, whereupon the clinical significance can be difficult to determine. Undertaking an exercise test to identify exercise‐induced arrhythmias is important in the assessment of poor athletic performance and the risk of sudden cardiac death during exercise. This paper describes the assessment of heart rate and rhythm during exercise. Most research has been undertaken on racehorses but, where data are available for other disciplines, they have been included. Considerations regarding the choice, type and design of exercise test were detailed in the first paper in this series.

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Cardiac Arrhythmias in Standardbreds During and After Racing—Possible Association Between Heart Size, Valvular Regurgitations, and Arrhythmias

Cited by 45 publications

References 37 publications

Appropriate threshold levels of cardiac beat-to-beat variation in semi-automatic analysis of equine ECG recordings

Appropriate threshold levels of cardiac beat-to-beat variation in semi-automatic analysis of equine ECG recordings

24‐Hour Kinetics of Cardiac Troponin‐T Using a “High‐Sensitivity” Assay in Thoroughbred Chuckwagon Racing Geldings after Race and Associated Clinical Sampling Guidelines

Evaluation of heart rate and rhythm during exercise

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