Clinical and echocardiographic follow-up study in warm-blood horses with heart valve insufficiency

Gehlen, Heidrun; Michl, A; Štádler, P

doi:10.21836/pem20030406

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…On the other hand, very little is known about the association between these two findings in horses. Gehlen et al [ 34 ] found that the dimensions and grade of murmurs increased from the first to the second examination in a follow-up examination of warmblood horses. However, no direct link between these findings could be detected [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gehlen et al [ 34 ] found that the dimensions and grade of murmurs increased from the first to the second examination in a follow-up examination of warmblood horses. However, no direct link between these findings could be detected [ 34 ]. In our study, the mean murmur intensity in horses with dimensional changes was 3.3/6 and, therefore, higher than in those without dimensional changes in which mean murmur intensity was 2.5/6.…”

Section: Discussionmentioning

confidence: 99%

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Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses

Hövener

Pokar²,

Merle

et al. 2021

Animals

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Heart murmurs are detected frequently when auscultating horses and certain murmurs can usually be linked to specific valvular regurgitations. Limited information exists about the accuracy of these broad rules in warmblood horses and the influence of grade of the regurgitation and dimensional changes on murmur intensity. This study aims to clarify the accuracy of cardiac auscultation in warmblood horses and the influence of the grade of regurgitation and dimensional changes on the loudness of the murmur. In this retrospective study, 822 warmblood horses presented for cardiac examination in a large equine referral center in northern Germany underwent a thorough cardiac auscultation. In total, 653 of these revealed one or more heart murmurs. Most common auscultatory findings were left-sided systolic murmurs (68%) or left-sided diastolic murmurs (15%). On 635 of these horses, an echocardiographic examination was performed, revealing regurgitations of the mitral valve as the most common valvular regurgitation (77%) followed by regurgitations of the aortic valve (23%). Thirty-one percent of horses that underwent echocardiographic examination displayed dimensional changes of one or more compartments of the heart, with the left atrium being most affected (21%), followed by the left ventricle (13%). The main goal of this study was to link certain auscultatory findings with results of the echocardiographic examinations, trying to determine whether auscultation and echocardiography agreed on the valve affected, as well as to find out if loudness of the murmur coincided with grade of regurgitation and presence of dimensional changes. Agreement between auscultation and cardiac ultrasound was substantial (Kappa 0.74) if one or more murmurs and regurgitations were present and almost perfect (Kappa 0.94) if only one murmur and one regurgitation were found. Auscultation was particularly well suited for detection of left-sided systolic and diastolic murmurs, with 87% of left-sided systolic murmurs being caused by a mitral valve regurgitation and 81% of left-sided diastolic murmurs originating from an aortic valve regurgitation. We found a fair agreement between the grade of regurgitation and the respective murmur. Association was particularly good between mild regurgitations and low-grade murmurs, while differentiation between moderate to severe regurgitation based upon the loudness of the murmur was less reliable. Dimensional changes were usually linked to more severe regurgitations and higher-grade murmurs. However, a direct correlation between murmur intensity and the presence or severity of dimensional changes, independent of the grade of valvular regurgitation, could not be established in this cohort of horses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses

Hövener

Pokar²,

Merle

et al. 2021

Animals

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Valvular regurgitations in the horse: The importance of an exercise ECG

Buhl

2010

The Veterinary Journal

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Cardiac pre‐purchase examination in horses – evaluation, outcome and athletic follow‐up

Woort¹,

Reef

Stefanovski

et al. 2021

Equine Veterinary Education

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Thisretrospective study describes the clinical, echocardiographic and electrocardiographic data for 174 horses presented for a cardiac evaluation as part of their prepurchase examination (PPE). Follow-up information regarding outcome and performance was obtained via interview and/ or FEI records. The objectives of this study were to (1) describe the abnormalities found on cardiac pre-purchase examinations (PPE), (2) assess whether athletic prognosis generated by comprehensive cardiovascular examination at the time of the PPE was predictive of cardiac limitations to intended athletic activity and (3) evaluate whether signalment, murmur characteristics, presence of an arrhythmia or final diagnosis could predict either the prognosis or cardiac limitations to performance. The majority of horses had mild disease or physiological murmurs/ arrhythmias (142 horses). However, performance-limiting conditions were found in 29 horses, and this included moderate or severe mitral and aortic regurgitation, cardiomyopathy, myocarditis, large ventricular septal defects, an aortocardiac fistula, atrial fibrillation, atrial tachycardia with second degree AV block and frequent ventricular premature complexes during exercise. Athletic prognosis was excellent in 142 horses (with 60 normal horses and 82 horses with mild disease and an excellent prognosis), fair in 18 horses and poor in 11 horses. Athletic outcome was analysed in 96 horses. Prognosis given at the time of the PPE was the only significant predictor of the athletic outcome. Signalment, auscultation findings and diagnosis were not significantly associated with prognosis or outcome. Comprehensive cardiac examinations in horses with murmurs and arrhythmias at the time of the pre-purchase examination should be recommended and provide a unique opportunity to eliminate at-risk horses from the sport.

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Clinical and echocardiographic follow-up study in warm-blood horses with heart valve insufficiency

Cited by 4 publications

References 7 publications

Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses

Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses

Valvular regurgitations in the horse: The importance of an exercise ECG

Cardiac pre‐purchase examination in horses – evaluation, outcome and athletic follow‐up

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