Effect of left‐sided valvular regurgitation on mortality and causes of death among a population of middle‐aged and older horses

Stevens, Kim; Marr, Celia M.; Horn, Julian; Pfeiffer, Dirk U.; Perkins, Justin; Bowen, Mark; Allan, Emma; Campbell, Jeffrey I.; Elliott, Jonathan

doi:10.1136/vr.164.1.6

Cited by 51 publications

(54 citation statements)

References 20 publications

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“…MR was the most frequent cardiac disease in our study with a prevalence of 4.4%. This prevalence is slightly higher than those reported in previous studies performed in a mixed equine population (2.9–3.5%) and in a trotter population (3.1%), but it is slightly less than the maximum prevalence reported in young trained thoroughbred racehorses (6%) . Furthermore, in the present study, warmbloods and trotters were more strongly associated with MR than other breeds, including thoroughbreds.…”

Section: Discussioncontrasting

confidence: 82%

Prevalence and Risk Factors for Cardiac Diseases in a Hospital‐Based Population of 3,434 Horses (1994–2011)

Leroux

Detilleux

Sandersen

et al. 2013

Veterinary Internal Medicne

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Background: Risk factors for cardiac diseases in horses have not been explored in a large population of animals. Objectives: To describe risk factors for various cardiac diseases in a hospital-based population of horses. Animals: Files of 3,434 horses admitted at the Internal Medicine Department of the Liege Equine Teaching Hospital between 1994 and 2011 were reviewed and of those, 284 were categorized as having moderate-to-severe cardiac disease.Methods: Observational study. After calculating prevalence for each cardiac disease, we tested whether breed (chisquare test) or sex, age, body weight (BW), and other cardiac diseases (logistic regressions) were risk factors (p < .05 significant).Results: Mitral regurgitation (MR, 4.4%), atrial fibrillation (AF, 2.3%), aortic regurgitation (AR, 2.1%), and tricuspid regurgitation (TR, 1.7%) were the most common cardiac abnormalities detected. Determinants were male sex and increasing age for AR (OR = 2.03, CI = 1.07-4.94), racehorses breed and middle-age for TR (OR = 4.36; CI = 1.10-17.24), and high BW for AF (OR = 3.54; CI = 1.67-7.49). MR was the most common valvular disease associated with AF, clinically important ventricular arrhythmia, pulmonary regurgitation (PR), and congestive heart failure (CHF). TR was also associated with AF, PR, and CHF; AR was not associated with CHF.Conclusions and Clinical Importance: Several previously suspected risk factors for a variety of equine cardiac diseases are statistically confirmed and other risk factors are highlighted in the studied hospital-based population. These observations should be taken into account in health and sport's monitoring of horses presenting predisposing factors.

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Section: Discussioncontrasting

confidence: 82%

Prevalence and Risk Factors for Cardiac Diseases in a Hospital‐Based Population of 3,434 Horses (1994–2011)

Leroux

Detilleux

Sandersen

et al. 2013

Veterinary Internal Medicne

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“…40 The prevalence of cardiac murmurs consistent with aortic or mitral valve regurgitation 17 was similar to the previously reported prevalence. 37 In the current study, cardiac valvular disease was noted at postmortem examination in only a few cases. Recurrent airway obstruction is considered more prevalent in older horses 13,18 and could account for abnormal respiratory sounds in many older equids.…”

Section: Discussionmentioning

confidence: 99%

What’s New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids

et al. 2015

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Postmortem findings in 241 equids admitted to a teaching hospital that were at least 15 years old at autopsy were reviewed (1) to determine disease prevalence, (2) to compare the cause of death (or euthanasia) in equids 15 to 19 years of age (n ¼ 116) with that in equids 20 years of age (n ¼ 125), and (3) to catalog coexisting lesions in equids with pituitary pars intermedia dysfunction (PPID). Breed and sex were evenly distributed between the age groups. Death or euthanasia was attributed to disease of the digestive system (41.5%), pituitary gland (12.9%), locomotor system (10.0%), nervous system (7.9%), cardiovascular system (4.6%), urinary system (4.6%), reproductive system (4.2%), respiratory system (4.2%), integumentary system (4.2%), lymphoid system (2.5%), liver (2.5%), or systemic neoplasia (1.2%). Nervous system disease was more common in the 15-to 19-year group; urinary tract disease was more common in the 20-year group. Neoplastic disease, regardless of systemic location, was the basis for death or euthanasia in 18.7% of all equids. Squamous cell carcinoma, lymphoma, and melanoma were the most common malignant neoplasms. PPID was the most common specific diagnosis, based on the postmortem presence of hyperplasia or adenoma, and was the reason for euthanasia in 47.7% of 65 equids with PPID. The most common nonpituitary causes for death or euthanasia in equids with PPID were colic, lameness, cancer, and spinal cord disease. Coexisting conditions in equids with PPID that were not considered the basis for euthanasia included neoplasms, infections, lameness, and recurrent airway obstruction.

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“…Although a typical diastolic murmur indicates the presence of AR, the murmur alone cannot provide a definitive diagnosis or assessment of AR severity and hemodynamic compensation . With an AR murmur typically being an incidental finding on clinical examination, the presence of other clinical signs such as exercise intolerance can vary and often even horses with moderate to severe disease do not show any other outward clinical signs …”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation

Boegli

Schwarzwald

Mitchell

2019

Veterinary Internal Medicne

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Background Noninvasive blood pressures (NIBP) and pulse pressures (PP) have not been published in horses with aortic and mitral regurgitation (AR or MR). Objectives To investigate NIBP and PP in healthy Warmblood horses and horses with AR and MR and propose PP cutoffs to identify and stage AR severity. Animals Seventy‐three Warmblood horses (healthy, 10; AR, 31; MR, 32). Methods Retrospective study. All horses had NIBP and an echocardiogram recorded. Cases were categorized based on severity of regurgitation. Pulse pressures were compared among healthy, MR, and AR groups and among AR severity groups. Cutoffs were determined by receiver operating characteristic curve analyses. Results Horses with AR had higher PP than horses with MR (mean difference [95% confidence interval (CI)], +17 [9‐26] mm Hg, P < .001) and controls (+17 [5‐30] mm Hg; P =.004). Horses with severe AR had higher PP compared those with mild (+38 [20‐54] mm Hg; P < 0.001) and moderate AR (+33 [18‐47] mm Hg; P < .001). The PP cutoffs to distinguish AR from MR and controls were 38 mm Hg (sensitivity [Sn], 100%; specificity [Sp], 19%) for maximal Sn and 61 mm Hg (Sn, 43%; Sp, 100%) for maximal Sp. The PP cutoffs to distinguish severe AR from mild and moderate AR were 57 mm Hg (Sn, 100%; Sp, 70%) for maximal Sn and 77 mm Hg (Sn, 75%; Sp, 100%) for maximal Sp. Conclusions and Clinical Importance Horses with AR have increased PP. Noninvasive PP measurements interpreted with provided cutoffs may aid clinicians in diagnosing and staging severity of AR in horses.

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Effect of left‐sided valvular regurgitation on mortality and causes of death among a population of middle‐aged and older horses

Cited by 51 publications

References 20 publications

Prevalence and Risk Factors for Cardiac Diseases in a Hospital‐Based Population of 3,434 Horses (1994–2011)

Prevalence and Risk Factors for Cardiac Diseases in a Hospital‐Based Population of 3,434 Horses (1994–2011)

What’s New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids

Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation

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