Topic:Cardiovascular Health
Cardiovascular health in horses encompasses the study of the heart and blood vessels, focusing on their structure, function, and associated disorders. The equine cardiovascular system is responsible for the circulation of blood, delivering oxygen and nutrients to tissues, and removing waste products. Research in this area includes the examination of cardiac anatomy, the electrophysiology of the heart, and common cardiovascular conditions such as arrhythmias, valvular diseases, and heart murmurs. Diagnostic tools such as echocardiography, electrocardiography, and cardiac biomarkers are utilized to assess cardiovascular function and detect abnormalities. This page compiles peer-reviewed research studies and scholarly articles that explore the physiological mechanisms, diagnostic approaches, and therapeutic strategies related to cardiovascular health in horses.
Pericardial Disease, Myocardial Disease, and Great Vessel Abnormalities in Horses. Pericardial, myocardial, and great vessel diseases are relatively rare in horses. The clinical signs are often nonspecific and vague, or related to the underlying cause. Physical examination usually reveals tachycardia, fever, venous distension or jugular pulsation, a weak or bounding arterial pulse, ventral edema, and abnormal cardiac auscultation such as arrhythmia, murmur, or muffled heart sounds. The prognosis depends on the underlying cause and the disease progression, and ranges from full recovery to poor prognosis for survival. This article focuses on the etiology, diagnosis, prognosis,...
Cardiovascular Response to Exercise and Training, Exercise Testing in Horses. The physiology of exercise and training is fascinating, and hundreds of interesting studies have given insight into its mechanisms. Exercise testing is a useful clinical tool that can help veterinarians assess poor performance, fitness, and performance potential and prevent injuries. The clinically applicable aspects of cardiovascular adaptions to training and exercise testing are highlighted in this review. Different exercise tests should be used to evaluate horses performing in different disciplines and levels. Exercise tests that simultaneously assess several body systems can be beneficial ...
Equine Acquired Valvular Disease. Degenerative myxomatous disease is common and is associated with aging. Poor prognostic indicators for equine aortic regurgitation specifically include ventricular ectopy, increased pulse pressure, and hyperkinetic pulses. Valvular prolapse is a functional abnormality diagnosed echocardiographically, about which knowledge is limited. A better understanding of its role in valvular regurgitation is needed. Infective endocarditis presents with fever and other systemic signs accompanying valvular regurgitation. The prognosis is poor, warranting aggressive therapy. Other forms of valvular disease o...
Equine Echocardiography. This article provides an overview on the principles of transthoracic echocardiography in horses. Indications for echocardiography, equipment, and technical considerations are discussed and a systematic approach for a complete echocardiographic examination in horses is described. Methods for assessment of chamber dimensions, allometric scaling of measurements, assessment of systolic and diastolic ventricular function, assessment of atrial function, hemodynamic assessment, and evaluation of valvular regurgitation are explained, focusing on traditional 2-dimensional (2D), motion-mode, and Doppler...
Equine Congenital Heart Disease. Congenital heart disease (CHD) represents a small proportion of horses undergoing clinical evaluation; however, both simple and complex defects occur during cardiac development leading to many unique malformations. This article reviews cardiac development and the fetal circulation, describes the morphologic method and the sequential segmental approach to CHD analysis, presents a summary of CHD in horses, and offers an overview of lesions that should be considered during evaluation of horses suspected to have CHD. For many forms of equine CHD, therapies are limited because cardiac interventions...
The application of Lempel-Ziv and Titchener complexity analysis for equine telemetric electrocardiographic recordings. The analysis of equine electrocardiographic (ECG) recordings is complicated by the absence of agreed abnormality classification criteria. We explore the applicability of several complexity analysis methods for characterization of non-linear aspects of electrocardiographic recordings. We here show that complexity estimates provided by Lempel-Ziv '76, Titchener's T-complexity and Lempel-Ziv '78 analysis of ECG recordings of healthy Thoroughbred horses are highly dependent on the duration of analysed ECG fragments and the heart rate. The results provide a methodological basis and a feasible refer...
Sustained atrial tachycardia in horses and treatment by transvenous electrical cardioversion. Atrial tachycardia including focal atrial tachycardia and macroreentrant atrial tachycardia (atrial flutter), are occasionally found in horses. Diagnosis, treatment and follow-up of these arrhythmias has been inadequately described. Objective: To describe the findings on surface electrocardiography (ECG), intra-atrial electrogram recording and tissue Doppler imaging (TDI), the response to treatment by transvenous electrical cardioversion (TVEC), and TDI follow-up, of sustained atrial tachycardia in horses. Methods: Case series. Methods: Records from horses with sustained atrial tachycardia tre...
Two-dimensional echocardiographic measurements of the right coronary artery in healthy horses – a pilot study. Precise understanding of the dimensions of the vascular lumina is essential for accurate interpretation of cardiac vessels imaging. To the authors' best knowledge, this is the first study focusing on the ultrasound measurement of the right coronary artery (RCA) in the horse. The aim of this study was to determine both the ultrasonographic range of the normal diameter and lumen area of the RCA in horses and the influence of gender, age and level of training on the RCA dimensions. An additional aim of the study was to assess intra- and inter-observer repeatability of the collected measurements. ...
Effects of dofetilide and ranolazine on atrial fibrillatory rate in a horse model of acutely induced atrial fibrillation. The atrial fibrillatory rate is a potential biomarker in the study of antiarrhythmic drug effects on atrial fibrillation (AF). The purpose of this study was to evaluate whether dose-dependent changes in the atrial fibrillatory rate can be monitored on surface electrocardiography (ECG) following treatment with dofetilide, ranolazine, and a combination of the two in an acute model of AF in horses. Eight horses were subjected to pacing-induced AF on 4 separate days. Saline (control), dofetilide, ranolazine, or a combination of dofetilide and ranolazine was administered in four incremental doses. ...
Compounds commonly used in equine medicine inhibits the voltage-gated potassium channel Kv11.1. The voltage-gated K-channel K11.1 has a central role in cardiac repolarization. Blockage of K11.1 has been linked to severe cardiovascular side effects, such as acquired long QT syndrome (aLQTS), torsade de pointes arrhythmia and sudden cardiac death (SCD). K11.1 is susceptible to unspecific drug interactions due to the presence of two aromatic amino acids residing in the inner vestibule of the pore. These aromatic residues are also present in the equine orthologue of K11.1. This suggests that equine K11.1 may also be prone to high-affinity block by a range of different chemical entities, whic...
Measurement of plasma endothelin-1 concentration in healthy horses and horses with cardiac disease during rest and after exercise. Cardiac biomarkers are important tools for monitoring disease progress and can monitor progression of therapy. Endothelin-1 (ET-1) has been studied for its use as a cardiac biomarker in human and small animal medicine while in horses with cardiac disease it has not been evaluated yet. The objective of the present study was to determine the concentration of plasma ET-1 in healthy horses and compare it with ET-1 concentration in horses with cardiac disease during rest and after exercise. Fifty four horses admitted to the Equine Clinic of Free University of Berlin were used in the present study, ...
Cardiovascular variables in eventing and endurance horses over a season. The objectives of this study were to describe the changes in clinical cardiovascular examination variables over a competition season in groups of competitive eventing and endurance horses and to compare these findings to non-competitive controls of the same breeds. Methods: This study included two eventing horses, 11 endurance horses, and 13 eventing and seven endurance control breed-matched horses. Methods: Cardiovascular examinations were performed before starting the competition season, in the middle and at the peak/end of the competition season. Examinations included auscultation of the he...
Total intravenous anaesthesia with ketamine, medetomidine and guaifenesin compared with ketamine, medetomidine and midazolam in young horses anaesthetised for computerised tomography. There is no information directly comparing midazolam with guaifenesin when used in combination with an alpha-2 agonist and ketamine to maintain anaesthesia via i.v. infusion in horses. Objective: To compare ketamine-medetomidine-guaifenesin with ketamine-medetomidine-midazolam for total intravenous anaesthesia (TIVA) in young horses anaesthetised for computerised tomography. Methods: Prospective, randomised, blinded, crossover trial. Methods: Fourteen weanlings received medetomidine 7 μg/kg bwt i.v. and anaesthesia was induced with ketamine 2.2 mg/kg bwt i.v. On two separate occasions hors...
The use of heart rate variability analysis to detect arrhythmias in horses undergoing a standard treadmill exercise test. Little is known about normal heart rate variability (HRV) in horses during exercise. It can be difficult to separate premature beats from normal beat-to-beat variation at higher heart rates. Objective: The aim was to quantify HRV in healthy horses during a high-speed treadmill-standardized exercise test (HSET) and to compare with the HRV in horses observed to have arrhythmias during exercise. Methods: Thirteen healthy horses (Group H), 30 horses with arrhythmias (Group A), and 11 horses with poor performance but no observed arrhythmias (Group O). Methods: Prospective, observational study. All ...
Physiological outcomes of calming behaviors support the resilience hypothesis in horses. To manage a stressful stimulus animals react both behaviorally and physiologically to restore the homeostasis. In stable horses, a stressful stimulus can be represented by social separation, riding discomfort or the presence of novel objects in their environment. Although Heart Rate Variability is a common indicator of stress levels in horses, the behavioral mechanisms concurrently occurring under stressful conditions are still unknown. The sudden inflation of a balloon was administered to 33 horses. Video-recording of self-directed behaviors (snore, vacuum chewing, snort, head/body shaking) a...
Real-time Evaluation of ECG Acquisition Systems through Signal Quality Assessment in Horses during Submaximal Treadmill Test. This paper reports on a novel real time index designed to assess the quality of electrocardiographic (ECG) traces recorded in a group of five horses during a submaximal treadmill test procedure. During the experimental protocol two ECG monitoring systems were simultaneously applied to the animals. The first system was equipped with textile electrodes while the second one with standard red-dot electrodes. The procedure comprised four phases with an increased treadmill velocity, specifically, Walk 1, Trot 1, Trot 2 and Gallop. Three signal quality levels have been fixed according to the amount o...
Clinical effects of constant rate infusions of medetomidine-propofol combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. The aim of the present study was to evaluate clinical efficacy of constant rate infusions (CRIs) of medetomidine-propofol combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Thirty horses were sedated intravenously (IV) with medetomidine (6.0 μg/kg) and midazolam (0.02 mg/kg) and induced IV with ketamine (1.0 mg/kg) and propofol (1.0 mg/kg). These horses were randomly allocated to three groups and maintained with sevoflurane and CRI of either medetomidine (3.0 μg/kg/h) (Group M; n = 10); or medetomidine (3.0 μg/kg/h) and propofol (3.0 ...
Very long-term outcome of coronary covered stents: a report from the SCAAR registry. Covered stents are mostly used for coronary perforations with a high risk of early adverse events; however, their long-term outcome is unknown. The aim of this study was to elucidate the short- and long-term outcome of patients treated with covered stents compared to all other stented patients. Results: The Swedish national registries from 2005-2017 disclosed 265 patients who had received 366 covered stents. Their outcomes were compared to all other stented patients (197,948) who had received 320,784 stents. Compared to regular stents, covered stents showed significant differences (p<0.001)...
Alfaxalone for total intravenous anaesthesia in horses. To determine the suitability of alfaxalone total intravenous (IV) anaesthesia in horses and concurrently evaluate infusion rates, cardiovascular effects, pharmacokinetics and the quality of the anaesthetic recovery period. Methods: Prospective, experimental study. Methods: Eight Standardbred horses. Methods: Horses were premedicated with IV acepromazine (0.03 mg kg) and xylazine (1 mg kg) and anaesthesia was induced with guaifenesin (35 mg kg) and alfaxalone (1 mg kg). Anaesthesia was maintained for 180 minutes using an IV infusion of alfaxalone at a rate determined by a horse's response to a ...
Can heart rate variability parameters derived by a heart rate monitor differentiate between atrial fibrillation and sinus rhythm? Heart rate variability (HRV) parameters, and especially RMSSD (root mean squared successive differences in RR interval), could distinguish atrial fibrillation (AF) from sinus rhythm(SR) in horses, as was demonstrated in a previous study. If heart rate monitors (HRM) automatically calculating RMSSD could also distinguish AF from SR, they would be useful for the monitoring of AF recurrence. The objective of the study was to assess whether RMSSD values obtained from a HRM can differentiate AF from SR in horses. Furthermore, the impact of artifact correction algorithms, integrated in the analyses ...
Cardiovascular images: vascular hamartoma of the mitral valve in a horse. An 8-month-old Hanoverian gelding was presented with a history of cardiac murmurs that were not apparent as a foal nor reported at the time of castration. Major echocardiographic findings included mitral valvular thickening, functional stenosis, and mitral regurgitation of sufficient severity to cause diastolic and systolic cardiac murmurs, left-sided volume overload, and pulmonary hypertension. Due to the hemodynamic severity of the lesion and poor prognosis for future performance and longevity, euthanasia was elected. On gross postmortem examination, there was focal fibrous epicarditis affec...
Assessment of systolic and diastolic function in clinically healthy horses using ambulatory acoustic cardiography. Assessment of cardiac electromechanical function in horses requires training, experience and specialised equipment and does not allow continuous monitoring over time. Objective: The objective of this study was to establish the use of an acoustic ECG monitor (Audicor ) in healthy horses. It provides noninvasive, examiner-independent, continuous analyses combining ECG and phonocardiography to calculate indices of cardiac mechanical activity and haemodynamics. Device usability was investigated, reference intervals calculated and reproducibility of analyses assessed. Methods: Prospective descripti...
The magnitude of respiratory sinus arrhythmia of a large mammal (the horse) is like that of humans. Heart rate (FH) accelerates in inspiration and decelerates in expiration, a phenomenon known as Respiratory Sinus Arrhythmia (RSA). Although the presence of RSA has been documented in many species, how its magnitude compares among species is unknown. We asked whether the magnitude of RSA in a large mammal, the horse, differed from that of previously measured humans. From electrocardiogram and pneumography, the peaks and troughs of FH were identified breath-by-breath in four horses (Italian Saddlebred geldings) during resting wakefulness. RSA was computed as the peak-trough FH difference, in pe...
Clinical evaluation of constant rate infusion of alfaxalone-medetomidine combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Alfaxalone has a number of pharmacological properties which are desirable for constant rate infusion (CRI). Previously, the co-administration of alfaxalone and medetomidine is shown to be suitable for short-term anesthesia in horses. However, the use of alfaxalone-medetomidine CRI with inhalational anesthesia under surgical procedures have not been investigated in clinical cases. The aim of the present study was to evaluate the clinical efficacy of alfaxalone-medetomidine CRI in sevoflurane-anesthetized Thoroughbred racehorses undergoing arthroscopic surgery. Sevoflurane requirement, cardiovas...
Time-dependent antiarrhythmic effects of flecainide on induced atrial fibrillation in horses. Pharmacological treatment of atrial fibrillation (AF) in horses can be challenging because of low efficacy and adverse effects. Flecainide has been tested with variable efficacy. Objective: To test whether the efficacy of flecainide is dependent on AF duration. Methods: Nine Standardbred mares. Methods: Factorial study design. All horses were instrumented with a pacemaker and assigned to a control or an AF group. On day 0, all horses were in sinus rhythm and received 2 mg/kg flecainide IV. Atrial fibrillation subsequently was induced in the AF group by pacemaker stimulation. On days 3, 9, 27, ...
Anticipatory response before competition in Standardbred racehorses. It is generally accepted that besides cortisol concentrations, parameters of heart rate variability (HRV) are appropriate indicators of stress in horses. The aim of this study was to determine anticipatory stress in eight Standardbred stallions participating in harness race. Cortisol and HRV responses to a mild exercise performed in training circumstances were compared to a maximal effort exercise performed in real trotting race conditions. Parameters of HRV reflecting vagal (root mean square of the successive differences, RMSSD) and sympathetic nervous system activity (ratio of the low and hi...
Evaluation of age-dependent changes of myocardial velocity using pulsed wave and colour tissue Doppler imaging in adult warmblood horses. Our aim was to evaluate the influence of the ageing process on the myocardium using pulsed wave tissue Doppler (PW-TDI) and colour tissue Doppler imaging (cTDI) to measure myocardial velocities at three different myocardial regions (right ventricular free wall: RVFW, interventricular septum: IVS, left ventricular free wall: LVFW). A total of 60 healthy warmblood horses, aged from 3 to 30 years, were examined. The horses were divided into five age groups (group 1: 3-8 years, n = 14; group 2: 9-13 years, n = 9; group 3: 14-18 years, n = 10; group 4: 19-23 years, n = 14; group 5: 24-...
Impact of Trendelenburg (head down) and reverse Trendelenburg (head up) position on respiratory and cardiovascular function in anaesthetized horses. To describe the cardiorespiratory effects of a change in table position in anaesthetized horses. Methods: Prospective, crossover, randomized, experimental study. Methods: Six adult horses (mean body weight 621 ± 59 kg, aged 13 ± 4 years). Methods: The horses were anaesthetized twice in dorsal recumbency. They were either placed in the Trendelenburg position (head down; HD) followed by reverse Trendelenburg position (head up; HU) or in reverse order. Every position was maintained for 90 minutes. The order of positions was randomly assigned at initial anaesthesia. Extensive cardiorespiratory m...