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Animals : an open access journal from MDPI2021; 11(12); doi: 10.3390/ani11123463

Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses.

Abstract: 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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Publication Date: 2021-12-05 PubMed ID: 34944240PubMed Central: PMC8698104DOI: 10.3390/ani11123463Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study examines the connection between cardiac auscultation, the process of listening to heart sounds, and echocardiographic findings in warmblood horses. The aim is to see how accurately auscultation identifies heart murmurs and how heart problems influence the loudness of these murmurs.

Overview of the Study

  • The study is retrospective in nature and looks at 822 warmblood horses which underwent cardiac examination in a large equine referral center in Germany.
  • Around 653 of these horses displayed one or more heart murmurs, with the most common being left-sided systolic murmurs (68%) and left-sided diastolic murmurs (15%).
  • Out of 635 of these horses that received an echocardiographic examination, mitral valve regurgitations were found to be the most frequent (77%) followed by aortic valve regurgitations (23%).
  • Approximately 31% of horses that were given an echocardiographic scan displayed dimensional changes in one or more parts of the heart.

Auscultation and Echocardiography Findings

  • The study’s primary aim was to establish a credible correlation between auscultation findings and echocardiographic results.
  • The research found that when one or more murmurs and regurgitations were present, the agreement between auscultation and cardiac ultrasound was significant (Kappa 0.74).
  • When only one murmur and one regurgitation were identified, the agreement was almost perfect (Kappa 0.94).
  • Auscultation was particularly useful for detecting left-sided systolic and diastolic murmurs, as 87% of such murmurs were caused by a mitral valve regurgitation and 81% from an aortic valve regurgitation.

Association Between Murmur Intensity and Severity of Condition

  • A fair agreement was found between the grade of regurgitation and the associated murmur.
  • Low-grade murmurs were typically associated with mild regurgitations, but distinguishing between moderate to severe regurgitation based on the loudness of the murmur was less reliable.
  • Dimensional changes were generally linked to severe regurgitations and high-grade murmurs, however, a direct connection between murmur intensity and the presence or severity of these changes, independent of the grade of valvular regurgitation, could not be made in this group of horses.

Cite This Article

APA
Hövener J, Pokar J, Merle R, Gehlen H. (2021). Association between Cardiac Auscultation and Echocardiographic Findings in Warmblood Horses. Animals (Basel), 11(12). https://doi.org/10.3390/ani11123463

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 11
Issue: 12

Researcher Affiliations

Hövener, Jakob
  • Equine Clinic Bargteheide, 22941 Bargteheide, Germany.
  • Institute for Veterinary Epidemiology and Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany.
  • Equine Clinic, Veterinary Department, Freie Universitaet Berlin, 14163 Berlin, Germany.
Pokar, Julie
  • Equine Clinic Bargteheide, 22941 Bargteheide, Germany.
Merle, Roswitha
  • Institute for Veterinary Epidemiology and Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany.
Gehlen, Heidrun
  • Equine Clinic, Veterinary Department, Freie Universitaet Berlin, 14163 Berlin, Germany.

Conflict of Interest Statement

The authors declare no conflict of interest.

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Citations

This article has been cited 1 times.
  1. Folgmann MS, Stock KF, Feige K, Delling U. Clinical findings of candidate stallions presented for licensing at all German Warmblood horse-breeding associations in 2018-2020. Equine Vet J 2025 Nov;57(6):1584-1591.
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