Journal of veterinary internal medicine2021; 35(3); 1573-1581; doi: 10.1111/jvim.16106

Prevalence and characteristics of ventricular septal defects in a non-racehorse equine population (2008-2019).

Abstract: Ventricular septal defects (VSDs) are the most common congenital cardiac defect in horses. Objective: To identify prevalence, age, breed, and sex distribution of VSD and to describe associated clinical and ultrasonographic findings. Methods: Hospital-based population of 21 136 horses presented to the equine internal medicine department. Methods: Medical records over a 12-year period were reviewed for VSD confirmed by ultrasonography. Age, breed, sex, sport discipline, murmur, clinical signs, outcome, VSD type, VSD size, shunt velocity, cardiac dimensions, concomitant cardiac anomalies, and valvular regurgitations were recorded. Results: From 1894 horses that underwent echocardiography, 54 had a VSD: 42 as an isolated lesion and 12 as part of complex congenital heart disease (CHD). Median age was 5 years (range, 0-26) and 1 year (range, 0-8), respectively. Warmbloods and males were overrepresented. In the isolated VSD group, only 15% had associated clinical signs and most horses had a perimembranous VSD (pmVSD; 36/42). Horses with a pmVSD and clinical signs showed a significantly lower maximal shunt velocity (3.77 vs 5.20 m/s; P < .001), higher VSD/Aortic root (Ao) diameter (0.52 vs 0.38; P = .05), higher left atrium/Ao diameter (1.94 vs 1.22; P < .001), and higher pulmonary artery/Ao diameter (1.15 vs 0.88; P = .005) compared to horses without clinical signs. All horses with complex CHD had clinical signs and abnormal cardiac dimensions. Conclusions: Most isolated VSD were diagnosed only at a later age and were not associated with clinical signs. Horses with complex CHD were more likely to have or develop clinical signs at younger age.
Publication Date: 2021-03-20 PubMed ID: 33742468PubMed Central: PMC8163134DOI: 10.1111/jvim.16106Google Scholar: Lookup
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  • Journal Article

Summary

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The study investigated the prevalence, characteristics, and clinical implications of Ventricular Septal Defects (VSDs) in a horse population that was not racehorses. The findings reveal that most isolated VSD were detected at older ages and typically didn’t show clinical symptoms, while horses with complex Congenital Heart Disease (CHD) are more likely to show symptoms at an earlier age.

Methods and Study Population

  • The research was conducted on a hospital-based population numbering 21,136 horses that were presented to the equine internal medicine department.
  • The medical records of these horses over a period of 12 years were thoroughly reviewed for instances of VSD as confirmed by ultrasonography.
  • Data such as age, breed, sex, sports discipline, any murmur, clinical signs, outcome, VSD type and size, shunt velocity, cardiac dimensions, any concomitant cardiac anomalies, and valvular regurgitations were recorded.

Results

  • Out of 1,894 horses that underwent echocardiography, 54 were found to have a VSD.
  • Among these, 42 had VSD as an isolated lesion while 12 had VSD as part of complex congenital heart diseases (CHD).
  • The median age for the horses with isolated VSD was 5 years while it was 1 year for horses with complex CHD.
  • Warmblood breeds and males were found to be overrepresented in cases of VSD.
  • Only 15% of horses with an isolated VSD showed associated clinical signs.
  • Most horses (36 of 42) had a perimembranous VSD (pmVSD).
  • Horses showing clinical signs with a pmVSD were found to have a significantly lower maximal shunt velocity, a higher VSD/Aortic root diameter, a higher left atrium/Aortic diameter, and a taller pulmonary artery/Aortic diameter compared to horses without any clinical signs.
  • All horses with complex CHD exhibited clinical signs and abnormal cardiac dimensions.

Conclusion

  • The study concluded that most isolated cases of VSDs are usually diagnosed at later ages and aren’t typically associated with any clinical symptoms.
  • However, horses with complex CHD are more likely to start showing clinical symptoms at a much younger age, making it important to Catch if suspected.

Cite This Article

APA
De Lange L, Vera L, Decloedt A, Van Steenkiste G, Vernemmen I, van Loon G. (2021). Prevalence and characteristics of ventricular septal defects in a non-racehorse equine population (2008-2019). J Vet Intern Med, 35(3), 1573-1581. https://doi.org/10.1111/jvim.16106

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 35
Issue: 3
Pages: 1573-1581

Researcher Affiliations

De Lange, Lisa
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Vera, Lisse
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Decloedt, Annelies
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Van Steenkiste, Glenn
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Vernemmen, Ingrid
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
van Loon, Gunther
  • Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

MeSH Terms

  • Animals
  • Echocardiography / veterinary
  • Heart Defects, Congenital / veterinary
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Heart Septal Defects, Ventricular / epidemiology
  • Heart Septal Defects, Ventricular / veterinary
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / epidemiology
  • Horses
  • Male
  • Prevalence
  • Ultrasonography

Grant Funding

  • 01B05818 / Special Research Fund of Ghent University
  • 01D16619 / Special Research Fund of Ghent University
  • 1S56217N / Research Foundation Flanders
  • 1134919N / Research Foundation Flanders

Conflict of Interest Statement

Authors declare no conflict of interest.

References

This article includes 23 references
  1. Reef VB. Evaluation of ventricular septal defects in horses using two-dimensional and Doppler echocardiography.. Equine Vet J Suppl 1995 Sep;(19):86-95.
  2. Leroux AA, Detilleux J, Sandersen CF, Borde L, Houben RM, Al Haidar A, Art T, Amory H. Prevalence and risk factors for cardiac diseases in a hospital-based population of 3,434 horses (1994-2011).. J Vet Intern Med 2013 Nov-Dec;27(6):1563-70.
    pubmed: 24112454doi: 10.1111/jvim.12197google scholar: lookup
  3. Scansen BA. Equine Congenital Heart Disease.. Vet Clin North Am Equine Pract 2019 Apr;35(1):103-117.
    pubmed: 30826104doi: 10.1016/j.cveq.2018.11.001google scholar: lookup
  4. Reef VB. Cardiovascular disease in the equine neonate.. Vet Clin North Am Equine Pract 1985 Apr;1(1):117-29.
    pubmed: 3907765doi: 10.1016/s0749-0739(17)30772-1google scholar: lookup
  5. Hall TL, Magdesian KG, Kittleson MD. Congenital cardiac defects in neonatal foals: 18 cases (1992-2007).. J Vet Intern Med 2010 Jan-Feb;24(1):206-12.
  6. Marr CM. Cardiac murmurs: congenital heart disease. Cardiology of the Horse; Second edition. W. B. Saunders; 2010;193u2010205.
  7. Reef VB, Bonagura J, Buhl R, McGurrin MK, Schwarzwald CC, van Loon G, Young LE. Recommendations for management of equine athletes with cardiovascular abnormalities.. J Vet Intern Med 2014 May-Jun;28(3):749-61.
    pmc: PMC4895474pubmed: 24628586doi: 10.1111/jvim.12340google scholar: lookup
  8. Chung IM, Rajakumar G. Genetics of Congenital Heart Defects: The NKX2-5 Gene, a Key Player.. Genes (Basel) 2016 Jan 23;7(2).
    pmc: PMC4773750pubmed: 26805889doi: 10.3390/genes7020006google scholar: lookup
  9. Schwarzwald CC. Sequential segmental analysis u2010 a systematic approach to the diagnosis of congenital cardiac defects. Equine Vet Educ. 2008;20(6):305u2010309.
  10. Bomassi E, Misbach C, Tissier R, Gouni V, Trehiou-Sechi E, Petit AM, Desmyter A, Damoiseaux C, Pouchelon JL, Chetboul V. Signalment, clinical features, echocardiographic findings, and outcome of dogs and cats with ventricular septal defects: 109 cases (1992-2013).. J Am Vet Med Assoc 2015 Jul 15;247(2):166-75.
    pubmed: 26133216doi: 10.2460/javma.247.2.166google scholar: lookup
  11. Schwarzwald CC. Disorders of the cardiovascular system. Equine Internal Medicine. 4th ed.; St Louis, Missouri: W. B. Saunders; 2018;387u2010541.
  12. Tohyama K, Satomi G, Momma K. Aortic valve prolapse and aortic regurgitation associated with subpulmonic ventricular septal defect.. Am J Cardiol 1997 May 1;79(9):1285-9.
    pubmed: 9164909doi: 10.1016/s0002-9149(97)00105-7google scholar: lookup
  13. Erou011flu AG, Oztunu00e7 F, Saltik L, Dedeou011flu S, Bakari S, Ahunbay G. Aortic valve prolapse and aortic regurgitation in patients with ventricular septal defect.. Pediatr Cardiol 2003 Jan-Feb;24(1):36-9.
    doi: 10.1007/s00246-002-1423-6pubmed: 12360382google scholar: lookup
  14. Vandecasteele T, Cornillie P, van Steenkiste G, Vandevelde K, Gielen I, Vanderperren K, van Loon G. Echocardiographic identification of atrial-related structures and vessels in horses validated by computed tomography of casted hearts.. Equine Vet J 2019 Jan;51(1):90-96.
    pubmed: 29808486doi: 10.1111/evj.12969google scholar: lookup
  15. Dru00e1bkovu00e1 Z, Amory H, Kabeu0161 R, Melkovu00e1 P, van Loon G. Partial atrioventricular septal defect in an adult sport horse.. J Vet Cardiol 2020 Oct;31:8-14.
    pubmed: 32858392doi: 10.1016/j.jvc.2020.06.003google scholar: lookup
  16. Franklin RCG, Bu00e9land MJ, Colan SD, Walters HL, Aiello VD, Anderson RH, Bailliard F, Boris JR, Cohen MS, Gaynor JW, Guleserian KJ, Houyel L, Jacobs ML, Juraszek AL, Krogmann ON, Kurosawa H, Lopez L, Maruszewski BJ, St Louis JD, Seslar SP, Srivastava S, Stellin G, Tchervenkov CI, Weinberg PM, Jacobs JP. Nomenclature for congenital and paediatric cardiac disease: the International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Iteration of the International Classification of Diseases (ICD-11).. Cardiol Young 2017 Dec;27(10):1872-1938.
    pubmed: 29286277doi: 10.1017/S1047951117002244google scholar: lookup
  17. Mostefa-Kara M, Houyel L, Bonnet D. Anatomy of the ventricular septal defect in congenital heart defects: a random association?. Orphanet J Rare Dis 2018 Jul 18;13(1):118.
    pmc: PMC6052685pubmed: 30021599doi: 10.1186/s13023-018-0861-zgoogle scholar: lookup
  18. Young LE, van Loon G. Diseases of the heart and vessels. Equine Sports Medicine and Surgery. 2nd ed. W. B. Saunders; 2013;695u2013743.
  19. Tweddell JS, Pelech AN, Frommelt PC. Ventricular septal defect and aortic valve regurgitation: pathophysiology and indications for surgery.. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2006;:147-52.
    doi: 10.1053/j.pcsu.2006.02.020pubmed: 16638560google scholar: lookup
  20. Yacoub MH, Khan H, Stavri G, Shinebourne E, Radley-Smith R. Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of Valsalva, and ventricular septal defect.. J Thorac Cardiovasc Surg 1997 Feb;113(2):253-60; discussion 261.
    pubmed: 9040618doi: 10.1016/S0022-5223(97)70321-0google scholar: lookup
  21. Short DM, Seco OM, Jesty SA, Reef VB. Spontaneous closure of a ventricular septal defect in a horse.. J Vet Intern Med 2010 Nov-Dec;24(6):1515-8.
  22. Isaaz K, Cloez JL, Maru00e7on F, Worms AM, Pernot C. Is the aorta truly dextroposed in tetralogy of Fallot? A two-dimensional echocardiographic answer.. Circulation 1986 May;73(5):892-9.
    pubmed: 3698234doi: 10.1161/01.cir.73.5.892google scholar: lookup
  23. Dufourni A, Decloedt A, De Clercq D, et al. Reversed patent ductus arteriosus and multiple congenital malformations in an 8u2010dayu2010old Arabou2010Friesian foal. Equine Vet Educ. 2018;30:315u2010321.

Citations

This article has been cited 2 times.
  1. Haake C, Kovacs SL, Choi EA. A retrospective study of congenital cardiac malformations in 29 goats.. J Vet Diagn Invest 2023 Jul;35(4):404-408.
    doi: 10.1177/10406387231171568pubmed: 37148279google scholar: lookup
  2. De Lange L, Vernemmen I, van Loon G, Decloedt A. Echocardiographic Features of the Ductus Arteriosus and the Foramen Ovale in a Hospital-Based Population of Neonatal Foals.. Animals (Basel) 2022 Aug 30;12(17).
    doi: 10.3390/ani12172242pubmed: 36077962google scholar: lookup