Prognostic value of echocardiographic and Doppler parameters in horses admitted for colic complicated by systemic inflammatory response syndrome.
Abstract: To assess the prognostic value of echocardiographic parameters of left ventricular (LV) function in horses with systemic inflammatory response syndrome (SIRS). Methods: Prospective observational study. Methods: Veterinary teaching hospital. Methods: Forty-one horses admitted for colic with clinical evidence of SIRS. Methods: All horses underwent Doppler echocardiographic examination on admission. LV echocardiographic parameters, including pulsed-wave tissue Doppler imaging parameters, were compared between nonsurvivors (n = 29) and horses that survived to discharge (n = 12). Results: With comparable heart rate and LV preload estimate, LV stroke volume index, the velocity time integral, deceleration time, ejection time of Doppler aortic flow, and peak early diastolic myocardial velocity were lower in the nonsurviving than in the surviving horses, while pre-ejection period to ejection time ratio (PEP/ET) of Doppler aortic flow and the peak early diastolic filling velocity to peak early diastolic myocardial velocity ratio (E/Em) were higher (P < 0.05). A cut-off value of 0.26 for PEP/ET predicted mortality with 100% sensitivity and 42% specificity (area under the receiver operating characteristic curve: 0.71), whereas a cut-off value of 2.67 for E/Em predicted mortality with 100% sensitivity and 83% specificity (area under the receiver operating characteristic curve: 0.89). Conclusions: Echocardiography may provide prognostic information in colic horses with clinical evidence of SIRS. Especially, PEP/ET and E/Em could be useful markers of systolic and diastolic dysfunction, respectively, to detect horses with a high risk of death requiring more intensive cardiovascular monitoring as it has been reported in human patients with septic shock.
© Veterinary Emergency and Critical Care Society 2014.
Publication Date: 2014-04-01 PubMed ID: 24690095DOI: 10.1111/vec.12177Google Scholar: Lookup
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- Evaluation Study
- Journal Article
Summary
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This study explored the prognostic significance of certain heart function parameters in horses suffering from systemic inflammatory response syndrome (SIRS) complicated by colic. Specific echocardiographic measurements were conducted with hopes of using these findings to recognize horses at high risk of mortality.
Methodology
- The study was a prospective observational research carried out in a veterinary teaching hospital.
- It involved a total of 41 horses, all of which were admitted due to colic and had observed evidence of SIRS.
- All the participating horses underwent Doppler echocardiographic examination upon their arrival at the hospital.
- A comparison was subsequently made between survivors and non-survivors. The comparison was in respect to echocardiographic parameters pertaining to the left ventricular (LV) functionality, including pulsed-wave tissue Doppler imaging parameters.
Key Findings
- In instances where the heart rate and LV preload estimate were similar, non-survivors had lower velocity time integral, LV stroke volume index, ejection time of Doppler aortic flow, and deceleration time.
- Furthermore, both the pre-ejection period to ejection time ratio (PEP/ET) of Doppler aortic flow and the peak early diastolic filling velocity to peak early diastolic myocardial velocity ratio (E/Em) were found to be higher in horses that eventually died.
- A PEP/ET cutoff of 0.26, and an E/Em cutoff of 2.67 were found to be strong predictors of mortality. The parameters showed sensitivity of 100% while the specificity stood at 42% and 83% respectively.
Conclusions and Significance
- The findings from the research indicate that echocardiography could provide valuable prognostic information for horses with SIRS complicated by colic.
- Specifically, the PEP/ET and E/Em parameters could be beneficial in detecting horses that are at an escalated risk of death. This information could then be used to inform a more intensive cardiovascular monitoring strategy for these at-risk horses.
- Similar research variables have been reported in human patients suffering from septic shock, thus deeper understanding about parallel treatment improvements in veterinary and human medicine can be gained.
Cite This Article
APA
Borde L, Amory H, Grulke S, Leroux AA, Houben RM, Detilleux J, Sandersen CC.
(2014).
Prognostic value of echocardiographic and Doppler parameters in horses admitted for colic complicated by systemic inflammatory response syndrome.
J Vet Emerg Crit Care (San Antonio), 24(3), 302-310.
https://doi.org/10.1111/vec.12177 Publication
Researcher Affiliations
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20, B41, 4000, Liège, Belgium.
MeSH Terms
- Animals
- Colic / complications
- Colic / diagnostic imaging
- Colic / veterinary
- Echocardiography / veterinary
- Female
- Horse Diseases / diagnostic imaging
- Horse Diseases / mortality
- Horse Diseases / physiopathology
- Horses
- Male
- Predictive Value of Tests
- Prognosis
- Prospective Studies
- ROC Curve
- Survival Analysis
- Systemic Inflammatory Response Syndrome / complications
- Systemic Inflammatory Response Syndrome / diagnostic imaging
- Systemic Inflammatory Response Syndrome / veterinary
- Ultrasonography, Doppler / veterinary
Citations
This article has been cited 8 times.- Mendoza FJ, Buzon-Cuevas A, Aguilera-Aguilera R, Gonzalez-De Cara CA, De Las Heras A, Perez-Ecija A. Hemodynamic Response to Lipopolysaccharide Infusion and Effect of Meloxicam Administration on Cardiac Function in Donkeys. Animals (Basel) 2024 Dec 18;14(24).
- Naseri A, Akyuz E, Turgut K, Guzelbektes H, Sen I. Sepsis-induced cardiomyopathy in animals: From experimental studies to echocardiography-based clinical research. Can Vet J 2023 Sep;64(9):871-877.
- Blangy-Letheule A, Vergnaud A, Dupas T, Rozec B, Lauzier B, Leroux AA. Spontaneous Sepsis in Adult Horses: From Veterinary to Human Medicine Perspectives. Cells 2023 Mar 30;12(7).
- Ince ME, Turgut K, Naseri A. Echocardiographic Assessment of Left Ventricular Systolic and Diastolic Functions in Dogs with Severe Sepsis and Septic Shock; Longitudinal Study. Animals (Basel) 2021 Jul 5;11(7).
- Taylor S. A review of equine sepsis. Equine Vet Educ 2015 Feb;27(2):99-109.
- Roy MF, Kwong GP, Lambert J, Massie S, Lockhart S. Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome. J Vet Intern Med 2017 Mar;31(2):582-592.
- McConachie E, Giguère S, Barton MH. Scoring System for Multiple Organ Dysfunction in Adult Horses with Acute Surgical Gastrointestinal Disease. J Vet Intern Med 2016 Jul;30(4):1276-83.
- Bauquier JR, Forbes G, Nath L, Tudor E, Bailey SR. Plasma HMGB-1 and Nucleosome Concentrations in Horses with Colic and Healthy Horses. J Vet Intern Med 2016 Jan-Feb;30(1):260-8.
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