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Background Indices combining diastolic and systolic tissue Doppler variables, the Ee′s′ index (E/[e′ × s′]) and e′a′s′ index (e′/[a′ × s′]), have aided detection of myocardial dysfunction and in prediction of poor outcomes in humans with cardiovascular diseases. Studies of Ee′s′ and e′a′s′ indices in dogs have not been performed. Hypothesis/Objectives Dogs with pulmonary stenosis (PS) have elevated right ventricular (RV) Ee′s′ and e′a′s′ indices compared to healthy dogs, which will decrease after pulmonary balloon valvuloplasty (BV) or stent implantation. Animals Thirty client‐owned dogs (15 healthy, 15 with PS). Methods Cross‐sectional study. All dogs had echocardiography performed, including the measurement of RV diastolic and systolic variables and calculation of the Ee′s′ and e′a′s′ indices. Dogs with PS had echocardiography performed prior to and after interventional procedures. Results The Ee′s′ index was lower (p = < 0.001) in healthy dogs (median 0.43, range 0.23–0.74) compared to dogs with PS pre‐operatively (1.49, 0.28–3.79). The e′a′s′ index was lower (p = 0.039) in healthy dogs (mean 8.03 ± 3.28) compared to dogs with PS pre‐operatively (11.39 ± 4.03). Compared to pre‐operative values, the Ee′s′ index (1.01, 0.36–1.62) and e′a′s′ index (8.35 ± 3.29) decreased (p = 0.018, p = 0.001, respectively) after pulmonary intervention in dogs with PS. Conclusions and Clinical Importance Dogs with PS have RV myocardial dysfunction that can be measured with Ee′s′ and e′a′s′ indices, and these values can be used to monitor response to pulmonary intervention over time. These findings suggest that calculation of Ee′s′ and e′a′s′ indices might have clinical importance in long‐term management of dogs with PS.

BACKGROUND: Left atrial (LA) enlargement, congestive heart failure (CHF), and aortic thromboembolism (ATE) are associated with decreased survival in cats with hypertrophic cardiomyopathy (HCM), but the prognostic value of echocardiographic variables has not been well characterized. HYPOTHESIS/OBJECTIVES: We hypothesized that LA echocardiographic variables and assessment of left ventricular (LV) diastolic and systolic function would have prognostic value in cats with HCM. ANIMALS: Two hundred eighty‐two cats diagnosed with HCM. METHODS: Clinical and echocardiographic records of affected cats seen at the Royal Veterinary College from 2004 to 2009 were retrospectively analyzed. Only cats with echocardiographic confirmation of LV diastolic wall thickness ≥6 mm were included. Outcomes were obtained from clinical records or referring veterinarians and owners. RESULTS: Deaths occurred in 164 cats, of which 107 were believed to have been cardiac deaths. Univariable predictors of an increased risk of cardiac death included older age, absence of a murmur, presence of a gallop sound or arrhythmia, presentation with either CHF or ATE, extreme LV hypertrophy (≥9.0 mm), LV fractional shortening (FS%) ≤30%, regional wall hypokinesis, increased left atrial size, decreased left atrial function, spontaneous echo‐contrast/thrombus or both, absence of left ventricular outflow tract obstruction, and a restrictive diastolic filling pattern. Cox's proportional hazard analysis identified LA dysfunction, low LV systolic function, and extreme LV hypertrophy as independent predictors of decreased cardiac survival time. CONCLUSIONS AND CLINICAL IMPORTANCE: Echocardiographic measurement of LA function, extreme LV hypertrophy, and LV systolic function provides important prognostic information in cats with HCM.

Background Bronchopneumonia (BP) can cause pulmonary hypertension (PH) and secondary cardiovascular changes. Objectives The aim of this study was to describe PH–related transthoracic Doppler echocardiography (TTE) changes in preweaned dairy calves with BP diagnosed by thoracic ultrasonography (TUS). Animals One hundred and sixty‐four calves were selected from 11 commercial dairy farms. Methods This is a case–control study. The enrolled calves were grouped according to TUS results into either the control group (with normally aerated lungs) or the BP group (calves with lobar BP). Both groups were then subjected to TTE. Results Three echocardiographic variables were statistically different between the two groups, which included 104 healthy calves and 60 diagnosed with BP. The internal end‐systolic (LVIDs) and end‐diastolic diameters of the left ventricle (LVIDd) were significantly (p = 0.033, 0.034, respectively) lower in BP‐affected calves (mean ± standard deviation [SD]: LVIDs, 29.65 ± 3.94 mm in healthy calves vs. 28.21 ± 4.44 mm in BP‐affected calves; LVIDd, 49.83 ± 4.7 mm in healthy calves vs. 48.11 ± 5.4 in BP‐affected calves). The pulmonary artery internal diameter in end‐diastole (PAdia) was significantly larger (p = 0.017) in BP‐affected calves (16.81 ± 2.68 mm) than in healthy calves (15.75 ± 2.67 mm). Conclusions and Clinical Importance The observed differences in the affected calves were within the normal reference ranges and exhibited clinical relevance. The lack of evident cardiac disturbances indicates that the BP diagnosis in our study sample was made without relevant cardiac alterations, highlighting the potential of TUS's early diagnostic capabilities during BP episodes.

Echocardiography is commonly used in veterinary clinical practice for many species but is not as easily applied in non-sedated marine mammals. Additionally, Doppler echocardiography provides further information on hemodynamics, estimation of cardiac output, characterization of flow patterns, and diastolic function. However, its applications in marine mammals have not been as widely explored either. The present report aimed to characterize the left ventricle structure and function of the Southern Sea Lion (Otaria flavescens) through a Doppler echocardiography study. Data were obtained from a healthy animal trained for different veterinary examination routines. This communication constitutes the first report of Doppler echocardiography with stroke volume, and cardiac output measurement in pinnipeds, and the first report of measurement of myocardial performance index in aquatic mammals. This data brought initial information about in vivo structure and function of the heart of the Southern Sea Lion that can be safely and effectively evaluated with the use of transthoracic Doppler echocardiography. Our data have both clinical and research implications for future studies evaluating diseases of the cardiopulmonary system in pinnipeds, and cardiovascular physiology investigation in diving mammals.

Background Left‐sided congestive heart failure (CHF) is characterized by increased filling pressures and related Doppler echocardiographic (DE) filling patterns. Hypothesis Doppler echocardiographic variables of left ventricular filling derived from transmitral flow, pulmonary vein flow, and tissue Doppler can be used to detect CHF in cats with hypertrophic cardiomyopathy (HCM). Animals Forty‐seven client‐owned cats. Methods Prospective clinical cohort study. Cats underwent physical examination, thoracic radiography, analysis of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), and transthoracic echocardiography and were divided into 3 age‐matched groups: Group 1 (apparently healthy control), Group 2 (preclinical HCM), and Group 3 (HCM and CHF). Measured and calculated variables included respiratory rate, DE estimates, serum NT‐proBNP concentration, and radiographic CHF score. Groups were compared using ANOVA, and receiver operating characteristic (ROC) curve and multivariate analyses were used to identify diagnostic cutoffs for the detection of CHF. Results Fifteen cats were in Group 1, 17 in Group 2, and 15 in Group 3. The ROC analysis indicated that the ratio of peak velocity of early diastolic transmitral flow to peak velocity of late diastolic transmitral flow (area under the curve [AUC], 1.0; diagnostic cutoff, 1.77; P = .001), ratio of left atrial size to aortic annular dimension (AUC, 0.91; diagnostic cutoff, 1.96; P = .003), left atrial diameter (AUC, 0.89; cutoff, 18.5 mm; P = .004), diastolic functional class (AUC, 0.89; cutoff, class 2; P = .005), respiratory (AUC, 0.79; cutoff, 36 breaths per minute [brpm]; P = .02), and the ratio of the peak velocity of fused early and late transmitral flow velocities to the peak velocity of the fused early and late diastolic tissue Doppler waveforms (AUC, 0.74; cutoff, 15.1; P = .05) performed best for detecting CHF. Conclusions and Clinical Importance Various DE variables can be used to detect CHF in cats with HCM. Determination of the clinical benefit of such variables in initiating treatments and assessing treatment success needs further study.

Background In livestock, identifying physiological and reproductive stages is crucial for informed decisions in nutrition, healthcare, and breeding management. Objective This study aimed to evaluate hematobiochemical and Doppler echocardiographic changes in dromedary camels during three key stages: non pregnant, late pregnancy, and early lactation. Methodology Thirty healthy camels were monitored across three physiological stages. Blood samples were analyzed for complete blood count (CBC) and serum metabolic parameters, including Beta-hydroxy-butyric acid (BHBA) and non-esterified fatty acids (NEFA). Doppler echocardiography assessed cardiac morphology and function. Results Late pregnancy was associated with a significant ( P  < 0.05) increase in red blood cell (RBC) count, hemoglobin (Hb), and neutrophils, while packed cell volume (PCV), total white blood cell (WBC) count, and monocytes decreased. Serum glucose and cholesterol declined significantly ( P  < 0.05) in late pregnancy and early lactation, while Beta-hydroxy-butyric acid (BHBA) increased. Late-pregnant camels showed elevated levels of albumin, globulin, potassium (K), and cardiac troponin, but lower total protein (TP). Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were highest in non-pregnant camels. NEFA levels rose significantly in early lactation. Echocardiographic findings revealed increased left ventricular wall thickness and decreased systolic diameter (LVIDs) in early lactation. Heart rate (HR) increased in late pregnancy. No significant changes were observed in pulsed-wave Doppler indices. Conclusions Distinct physiological stages in dromedary camels are associated with significant hematobiochemical alterations and minor echocardiographic changes, offering valuable insights for clinical and reproductive management.

Background Heart murmurs are detected commonly in apparently healthy cats during routine physical examination, and Doppler echocardiography ultimately is required to identify the source of flow turbulence causing the murmur. However, in some cases, the origin of the murmur cannot be identified on echocardiographic examination, even by experienced clinicians. The application of gentle pressure with the ultrasound transducer against the chest wall of a cat can induce temporary narrowing of the mid‐right ventricular (RV) lumen, causing blood flow turbulence even in the absence of cardiac abnormalities. Objectives/Hypotheses To evaluate the effect of pressure of the ultrasound transducer against the chest wall of cats during echocardiography (provocative testing) on RV blood flow. The main hypothesis is that provocative testing can increase RV outflow velocity and cause flow turbulence. The second hypothesis is that the effect of this maneuver is independent of changes in heart rate during testing. Animals Sixty‐one client‐owned, apparently healthy cats with heart murmurs on physical examination. Methods Retrospective review of echocardiographic examinations of 723 cats presented for investigation of a heart murmur. Results Outflow systolic velocity increased from 1.05 ± 0.26 to 1.94 ± 0.51 m/s during provocative testing (P < .0001); no correlation was found between RV outflow peak velocity and heart rate during provocative testing (P = .34; r = 0.1237). Conclusions and Clinical Relevance Right ventricular outflow tract obstruction and associated heart murmur can be iatrogenically induced in apparently healthy cats by increasing pressure on the right chest wall with an ultrasound probe.

Background Based on its pharmacokinetic profile and electrophysiological effects in healthy horses, sotalol potentially could be used as a long‐term PO antiarrhythmic drug in horses. Objectives To evaluate the effect of sotalol on heart rate (HR), QT interval, atrial fibrillatory rate, and success of cardioversion in horses with naturally occurring chronic atrial fibrillation (AF). Animals Twenty‐eight horses referred for transvenous electrical cardioversion of AF were treated with 2 mg/kg sotalol PO q12h for 3 days before cardioversion, and 13 horses underwent the same protocol without sotalol administration. Methods Retrospective study. Before and after sotalol or no treatment, the HR was measured at rest and during an exercise test. The QT interval and atrial fibrillation cycle length (AFCL) were measured at rest using tissue Doppler velocity imaging. Results In the control group, no significant differences were found between the 2 examinations. In the sotalol group, the HR at rest and during exercise was significantly lower after sotalol treatment, whereas the QT interval and AFCL measured by tissue Doppler increased significantly. Cardioversion to sinus rhythm was achieved in 25/28 horses in the sotalol group and all horses in the control group, but the median number of shocks and energy at cardioversion were significantly lower in the sotalol group. Conclusions and Clinical Importance In horses with AF, sotalol administration results in class III antiarrhythmic effects and β‐blocking activity, with moderate HR reduction during exercise.

Background Cardiomyopathy of obesity occurs in humans, but the gross and cellular myocardial response to obesity in dogs is not well defined. Objectives To characterize in vivo myocardial morphology and function in normotensive obese dogs, and quantitate collagen, triglyceride and myocyte cross‐sectional area (CSA) in postmortem tissues from obese dogs. Animals Echocardiographic‐Doppler measurements of normotensive obese dogs (n = 19) without historical or physical examination evidence of disease, and lean healthy dogs (n = 19) matched for age and ideal weight. Postmortem data were obtained from a separate population of 4 obese and 12 lean dogs without evidence of cardiac disease. Methods A prospective, observational study of myocardial morphology and function was conducted by echocardiographic‐Doppler measurement. Left ventricular (LV) tissue was collected for quantitation of triglyceride, collagen, and myocyte CSA. Results Compared with lean control dogs, obese dogs had increased systolic blood pressure (obese 153 ± 19 mm Hg; lean 133 ± 20 mm Hg; P = .003), and increased LV free wall thickness at end‐diastole (obese 9.9 ± 1.8 mm, lean 8.7 ± 1.5 mm; P = .03) and end‐systole (obese 15.2 ± 2.3 mm, lean 12.9 ± 2.3 mm; P = .004). Isovolumic relaxation time was prolonged in 7/19 (37%) of obese dogs, compared with normal ranges. Myocardial triglyceride and collagen content and myocyte CSA were similar between groups. Conclusions and Clinical Importance As in humans, LV hypertrophy and diastolic dysfunction can be an early myocardial change in some obese dogs.

BACKGROUND: Subaortic stenosis (SAS) is one of the most common congenital cardiac defects in dogs. Severe SAS frequently is treated with a beta adrenergic receptor blocker (beta blocker), but this approach largely is empirical. OBJECTIVE: To determine the influence of beta blocker treatment on survival time in dogs with severe SAS. METHODS: Retrospective review of medical records of dogs diagnosed with severe, uncomplicated SAS (pressure gradient [PG] ≥80 mmHg) between 1999 and 2011. RESULTS: Fifty dogs met the inclusion criteria. Twenty‐seven dogs were treated with a beta blocker and 23 received no treatment. Median age at diagnosis was significantly greater in the untreated group (1.2 versus 0.6 years, respectively; P = .03). Median PG at diagnosis did not differ between the treated and untreated groups (127 versus 121 mmHg, respectively; P = .2). Cox proportional hazards regression was used to identify the influence of PG at diagnosis, age at diagnosis, and beta blocker treatment on survival. In the all‐cause multivariate mortality analysis, only age at diagnosis (P = .02) and PG at diagnosis (P = .03) affected survival time. In the cardiac mortality analysis, only PG influenced survival time (P = .03). Treatment with a beta blocker did not influence survival time in either the all‐cause (P = .93) or cardiac‐cause (P = .97) mortality analyses. CONCLUSIONS: Beta blocker treatment did not influence survival in dogs with severe SAS in our study, and a higher PG at diagnosis was associated with increased risk of death.