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      Assessment of left atrial function in feline hypertrophic cardiomyopathy by using two- dimensional speckle tracking echocardiography

      research-article
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      BMC Veterinary Research
      BioMed Central
      Cats, Heart, Left atrium, Strain

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          Abstract

          Background

          Left atrial (LA) function plays an important role in diastolic dysfunction in cats with hypertrophic cardiomyopathy (HCM). Two-dimensional speckle tracking echocardiography (2D-STE) is a technique for assessing LA function. This study aimed to evaluate the LA function in HCM cats compared to normal cats, using 2D-STE.

          Results

          Seventeen client-owned cats affected with HCM and twenty healthy control cats were studied. Conventional echocardiographic and 2D-STE variables were measured and compared between groups (control and HCM groups). Variability of the peak atrial longitudinal strain (PALS) displayed good reproducibility with 4.7% intra-observer and 14% inter-observer repeatability. The mean value of PALS in the HCM group (13.16 ± 8.64) was lower than that in the control group (28.54 ± 10.31) ( P < 0.001). PALS was lowest in the LA roof region. The atrial longitudinal strains of septal and lateral regions were significantly lower in the HCM group than in the normal group. The PALS correlated with the percentage of the LA fractional shortening (LA-FS) (r = 0.538, P = 0.001), the percentage of the LA ejection fraction (LA-EF) (r = 0.797, P < 0.001), and the LA fractional area change (FAC) (r = 0.746, P < 0.001).

          Conclusions

          PALS is a feasible and reproducible method to evaluate the LA function in cats affected with HCM.

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          Most cited references33

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          Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects.

          Increased left atrial (LA) size and reduced global contractility are related to adverse cardiac events. The potential incremental value of assessing regional LA contractility is unknown. To assess the feasibility of measuring this variable angle, independent 2-dimensional speckle-tracking strain echocardiography (2D-SpTr) was used to measure regional LA strain (epsilon) and strain rate (SR) in normal individuals of various ages. From standard apical views, 2D-SpTr was used on 84 normal subjects to measure longitudinal velocity, epsilon, and SR in 13 LA segmental regions. The values obtained from the different atrial regions were compared with each other and corresponding LA volumes before and after LA contraction. Regional LA epsilon and SR could be measured in 77 of 84 normal subjects (94%). A consistent pattern of differences in LA regional function was noted with the annular regions, and particularly the inferior wall having a larger average peak velocity and epsilon and SR values in comparison with the mid and superior LA segments. Peak epsilon and SR during LA contraction had only a modest correlation with LA volumes. The angle-independent technique of 2D-SpTr tracking can analyze regional LA epsilon and SR in 94% of normal subjects. Regional differences in LA contractility are consistently present. The annular regions, and especially the inferior wall have the highest values for LA epsilon and SR. The significance of these findings and their possible use in identifying disease states will require further study.
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            ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats

            Abstract Cardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are well‐tolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death. Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk of life‐threatening complications and those at higher risk. Based on the available literature, we offer recommendations for the approach to diagnosis and staging of cardiomyopathies, as well as for management at each stage.
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              Left atrial function: pathophysiology, echocardiographic assessment, and clinical applications.

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                Author and article information

                Contributors
                sirilakd27@gmail.com
                Journal
                BMC Vet Res
                BMC Vet. Res
                BMC Veterinary Research
                BioMed Central (London )
                1746-6148
                18 September 2020
                18 September 2020
                2020
                : 16
                : 344
                Affiliations
                GRID grid.7922.e, ISNI 0000 0001 0244 7875, Department of Veterinary Medicine, Faculty of Veterinary Science, , Chulalongkorn University, ; 10330 Bangkok, Thailand
                Article
                2557
                10.1186/s12917-020-02557-3
                7501631
                32948164
                5659207f-fe5a-42eb-89b1-86c5c1aa8f47
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 9 March 2020
                : 4 September 2020
                Funding
                Funded by: the 90th Anniversary of Chulalongkorn University, Rachadapisek Sompote Fund, Chualongkorn University, Thailand
                Funded by: the 72nd anniversary of his Majesty King Bhumibala Aduladeja Fund, Graduate School, Chulalongkorn University, Thailand
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Veterinary medicine
                cats,heart,left atrium,strain
                Veterinary medicine
                cats, heart, left atrium, strain

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