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- Title
Retrospektive Studie zur Entwicklung von klinischen und echokardiographischen Herzbefunden bei Warmblutpferden.
- Authors
Kähn, Ferdinand; Merle, Roswitha; Hövener, Jakob; Gehlen, Heidrun
- Abstract
Assessing the prognosis of clinical cardiological and echocardiographic findings in warm-blooded horses is a major challenge. Nonetheless, horse owners and prospective buyers want the highest degree of accuracy in predicting how heart disease may affect their horse’s long-term survival, quality of life and performance. The study aimed to enhance these prognostic assessments, resulting in the documentation of the course of clinical and echocardiographic findings in 104 Warmblood horses. The study involved horses that were examined at a renowned equine clinic in northern Germany between January 1, 2000, and May 25, 2022. Each horse underwent both an initial and a follow-up cardiological assessment (U1 and U2) and received clinical examinations and cardiac ultrasounds during both visits. The two evaluations were separated by a minimum of two weeks, and they included a reevaluation of cardiac ultrasound data. Every horse only appeared once in the U1 and once in the U2 and no control group was employed. A p-value<0.05 was considered significant. The Odds Ratio (OR) included a 95% confidence interval and was calculated to determine whether the occurrence or development of certain findings was associated with an increased risk of deterioration or the occurrence of further findings. The risk was considered significant if the OR exceeded 1.00 and the p-value was significant. The study revealed that ultrasound findings typically remain stable or tended to worsen up to U2. With the majority of cases, there was no deterioration in findings between the U1 and the U2. Only 2.9% of cases exhibited abnormalities in U2 that were not initially detected in U1. This aligns with previous studies demonstrating that ultrasonographic findings generally only tend to worsen up to U2. Additionally, the study demonstrated that conditions such as arrhythmias and atrial fibrillation (AF) frequently recurred during the U2 examination. The correlation between the occurrence of an enlarged LA and AF was confirmed to be highly significant (p=0.007). Horses are more prone to AF in U2 if they have an enlarged LA in U1. In addition the study population was most likely to have AF, when an enlarged LA was present, which is a fact that differs from another study population that mostly has no structural changes, when AF is present [22]. Disparities in this case might be explained as other studies were no follow-up studies and referring veterinarians in practice might tend to recommend a U2 when the U1 showed sonographic findings. Consistent with these findings the study was also able to demonstrate that the enlargement of the LA depended on the period between examination and occurred particularly when the examination interval was longer than 15 months (OR=5.647; p=0.019). The degree of heart murmurs varied compared to the U1. Heart murmurs were both of higher and lower grades. This emphasis that the grade of a heart murmur is not necessarily a reliable indicator of the severity of a heart disease. It is also known that heart murmurs can occur briefly due to physiological modeling and abnormal pressure conditions in the abdomen. The study investigated whether the influence of a changing finding is different from the influence of a constant finding. However, we were able to demonstrate that, both the worsening of the mitral regurgitation (MVI) Grade and the presence of MVI in U1 had no significant effect on LA. A previous study with subjects from the same population shows that MVI in U1 influences the presence of an enlarged LA. Despite, the study undertaken did not establish a direct causal relationship between MVI and AF. This contradicts another study, which may be explained by the fact that no horse with severe MVI was found in the study. Furthermore, the study investigated whether combination findings of MVI and AF significantly increased the likelihood of an enlarged LA in U2. This hypothesis was not confirmed by the data, possibly due to insufficient sample size. The study population lacked measurements of body size, weight and patient age, which must be acknowledged as a limitation when interpreting heart dimensions. Absolute cut-off values may not accurately apply to exceptional large or small horses and the inclusion of patient age could yield more meaningful results. Future research endeavors should prioritize more comprehensive prevalence and follow-up studies that encompass heart dimensions in conjunction with the weight, size, and age of the horses.
- Subjects
U2 (Performer); ATRIAL arrhythmias; HEART murmurs; HORSE owners; MITRAL valve insufficiency; BODY size; HORSE breeding; ATRIAL fibrillation
- Publication
Pferdeheilkunde, 2024, Vol 40, Issue 1, p49
- ISSN
0177-7726
- Publication type
Article
- DOI
10.21836/PEM20240106