Feline cardiomyopathies (CM) represent an heterogeneous group of myocardial disease. Idiopathic Hypertrophic cardiomyopathy (HCM) is the most common CM in cats, characterized by an hypertrophied left ventricle in the absence of concurrent diseases responsible to increase myocardial mass. The second most common CM in cats is restrictive cardiomyopathy (RCM), identified by biatrial enlargement, stiff left ventricle in the absence of marked LV hypertrophy. Secondary CM due to hyperthyroidism and systemic hypertension are frequent as well. Aim of this retrospective study was to compare survival and prognostic factors in cats affected by HCM, RCM or secondary CM referred in our institution over a 10 year period. The study included 101 cats with complete case record and echocardiographic exam. 54 cats presented HCM, 16 RCM and 30 secondary CM ( 12 cats were diagnosed with hyperthyroidism, while 18 cats presented BP > 170mmHg). A statistically significant different survival time was identified for HCM (mean survival time of 578days), RCM (466days) and secondary CM (643 days). In the overall population, risk factors in the multivariate analysis, regardless of the CM considered, were : presence of symptoms ( OR 4,07, p<0.004), an increased LA/Ao ratio ( OR 30.1, p<0.001) and presence of LA thrombi/smoke effect ( OR 4.7, p<0.003). Univariate analysis and multivariate analysis was carried on in HCM +RCM population. Univariate analysis identified RCM (OR 2.69, p<0.001), no murmur (OR 2.89, p<0.003), symptoms (OR 7.78), p<0.001), concentric symmetric hypertrophy vs asymmetrical septal hypertrophy (OR 3.89, p<0.004), biatrial enlargement+absence of hypertrophy vs asymmetrical septal hypertrophy (OR 5.01, p<0.001),absence of SAM (OR 2.22, p<0.02), LA/Ao >2.5 vs normal LA/Ao( OR 58.69, p<0.001),presence of LA thrombi/ smoke effect ( OR 11.2, p<0.001) as risk factors for cardiac death. Multivariate analysis identified only LA/Ao >2.5 vs normal LA/Ao ( OR 45.06, p<0.001) and LA thrombi/smoke effect ( OR 5.6, p<0.003) as risk factors for cardiac related death. In conclusion, HCM and RCM are two distinct CM with different echocardiographic presentation, evolution over time, but they share some common features ( i.e. LA dimension and hyperviscosity syndrome) linked to feline cardiovascular physiology, which influence greatly survival in end-stage CM. Secondary CM are more benign conditions, but if the primary disease is not properly managed, prognosis might be poor also in this patients.

Feline cardiomyopathies: a survival study / I. Spalla, E. Cremaschi, C. Locatelli, G. Riscazzi, P.G. Brambilla - In: Proceeding 22° ECVIM-CA congress, Maastricht 2012[s.l] : ECVIM-CA congress, 2012 Sep. - pp. 1-1 (( Intervento presentato al 22. convegno ECVIM-CA tenutosi a Maastricht nel 2012.

Feline cardiomyopathies: a survival study

I. Spalla;C. Locatelli;G. Riscazzi;P.G. Brambilla
2012

Abstract

Feline cardiomyopathies (CM) represent an heterogeneous group of myocardial disease. Idiopathic Hypertrophic cardiomyopathy (HCM) is the most common CM in cats, characterized by an hypertrophied left ventricle in the absence of concurrent diseases responsible to increase myocardial mass. The second most common CM in cats is restrictive cardiomyopathy (RCM), identified by biatrial enlargement, stiff left ventricle in the absence of marked LV hypertrophy. Secondary CM due to hyperthyroidism and systemic hypertension are frequent as well. Aim of this retrospective study was to compare survival and prognostic factors in cats affected by HCM, RCM or secondary CM referred in our institution over a 10 year period. The study included 101 cats with complete case record and echocardiographic exam. 54 cats presented HCM, 16 RCM and 30 secondary CM ( 12 cats were diagnosed with hyperthyroidism, while 18 cats presented BP > 170mmHg). A statistically significant different survival time was identified for HCM (mean survival time of 578days), RCM (466days) and secondary CM (643 days). In the overall population, risk factors in the multivariate analysis, regardless of the CM considered, were : presence of symptoms ( OR 4,07, p<0.004), an increased LA/Ao ratio ( OR 30.1, p<0.001) and presence of LA thrombi/smoke effect ( OR 4.7, p<0.003). Univariate analysis and multivariate analysis was carried on in HCM +RCM population. Univariate analysis identified RCM (OR 2.69, p<0.001), no murmur (OR 2.89, p<0.003), symptoms (OR 7.78), p<0.001), concentric symmetric hypertrophy vs asymmetrical septal hypertrophy (OR 3.89, p<0.004), biatrial enlargement+absence of hypertrophy vs asymmetrical septal hypertrophy (OR 5.01, p<0.001),absence of SAM (OR 2.22, p<0.02), LA/Ao >2.5 vs normal LA/Ao( OR 58.69, p<0.001),presence of LA thrombi/ smoke effect ( OR 11.2, p<0.001) as risk factors for cardiac death. Multivariate analysis identified only LA/Ao >2.5 vs normal LA/Ao ( OR 45.06, p<0.001) and LA thrombi/smoke effect ( OR 5.6, p<0.003) as risk factors for cardiac related death. In conclusion, HCM and RCM are two distinct CM with different echocardiographic presentation, evolution over time, but they share some common features ( i.e. LA dimension and hyperviscosity syndrome) linked to feline cardiovascular physiology, which influence greatly survival in end-stage CM. Secondary CM are more benign conditions, but if the primary disease is not properly managed, prognosis might be poor also in this patients.
Settore VET/08 - Clinica Medica Veterinaria
European College of Veterinary Internal Medicine
ECVIM
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/190669
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