Abstract
Simple SummaryThe endomyocardial form of restrictive cardiomyopathy, a primary disorder of the myocardium, is one of the diseases with poor prognosis in cats. While two-dimensional speckle-tracking echocardiography has been known to identify myocardial deformations, its function relative to cats with the endomyocardial form of restrictive cardiomyopathy has yet to be characterized. We hypothesized that both the left and right myocardial functional abnormalities may occur in cats with the endomyocardial form of restrictive cardiomyopathy, causing this disease pathophysiology and clinical status. In the current study, cats were assessed for layer-specific myocardial function (whole, endocardial, and epicardial) in the left ventricular longitudinal and circumferential directions, and right ventricular longitudinal direction, via two-dimensional speckle-tracking echocardiography. Our study indicated that cats with restrictive cardiomyopathy have reduced left ventricular myocardial function. Notably, left ventricular systolic circumferential endocardial strain and circumferential endocardial-to-epicardial strain ratio were lower in cats with restrictive cardiomyopathy. Furthermore, some right ventricular myocardial deformations were also differerent in cats with restrictive cardiomyopathy. Myocardial function assessed by two-dimensional speckle-tracking echocardiography could reveal left and right myocardial dysfunction.The endomyocardial form of restrictive cardiomyopathy (EMF-RCM), a primary disorder of the myocardium, is one of the diseases with poor prognosis in cats. We hypothesized that both the left and right myocardial functional abnormalities may occur in cats with EMF-RCM, causing this disease pathophysiology and clinical status. Out of the 25 animals included in this study, 10 were client-owned cats with EMF-RCM, and 15 were healthy cats. In this study, cats were assessed for layer-specific myocardial function (whole, endocardial, and epicardial) in the left ventricular longitudinal and circumferential directions, and right ventricular longitudinal direction, via two-dimensional speckle-tracking echocardiography (2D-STE). Cats with EMF-RCM had depressed left ventricular myocardial deformations both in systole (whole longitudinal strain, epicardial longitudinal strain, and endocardial circumferential strain) and diastole (early and late diastolic longitudinal strain rates, and late diastolic circumferential strain rate) compared to controls. Furthermore, some right ventricular myocardial deformations (systolic longitudinal strain in epicardial layers, and endocardial-to-epicardial strain ratio) were significantly differerent in cats with EMF-RCM. Myocardial function assessed by 2D-STE could reveal left and right myocardial dysfunction.
Highlights
Restrictive cardiomyopathy is primary cardiomyopathy form in cats, which is classified into the endomyocardial and myocardial forms
10 cats with endomyocardial form of restrictive cardiomyopathy (EMF-RCM) and 15 healthy cats serving as controls were enrolled in this study
Staging was according to American College of Veterinary Internal Medicine consensus: Stage B2 identified asymptomatic cats with significant left atrial enlargement based on echocardiography, and Stage C identified symptomatic cats with current or past clinical findings of heart failure caused by cardiomyopathy
Summary
Restrictive cardiomyopathy is primary cardiomyopathy form in cats, which is classified into the endomyocardial and myocardial forms. As feline cardiomyopathy is based on a primary disorder of the myocardium (endomyocardial fibrosis) [1,2,3], myocardial assessment is important in feline cases for EMF-RCM diagnosis and understanding its pathophysiology. We have reported on two-dimensional speckle-tracking echocardiography (2D-STE) applied to cats with hypertrophic cardiomyopathy (HCM) and assessed myocardial functionality in HCM cats [7,8,9]. In these previous studies, the 2D-STE techniques revealed that cats with HCM have myocardial dysfunction, which may reflect characteristics of the HCM myocardium [7,8,9] and layer-specific compensative disease pathophysiology in cats with HCM [7]. We hypothesized that myocardial functional assessment with 2D-STE could reveal more detailed myocardial function, or lack thereof, in cats with EMF-RCM to develop its pathophysiological characteristics
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