ABSTRACT
As miocardiopatias são as cardiopatias mais comumente diagnosticadas em felinos domésticos. A cardiomiopatia hipertrófica (CMH) soma a maioria dos casos de cardiomiopatias em pacientes atendidos na rotina da medicina interna de felinos. Gatos com doenças cardíacas podem não apresentar manifestações clínicas evidentes podendo apresentar sinais sutis de insuficiência cardíaca (IC) ao longo do tempo de modo que em um dado momento descompensam e evidenciam sinais clínicos. O pimobendan é um fármaco denominado inodilatador devido a sua capacidade de promover inotropismo positivo e vasodilatação. Apesar de escassos, os estudos existentes com a utilização de pimobendan demonstram boa tolerância em gatos saudáveis e com cardiopatias diversas. Atualmente, o uso do pimobendan em gatos é extra bula e a dose baseia-se em estudos realizados com cães. No entanto, sabe-se que as concentrações plasmáticas diferem entre as espécies o que pode requerer possíveis ajustes. A terapia da IC em gatos é bastante discutida e evidências recentes demonstram que o pimobendan pode ser um aliado no tratamento de diversas doenças cardíacas que levem à disfunção sistólica sendo capaz de prover melhora dos sinais clínicos e até aumento da expectativa de vida desses pacientes. Contudo, pesquisas são necessárias para melhor entendimento dos efeitos hemodinâmicos do medicamento em gatos com disfunção diastólica.
Myocardiopathies are the most diagnosed heart disease in domestic cats. Hypertrophic cardiomyopathy (HCM) adds up to most cases of cardiomyopathies in patients seen in the routine of feline internal medicine. Cats with heart disease may not have evident clinical manifestations and may show subtle signs of heart failure (HF) over time so that at a given moment they decompensate and show clinical symptoms. Pimobendan is an inodilator drug due to its ability to promote positive inotropism and vasodilation. Although scarce, the existing studies with the use of pimobendan demonstrate good tolerance in healthy cats with various heart diseases. Currently, the use of pimobendan in cats is off-label and the dose is based on studies conducted in dogs. However, it is known that plasma concentrations differ between species, which may require possible adjustments. The therapy of HF in cats is widely discussed and recent evidence shows that pimobendan can be an ally in the treatment of various heart diseases that lead to systolic dysfunction, being able to provide improvement in clinical signs and even increase the life expectancy of these patients. However, research is necessary to better understand the hemodynamic effects of the drug in cats with diastolic dysfunction.
Subject(s)
Animals , Cats , Cardiotonic Agents/analysis , Cardiotonic Agents/therapeutic use , Heart Failure/drug therapy , Heart Failure/veterinary , Cardiomyopathies/drug therapy , Cardiomyopathies/veterinaryABSTRACT
A hipertensão arterial sistólica é frequentemente reconhecida na prática clínica da medicina interna felina, sendo um problema comum em gatos mais velhos. Esta enfermidade é, costumeiramente, secundária a outras doenças, tais como, doença renal crônica e hipertireoidismo. No entanto, em alguns pacientes a causa subjacente não é identificada, portanto denominada de hipertensão idiopática. Elevações na pressão arterial, de forma sustentada ou não, podem levar a danos em diversos órgãos como, cérebro, olhos, coração e rins. Essas injúrias são denominadas de lesão de órgãos-alvo. Pressão arterial sistêmica acima de 160mmHg possue risco moderado a grave de dano aos órgãos-alvo. Desta maneira, o tratamento procura idealmente atingir riscos de dano mínimos. Alguns fármacos podem ser utilizados como terapia anti-hipertensiva, dentre elas, a amlodipina, um bloqueador de canal de cálcio, que é o medicamento de primeira escolha para tratamento em gatos. Além disso, é de extrema importância o diagnóstico de doenças que possam gerar o quadro hipertensivo ou estar em associação para que desta forma seja possível um controle adequado da pressão arterial. O diagnóstico precoce da doença é fundamental pois auxilia reduzir as chances de lesão nos órgãos-alvo, e consequentemente, reduz a mortalidade e melhora a qualidade de vida dos pacientes.
Systolic arterial hypertension is often recognized in the clinical practice of feline internal medicine and is a common problem in older cats. This disease is usually secondary to other diseases, such as chronic kidney disease and hyperthyroidism. However, in some patients the underlying cause is not identified, therefore called idiopathic hypertension. Elevations in blood pressure, whether sustained or not, can cause damage to various organs such as the brain, eyes, heart and kidneys. These injuries are called target organ damage. Systemic blood pressure above 160mmHg has a moderate to severe risk of damage to target organs. In this way, the treatment ideally seeks to achieve risks of cognitive damage. Pharmacological substances can be used as antihypertensive therapy, among them, an amlodipine, a calcium channel blocker, which is the drug of choice for treatment in cats. In addition, it is extremely important to diagnose diseases that cause hypertension or to be associated with it, so that this form of blood pressure is adequate. Early diagnosis of the disease is essential because it helps to reduce the chances of target organ damage, and consequently, reduce mortality and improve patients' quality of life.
Subject(s)
Animals , Cats , Arterial Pressure , Hypertension/complications , Hypertension/veterinaryABSTRACT
Background: Boxer dog cardiomyopathy was initially described by Neil Harpster in 1983 and has received different names. However, several recent studies demonstrated a similarity to the human arrhythmogenic right ventricular cardiomyopathy (ARVC), which led to the name Boxer ARVC. This hereditary disease seems to be linked to a mutation in the gene that codifies the cardiac ryanodine receptor. This mutation leads to an alteration of the calcium cycle in the heart. The analysis of the heart rate variability is an important predictive factor for diagnosing this disease. Therefore, this study aims to report a case of a Boxer ARVC providing electrocardiographic data and heart rate variability.Case: A 11 year-old male Boxer dog, weighting 29.65 kg, was submitted to a heart check-up due to sudden occurrence of fatigue and syncope. At the clinical examination, heart auscultation did not revealed sounds or arrhythmias. The electrocardiogram results presented tachycardia and a regular rhythm with ventricular premature complexes (VPC´s). Ecodopplercargiogram was performed and values were within normal standards. Thus, a dynamic monitoring of 24 h was performed using a Holter monitor. This analysis demonstrated tachycardia in the sinus rhythm, type I second degree sinoatrial block, normal PR interval and normal length of QRS complexes. In addition, severe ventricular ectopy was identified in the following forms: isolated, paired, and nonsustained ventricular tachycardia. The heart rate variability analysis resulted in mean values of 213 ms (SNDD), 132 ms (SDANN), 211ms (rMSSD) and 33.46% (pNN50). Based on these data, Boxer ARVC is the probable diagnosis. However, a ventricular myocardial biopsy necessary to confirm the disease was not performed due to the inherent risk of the procedure. Treatment was performed with sotalol and a commercial feed specially designed for dogs with for cardiac diseases.[...]
Subject(s)
Male , Animals , Adult , Dogs , Arrhythmogenic Right Ventricular Dysplasia/diagnostic imaging , Arrhythmogenic Right Ventricular Dysplasia/veterinary , Heart Rate , Electrocardiography, Ambulatory/methods , Electrocardiography, Ambulatory/veterinaryABSTRACT
Background: Boxer dog cardiomyopathy was initially described by Neil Harpster in 1983 and has received different names. However, several recent studies demonstrated a similarity to the human arrhythmogenic right ventricular cardiomyopathy (ARVC), which led to the name Boxer ARVC. This hereditary disease seems to be linked to a mutation in the gene that codifies the cardiac ryanodine receptor. This mutation leads to an alteration of the calcium cycle in the heart. The analysis of the heart rate variability is an important predictive factor for diagnosing this disease. Therefore, this study aims to report a case of a Boxer ARVC providing electrocardiographic data and heart rate variability.Case: A 11 year-old male Boxer dog, weighting 29.65 kg, was submitted to a heart check-up due to sudden occurrence of fatigue and syncope. At the clinical examination, heart auscultation did not revealed sounds or arrhythmias. The electrocardiogram results presented tachycardia and a regular rhythm with ventricular premature complexes (VPC´s). Ecodopplercargiogram was performed and values were within normal standards. Thus, a dynamic monitoring of 24 h was performed using a Holter monitor. This analysis demonstrated tachycardia in the sinus rhythm, type I second degree sinoatrial block, normal PR interval and normal length of QRS complexes. In addition, severe ventricular ectopy was identified in the following forms: isolated, paired, and nonsustained ventricular tachycardia. The heart rate variability analysis resulted in mean values of 213 ms (SNDD), 132 ms (SDANN), 211ms (rMSSD) and 33.46% (pNN50). Based on these data, Boxer ARVC is the probable diagnosis. However, a ventricular myocardial biopsy necessary to confirm the disease was not performed due to the inherent risk of the procedure. Treatment was performed with sotalol and a commercial feed specially designed for dogs with for cardiac diseases.[...](AU)