Prophylactic use of a lidocaine constant rate infusion versus saline in dogs undergoing balloon valvuloplasty for management of pulmonic stenosis: A randomized control trial.

OBJECTIVE: To evaluate the effect of a prophylactic lidocaine constant rate infusion (CRI) on the incidence and malignancy of catheter-induced ventricular ectopic complexes (VECs) during balloon valvuloplasty for management of pulmonic stenosis in dogs. STUDY DESIGN: Single-centre, prospective, randomized study. ANIMALS: Client-owned dogs (n = 70) with pulmonic stenosis. METHODS: Dogs were randomly assigned to one of two anaesthetic protocols: administration of lidocaine 2 mg kg-1 bolus followed by a CRI (50 µg kg-1 minute-1; group LD) or a saline placebo (group SL) during balloon valvuloplasty. All dogs were premedicated with methadone (0.3 mg kg-1) intramuscularly and a digital three-lead Holter monitor was applied. Anaesthetic co-induction was performed with administration of alfaxalone (2 mg kg-1) and diazepam (0.4 mg kg-1), and anaesthesia was maintained with isoflurane vaporised in 100% oxygen. CRIs were started on positioning of the dog in theatre and discontinued as the last vascular catheter was removed from the heart. All dogs recovered well and were discharged 24 hours postoperatively. Blinded Holter analysis was performed by an external veterinary cardiologist using commercially available dedicated analysis software; p < 0.05. RESULTS: Of the 70 dogs enrolled in the study, 61 were included in the final analysis: 31 in group LD and 30 in group SL. There was no significant difference between sinus beats (p = 0.227) or VECs (p = 0.519) between groups. In group LD, 19/31 (61.3%) dogs had a maximum ventricular rate ≥250 units and 20/30 (66.7%) dogs in group SL (p = 0.791). CONCLUSION AND CLINICAL RELEVANCE: In this study, the use of a prophylactic lidocaine bolus followed by CRI in dogs undergoing balloon valvuloplasty for management of pulmonic stenosis did not significantly decrease the incidence nor the malignancy of VECs during right heart catheterization compared with a saline CRI.

Effect of pimobendan on left atrial function in dogs with preclinical myxomatous mitral valve disease.

Background: Left atrial (LA) function is an important determinant of the left ventricular (LV) filling, playing a key role in maintaining optimal cardiac performance. Pimobendan is a phosphodiesterase III inhibitor with positive inotropic and vasodilator effects. The present study aims to investigate the effects of pimobendan on LA function in dogs with stage B2 myxomatous mitral valve disease (MMVD). Aim: The aim of this investigation was to study the effects of pimobendan on LA function in dogs with preclinical MMVD. Methods: Twenty-seven dogs with stage B2 MMVD were retrospectively included. LA function was assessed before and 1-6 months following pimobendan initiation. For each dog, two-dimensional (2D) echocardiography was performed to assess LA diameter and volume for each phase of the LA cycle and to assess complete, passive, and active LA function. Pulsed-wave tissue Doppler imaging (TDI) of the left ventricular longitudinal myocardial velocity associated with atrial contraction (A'), both at the level of the interventricular septum and the LV free wall, was also used as an indicator of LA function. Results: There were no significant differences in any of the left atrial variables pre- and posttreatment. Conclusion: Echocardiographic estimates of LA function by 2D diameters and volumes and TDI A' in dogs with MMVD do not change after treatment with pimobendan.

Feasibility and reproducibility of echocardiographic assessment of regional left atrial deformation and synchrony by tissue Doppler ultrasonographic imaging in healthy dogs.

OBJECTIVE: To assess the feasibility and reproducibility of longitudinal tissue Doppler ultrasonographic imaging with regard to determination of velocity, strain, and strain rate (SR) of the left atrium (LA) and use those data to characterize LA synchrony (LAS) for a group of healthy dogs. ANIMALS: 15 healthy dogs. PROCEDURES: For each dog, apical 4- and 2-chamber echocardiographic views were obtained. Peak velocity, strain, and SR and time to peak value during systole, early diastole, and late diastole were measured for each of the 4 LA walls. To characterize LAS, mean and SD maximal late diastolic time difference (LAD) among the 4 walls were calculated on the basis of time to peak for velocity, strain, and SR; for each, the 95% confidence interval (mean ± 2SD) was calculated. Within-day and between-day intraobserver variability was calculated. RESULTS: For all dogs, tissue velocity and SR had peak positive values during systole and 2 negative peaks during early and late diastole. Atrial strain had a peak positive value during systole, positive values during early diastole, and a negative peak value during late diastole. Reproducibility was acceptable for most variables. Diastolic strain and SR had the highest variability, but times to peak values were always reproducible. For velocity, strain, and SR, the 95% confidence interval for the maximal LAD was < 50 milliseconds and that for the SD of the LAD was < 23 milliseconds. CONCLUSIONS AND CLINICAL RELEVANCE: Longitudinal tissue Doppler imaging of LA deformation was feasible in healthy dogs, and its application may be useful for understanding atrial pathophysiologic changes associated with various cardiac diseases in dogs.