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Assessment of systolic and diastolic function in clinically healthy horses using ambulatory acoustic cardiography


Zuber, N; Zuber, M; Schwarzwald, Colin C (2019). Assessment of systolic and diastolic function in clinically healthy horses using ambulatory acoustic cardiography. Equine Veterinary Journal, 51(3):391-400.

Abstract

BACKGROUND: Assessment of cardiac electromechanical function in horses requires training, experience and specialised equipment and does not allow continuous monitoring over time.
OBJECTIVES: The objective of this study was to establish the use of an acoustic ECG monitor (Audicor® ) in healthy horses. It provides noninvasive, examiner-independent, continuous analyses combining ECG and phonocardiography to calculate indices of cardiac mechanical activity and haemodynamics. Device usability was investigated, reference intervals calculated and reproducibility of analyses assessed.
STUDY DESIGN: Prospective descriptive study.
METHODS: Continuous overnight recordings were obtained in 123 healthy horses. ECG and acoustic cardiography analyses were performed. Electromechanical activating time (EMAT), rate-corrected EMATc, left ventricular systolic time (LVST), rate-corrected LVSTc and intensity and persistence of the third and fourth heart sound (S3, S4) were reported. Associations with age and reproducibility of analyses were assessed.
RESULTS: Audicor® recordings of diagnostic quality were obtained in 116 horses, with an artefact-free recording time of 1:08-14:03 h (mean 10:21 h). 44.8% of the horses had atrial premature complexes (up to 0.18% of analysed beats), 4.3% had ventricular premature complexes (up to 0.021% of analysed beats). Reference intervals for acoustic cardiography variables were reported. S3 was significantly more often graded ≥5 (scale 0-10) in younger compared to older horses (P = 0.0036, R2 = 0.072). The between-day coefficient of variation ranged from 2.5 to 7.7% for EMAT, EMATc, LVST and LVSTc.
MAIN LIMITATIONS: Audicor® algorithms are based on human databases. Horses were deemed clinically healthy without advanced diagnostics. Some data were lost because of technical difficulties, artefacts and noises.
CONCLUSIONS: Overnight Audicor® recordings are feasible in horses. Combining ambulatory ECG and phonocardiography allows noninvasive, continuous assessment of variables representing systolic and diastolic cardiac function. ECG rhythm analyses require over-reading by a specialist, but acoustic cardiography variables are based on automated algorithms independent of examiner input. Further studies are required to establish the clinical value of acoustic cardiography in horses.

Abstract

BACKGROUND: Assessment of cardiac electromechanical function in horses requires training, experience and specialised equipment and does not allow continuous monitoring over time.
OBJECTIVES: The objective of this study was to establish the use of an acoustic ECG monitor (Audicor® ) in healthy horses. It provides noninvasive, examiner-independent, continuous analyses combining ECG and phonocardiography to calculate indices of cardiac mechanical activity and haemodynamics. Device usability was investigated, reference intervals calculated and reproducibility of analyses assessed.
STUDY DESIGN: Prospective descriptive study.
METHODS: Continuous overnight recordings were obtained in 123 healthy horses. ECG and acoustic cardiography analyses were performed. Electromechanical activating time (EMAT), rate-corrected EMATc, left ventricular systolic time (LVST), rate-corrected LVSTc and intensity and persistence of the third and fourth heart sound (S3, S4) were reported. Associations with age and reproducibility of analyses were assessed.
RESULTS: Audicor® recordings of diagnostic quality were obtained in 116 horses, with an artefact-free recording time of 1:08-14:03 h (mean 10:21 h). 44.8% of the horses had atrial premature complexes (up to 0.18% of analysed beats), 4.3% had ventricular premature complexes (up to 0.021% of analysed beats). Reference intervals for acoustic cardiography variables were reported. S3 was significantly more often graded ≥5 (scale 0-10) in younger compared to older horses (P = 0.0036, R2 = 0.072). The between-day coefficient of variation ranged from 2.5 to 7.7% for EMAT, EMATc, LVST and LVSTc.
MAIN LIMITATIONS: Audicor® algorithms are based on human databases. Horses were deemed clinically healthy without advanced diagnostics. Some data were lost because of technical difficulties, artefacts and noises.
CONCLUSIONS: Overnight Audicor® recordings are feasible in horses. Combining ambulatory ECG and phonocardiography allows noninvasive, continuous assessment of variables representing systolic and diastolic cardiac function. ECG rhythm analyses require over-reading by a specialist, but acoustic cardiography variables are based on automated algorithms independent of examiner input. Further studies are required to establish the clinical value of acoustic cardiography in horses.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Equine Department
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Uncontrolled Keywords:Equine, General Medicine, cardiovascular; electrocardiogram; heart sounds; horse; phonocardiogram
Language:English
Date:May 2019
Deposited On:05 Nov 2018 17:47
Last Modified:28 Feb 2020 08:25
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0425-1644
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/evj.13014
PubMed ID:30171766

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