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Prognostic indicators in cats with hypertrophic cardiomyopathy

J R Payne1, K Borgeat, D J Connolly

  • 1Clinical Sciences and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.

Journal of Veterinary Internal Medicine
|October 19, 2013
PubMed

Insights

Echocardiography can predict survival in cats with hypertrophic cardiomyopathy (HCM). Left atrial dysfunction, poor left ventricular systolic function, and extreme left ventricular hypertrophy are key indicators of reduced cardiac survival in feline HCM.

Area of Science:

  • Veterinary Cardiology
  • Echocardiography
  • Feline Medicine

Background:

  • Hypertrophic cardiomyopathy (HCM) in cats is linked to reduced survival.
  • Left atrial enlargement, congestive heart failure (CHF), and aortic thromboembolism (ATE) are known poor prognostic indicators.
  • The prognostic value of specific echocardiographic variables in feline HCM remains incompletely understood.

Purpose of the Study:

  • To investigate the prognostic value of left atrial (LA) echocardiographic variables.
  • To assess the predictive capability of left ventricular (LV) diastolic and systolic function in cats with HCM.
  • To identify echocardiographic predictors of cardiac survival in feline HCM.

Main Methods:

  • Retrospective analysis of clinical and echocardiographic records from 282 cats diagnosed with HCM.
  • Inclusion criteria: Echocardiographic confirmation of LV diastolic wall thickness ≥ 6 mm.
  • Outcomes (cardiac death) were determined from clinical records and veterinarian/owner reports.

Main Results:

  • Univariable analysis identified numerous predictors of cardiac death, including age, arrhythmias, CHF, ATE, extreme LV hypertrophy (≥ 9.0 mm), low LV fractional shortening (≤ 30%), regional wall hypokinesis, LA dysfunction, spontaneous echo-contrast/thrombus, and restrictive filling patterns.
  • Cox's proportional hazard analysis revealed LA dysfunction, impaired LV systolic function, and extreme LV hypertrophy as independent predictors of decreased cardiac survival.
  • LA dysfunction, low LV systolic function, and extreme LV hypertrophy independently predicted decreased cardiac survival time.

Conclusions:

  • Echocardiographic assessment of LA function is crucial for feline HCM prognosis.
  • Measurement of LV systolic function provides significant prognostic information in cats with HCM.
  • Extreme LV hypertrophy is an independent predictor of survival in feline hypertrophic cardiomyopathy.
Abstract

Keywords:
EchocardiographyFelineHypertrophic cardiomyopathySurvival

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