Effect of physiological and pharmacological stress on heart rate, blood pressure, and echocardiographic measurements in healthy Warmblood horses.

N-butylscopolammonium bromide equine hypertension pharmacological challenge test physiological stress tachycardia

Journal

Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660

Informations de publication

Date de publication:
04 Jan 2024
Historique:
received: 03 02 2023
accepted: 20 11 2023
medline: 4 1 2024
pubmed: 4 1 2024
entrez: 4 1 2024
Statut: aheadofprint

Résumé

Echocardiographic measurements are important prognostic indicators but might be influenced by heart rate and blood pressure. This is particularly important when comparing repeated examinations. To determine the effect of physiological stress at mildly increased heart rates and pharmacological challenge using IV administration of N-butylscopolammonium bromide and metamizol sodium on heart rate, blood pressure, and echocardiographic measurements. Twenty healthy Warmblood horses. Randomized crossover study. Horses were examined echocardiographically by 2-dimensional, M-mode, pulsed wave (PW) Doppler, and PW tissue Doppler imaging with simultaneous ECG recording and noninvasive blood pressure measurements during rest, physiological stress, and pharmacological challenge. Cardiac dimensions and functions were measured by a blinded observer. Data were analyzed using repeated-measures analysis of variance. Mean heart rate and arterial blood pressure were significantly higher during physiological stress (46 ± 2 bpm, 93 ± 16 mm Hg) and pharmacological challenge (62 ± 13 bpm, 107 ± 17 mm Hg) compared with rest (34 ± 3 bpm, 86 ± 12 mm Hg; P < .05). Compared with rest, physiological stress resulted in increased left atrial fractional area change (34.3 ± 7.5 vs 27.3 ± 5.1%; P = .01) and left ventricular late diastolic radial wall motion velocity (13 ± 3 vs 10 ± 2 cm/s; P = .01) but had no significant effect on most other echocardiographic variables. Compared with rest, pharmacological challenge led to significantly decreased left atrial and diastolic ventricular dimensions (left ventricular internal diameter: 10.3 ± 0.9 vs 10.7 ± 0.8 cm; P = .01), increased aortic and pulmonary diameters, and ventricular wall thickness. Physiological stress at mildly increased heart rates significantly enhanced atrial pump function. Larger heart rate and blood pressure increases during pharmacological challenge resulted in altered cardiac dimensions. This should be taken into account when evaluating echocardiographic measurements at increased heart rates.

Sections du résumé

BACKGROUND BACKGROUND
Echocardiographic measurements are important prognostic indicators but might be influenced by heart rate and blood pressure. This is particularly important when comparing repeated examinations.
HYPOTHESIS OBJECTIVE
To determine the effect of physiological stress at mildly increased heart rates and pharmacological challenge using IV administration of N-butylscopolammonium bromide and metamizol sodium on heart rate, blood pressure, and echocardiographic measurements.
ANIMALS METHODS
Twenty healthy Warmblood horses.
METHODS METHODS
Randomized crossover study. Horses were examined echocardiographically by 2-dimensional, M-mode, pulsed wave (PW) Doppler, and PW tissue Doppler imaging with simultaneous ECG recording and noninvasive blood pressure measurements during rest, physiological stress, and pharmacological challenge. Cardiac dimensions and functions were measured by a blinded observer. Data were analyzed using repeated-measures analysis of variance.
RESULTS RESULTS
Mean heart rate and arterial blood pressure were significantly higher during physiological stress (46 ± 2 bpm, 93 ± 16 mm Hg) and pharmacological challenge (62 ± 13 bpm, 107 ± 17 mm Hg) compared with rest (34 ± 3 bpm, 86 ± 12 mm Hg; P < .05). Compared with rest, physiological stress resulted in increased left atrial fractional area change (34.3 ± 7.5 vs 27.3 ± 5.1%; P = .01) and left ventricular late diastolic radial wall motion velocity (13 ± 3 vs 10 ± 2 cm/s; P = .01) but had no significant effect on most other echocardiographic variables. Compared with rest, pharmacological challenge led to significantly decreased left atrial and diastolic ventricular dimensions (left ventricular internal diameter: 10.3 ± 0.9 vs 10.7 ± 0.8 cm; P = .01), increased aortic and pulmonary diameters, and ventricular wall thickness.
CONCLUSIONS AND CLINICAL IMPORTANCE CONCLUSIONS
Physiological stress at mildly increased heart rates significantly enhanced atrial pump function. Larger heart rate and blood pressure increases during pharmacological challenge resulted in altered cardiac dimensions. This should be taken into account when evaluating echocardiographic measurements at increased heart rates.

Identifiants

pubmed: 38174810
doi: 10.1111/jvim.16967
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.

Références

Buhl R, Ersbøll AK, Eriksen L, Koch J. Sources and magnitude of variation of echocardiographic measurements in normal standardbred horses. Vet Radiol Ultrasound. 2004;45(6):505-512. doi:10.1111/j.1740-8261.2004.04086.x
Menzies-Gow NJ. Effects of sedation with acepromazine on echocardiographic measurements in eight healthy thoroughbred horses. Vet Rec. 2008;163(1):21-25. doi:10.1136/vr.163.1.21
Reef VB, Bonagura J, Buhl R, et al. Recommendations for management of equine athletes with cardiovascular abnormalities. J Vet Intern Med. 2014;28(3):749-761. doi:10.1111/jvim.12340
Schwarzwald CC. Disorders of the cardiovascular system. In: Reed S, Bayly W, Sellon D, eds. Equine Internal Medicine. Elsevier, St. Louis, Missouri; 2018:387-541.
Schwarzwald CC, Schober KE, Bonagura JD. Methods and reliability of echocardiographic assessment of left atrial size and mechanical function in horses. Am J Vet Res. 2007;68(7):735-747. doi:10.2460/ajvr.68.7.735
Schwarzwald CC, Schober KE, Bonagura JD. Methods and reliability of tissue Doppler imaging for assessment of left ventricular radial wall motion in horses. J Vet Intern Med. 2009;23(3):643-652. doi:10.1111/j.1939-1676.2009.0287.x
Reef VB. Heart murmurs in horses: determining their significance with echocardiography. Equine Vet J Suppl. 1995;19:71-80. doi:10.1111/j.2042-3306.1995.tb04992.x
Ven S, Decloedt A, van der Vekens N, de Clercq D, van Loon G. Assessing aortic regurgitation severity from 2D, M-mode and pulsed wave Doppler echocardiographic measurements in horses. Vet J. 2016;210:34-38. doi:10.1016/j.tvjl.2016.01.011
Keen JA. Examination of horses with cardiac disease. Vet Clin North Am Equine Pract. 2019;35(1):23-42. doi:10.1016/j.cveq.2018.12.006
Patteson MW. Chapter 4: Diagnostic aids in equine cardiology. In: Patteson MW, ed. Equine Cardiology. Blackwell Science Ltd., Oxford; 1996:87.
Gasthuys F, De Moor A, Parmentier D. Haemodynamic changes during sedation in ponies. Vet Res Commun. 1990;14(4):309-327. doi:10.1007/BF00350713
Buhl R, Ersbøll AK, Larsen NH, Eriksen L, Koch J. The effects of detomidine, romifidine or acepromazine on echocardiographic measurements and cardiac function in normal horses. Vet Anaesth Analg. 2007;34(1):1-8. doi:10.1111/j.1467-2995.2005.00269.x
Yamashita K, Tsubakishita S, Futaok S, et al. Cardiovascular effects of medetomidine, detomidine and xylazine in horses. J Vet Med Sci. 2000;62(10):1025-1032. doi:10.1292/jvms.62.1025
Mama KR, Grimsrud K, Snell T, Stanley S. Plasma concentrations, behavioural and physiological effects following intravenous and intramuscular detomidine in horses. Equine Vet J. 2009;41(8):772-777. doi:10.2746/042516409x421624
Gehlen H, Kroker K, Deegen E, Stadler P. Einfluss von Detomidin auf echokardiographische Funktionsparameter und kardiale Hämodynamik bei Pferden mit und ohne Herzgeräusch. Schweiz Arch Tierheilkd. 2004;146(3):119-126.
Frye MA, Bright JM, Dargatz DA, et al. A comparison of dobutamine infusion to exercise as a cardiac stress test in healthy horses. J Vet Intern Med. 2003;17(1):58-64. doi:10.1892/0891-6640(2003)0172.3.co;2
Durando MM, Slack J, Reef VB, Birks EK. Right ventricular pressure dynamics and stress echocardiography in pharmacological and exercise stress testing. Equine Vet J Suppl. 2006;36:183-192. doi:10.1111/j.2042-3306.2006.tb05537.x
Gehlen H, Marnette S, Rohn K, Stadler P. Stress echocardiography in warmblood horses: comparison of dobutamine/atropine with treadmill exercise as cardiac stressors. J Vet Intern Med. 2006;20(3):562-568. doi:10.1892/0891-6640(2006)20[562:seiwhc]2.0.co;2
Sandersen CF, Amory H. Stress echocardiography in horses-a review. Pferdeheilkunde. 2006;22(5):609-617.
Decloedt A, De Clercq D, Ven Sofie S, et al. Echocardiographic measurements of right heart size and function in healthy horses. Equine Vet J. 2017;49(1):58-64. doi:10.1111/evj.12554
Meier M, Bettschart-Wolfensberger R, Schwarzwald CC, Portier K, Gysler A, Ringer SK. Effects of dobutamine on cardiovascular function and oxygen delivery in standing horses. J Vet Pharmacol Ther. 2020;43(5):470-476. doi:10.1111/jvp.12869
Sandersen CF, Detilleux J, Delguste C, Pierard L, van Loon G, Amory H. Atropine reduces dobutamine-induced side effects in ponies undergoing a pharmacological stress protocol. Equine Vet J. 2005;37(2):128-132. doi:10.2746/0425164054223868
Sandersen CF, Detilleux J, de Moffarts B, van Loon G, Amory H. Effect of atropine-dobutamine stress test on left ventricular echocardiographic parameters in untrained warmblood horses. J Vet Intern Med. 2006;20(3):575-580. doi:10.1892/0891-6640(2006)20[575:eoasto]2.0.co;2
Gehlen H, Marnette S, Stadler P. Stress echocardiography in warmblood horses: active stress induction by treadmill and longing exercise. Pferdeheilkunde. 2005;21(4):303-310.
Gehlen H, Becker J, Deegen E, Stadler P. Veränderung echokardiographischer Funktionsparameter unter Dobutaminwirkung bei Warmblutpferden mit und ohne Herzgeräusch. Vet Med. 2004;91:103-111.
Gehlen H, Marnette S, Stadler P. The influence of adrenaline on echocardiographic parameters of left ventricular function in the horse. Equine Comp Exerc Physiol. 2005;2(2):89-96.
Sandersen C, Detilleux J, Art T, Amory H. Exercise and pharmacological stress echocardiography in healthy horses. Equine Vet J Suppl. 2006;36:159-162. doi:10.1111/j.2042-3306.2006.tb05533.x
Morton AJ, Varney CR, Ekiri AB, Grosche A. Cardiovascular effects of N-butylscopolammonium bromide and xylazine in horses. Equine Vet J Suppl. 2011;39:117-122. doi:10.1111/j.2042-3306.2011.00400.x
de Lagarde M, Rodrigues N, Chevigny M, Beauchamp G, Albrecht B, Lavoie JP. N-butylscopolammonium bromide causes fewer side effects than atropine when assessing bronchoconstriction reversibility in horses with heaves. Equine Vet J. 2014;46(4):474-478. doi:10.1111/evj.12229
Tapio HA, Raekallio MR, Mykkänen A, et al. Effects of MK-467 hydrochloride and hyoscine butylbromide on cardiorespiratory and gastrointestinal changes induced by detomidine hydrochloride in horses. Am J Vet Res. 2018;79(4):376-387. doi:10.2460/ajvr.79.4.376
Henneke DR, Potter GD, Kreider JL, Yeates BF. Relationship between condition score, physical measurements and body fat percentage in mares. Equine Vet J. 1983;15(4):371-372. doi:10.1111/j.2042-3306.1983.tb01826.x
Carroll CL, Huntington PJ. Body condition scoring and weight estimation of horses. Equine Vet J. 1988;20(1):41-45. doi:10.1111/j.2042-3306.1988.tb01451.x
Wagner EL, Tyler PJ. A comparison of weight estimation methods in adult horses. J Equine Vet. 2011;31(12):706-710.
Vernemmen I, Vera L, Van Steenkiste G, van Loon G, Decloedt A. Reference values for 2-dimensional and M-mode echocardiography in Friesian and Warmblood horses. J Vet Intern Med. 2020;34(6):2701-2709. doi:10.1111/jvim.15938
Verheyen T, Decloedt A, De Clercq D, Deprez P, Sys S, van Loon G. Electrocardiography in horses, part 1: how to make a good recording. Vlaams Diergeneeskd Tijdschr. 2010;79(5):331-336.
Vera L, Van Steenkiste G, Decloedt A, Chiers K, van Loon G. Age-related differences in blood pressure, ultrasound-derived arterial diameters and arterial wall stiffness parameters in horses. Equine Vet J. 2020;52(6):868-875. doi:10.1111/evj.13263
Vera L, De Clercq D, Van Steenkiste G, Decloedt A, Chiers K, van Loon G. Differences in ultrasound-derived arterial wall stiffness parameters and noninvasive blood pressure between Friesian horses and Warmblood horses. J Vet Intern Med. 2020;34(2):893-901. doi:10.1111/jvim.15705
Ven S, Decloedt A, De Clercq D, Vera L, Rademakers F, van Loon G. Detection of subclinical left ventricular dysfunction by tissue Doppler imaging in horses with aortic regurgitation. Equine Vet J. 2018;50(5):587-593. doi:10.1111/evj.12805
Schwarzwald CC. Equine echocardiography. Vet Clin North Am Equine Pract. 2019;35(1):43-64. doi:10.1016/j.cveq.2018.12.008
De Clercq D, van Loon G, Tavernier R, Duchateau L, Deprez P. Atrial and ventricular electrical and contractile remodeling and reverse remodeling owing to short-term pacing-induced atrial fibrillation in horses. J Vet Intern Med. 2008;22(6):1353-1359. doi:10.1111/j.1939-1676.2008.0202.x
Decloedt A, Schwarzwald CC, De Clercq D, et al. Risk factors for recurrence of atrial fibrillation in horses after cardioversion to sinus rhythm. J Vet Intern Med. 2015;29(3):946-953. doi:10.1111/jvim.12606
Decloedt A, Verheyen T, Van Der Vekens N, Sys S, De Clercq D, van Loon G. Long-term follow-up of atrial function after cardioversion of atrial fibrillation in horses. Vet J. 2013;197(3):583-588. doi:10.1016/j.tvjl.2013.05.032
Vandecasteele T, Cornillie P, van Steenkiste G, et al. Echocardiographic identification of atrial-related structures and vessels in horses validated by computed tomography of casted hearts. Equine Vet J. 2019;51(1):90-96. doi:10.1111/evj.12969
Berthoud D, Schwarzwald CC. Echocardiographic assessment of left ventricular size and systolic function in Warmblood horses using linear measurements, area-based indices, and volume estimates: a retrospective database analysis. J Vet Intern Med. 2021;35(1):504-520. doi:10.1111/jvim.15968
Koenig TR, Mitchell KJ, Schwarzwald CC. Echocardiographic assessment of left ventricular function in healthy horses and in horses with heart disease using pulsed-wave tissue Doppler imaging. J Vet Intern Med. 2017;31(2):556-567. doi:10.1111/jvim.14641
Decloedt A, Verheyen T, Sys S, De Clercq D, van Loon G. Evaluation of tissue Doppler imaging for regional quantification of radial left ventricular wall motion in healthy horses. Am J Vet Res. 2013;74(1):53-61. doi:10.2460/ajvr.74.1.53
Bland M. Clinical measurement. In: Bland M, ed. An Introduction to Medical Statistics. 4th ed. Oxford: Oxford University Press; 2015:313-346.
Piotrowski G, Goch A, Wlazłowski R, Gawor Z, Goch JH. Non-invasive methods of atrial function evaluation in heart diseases. Med Sci Monit. 2000;6(4):827-839.
Pagel PS, Kehl F, Gare M, Hettrick DA, Kersten JR, Warltier DC. Mechanical function of the left atrium: new insights based on analysis of pressure-volume relations and Doppler echocardiography. Anesthesiology. 2003;98(4):975-994. doi:10.1097/00000542-200304000-00027
Blume GG, Mcleod CJ, Barnes ME, et al. Left atrial function: physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12(6):421-430. doi:10.1093/ejechocard/jeq175
Schefer KD, Bitschnau C, Weishaupt MA, Schwarzwald CC. Quantitative analysis of stress echocardiograms in healthy horses with 2-dimensional (2D) echocardiography, anatomical M-mode, tissue Doppler imaging, and 2D speckle tracking. J Vet Intern Med. 2010;24(4):918-931. doi:10.1111/j.1939-1676.2010.0542.x
Yu CM, Sanderson JE. Right and left ventricular diastolic function in patients with and without heart failure: effect of age, sex, heart rate, and respiration on Doppler-derived measurements. Am Heart J. 1997;134(3):426-434. doi:10.1016/s0002-8703(97)70077-2
Disatian S, Bright JM, Boon J. Association of age and heart rate with pulsed-wave Doppler measurements in healthy, nonsedated cats. J Vet Intern Med. 2008;22(2):351-356. doi:10.1111/j.1939-1676.2008.0066.x
Huesler IM, Mitchell KJ, Schwarzwald CC. Echocardiographic assessment of left atrial size and function in Warmblood horses: reference intervals, allometric scaling, and agreement of different echocardiographic variables. J Vet Intern Med. 2016;30(4):1241-1252. doi:10.1111/jvim.14368
Geimer TR, Ekström PM, Ludders JW, Erichsen DF, Gleed RD. Haemodynamic effects of hyoscine-N-butylbromide in ponies. J Vet Pharmacol Ther. 1995;18(1):13-16. doi:10.1111/j.1365-2885.1995.tb00544.x
Cnota JF, Mays WA, Knecht SK, et al. Cardiovascular physiology during supine cycle ergometry and dobutamine stress. Med Sci Sports Exerc. 2003;35(9):1503-1510. doi:10.1249/01.MSS.0000084436.15808.52
Covella M, Milan A, Totaro S, et al. Echocardiographic aortic root dilatation in hypertensive patients: a systematic review and meta-analysis. J Hypertens. 2014;32(10):1928-1935. doi:10.1097/HJH.0000000000000286
Vizzardi E, Maffessanti F, Lorusso R, et al. Ascending aortic dimensions in hypertensive subjects: reference values for two-dimensional echocardiography. J Am Soc Echocardiogr. 2016;29(9):827-837. doi:10.1016/j.echo.2016.03.016
Farasat SM, Morrell CH, Scuteri A, et al. Do hypertensive individuals have enlarged aortic root diameters? Insights from studying the various subtypes of hypertension. Am J Hypertens. 2008;21(5):558-563. doi:10.1038/ajh.2008.10
Vasan RS, Larson MG, Levy D. Determinants of echocardiographic aortic root size. The Framingham Heart Study. Circulation. 1995;91(3):734-740. doi:10.1161/01.cir.91.3.734
Mertens HM, Mannebach H, Trieb G, Gleichmann U. Influence of heart rate on systolic time intervals: effects of atrial pacing versus dynamic exercise. Clin Cardiol. 1981;4(1):22-27. doi:10.1002/clc.4960040106
Bonagura JD, Fuentes VL. Echocardiography. In: Mattoon JS, Nyland TG, eds. Small Animal Diagnostic Ultrasound. Elsevier, St. Louis, Missouri; 2015:217-331.
Lanfranchi PA, Pépin JL, Somers VK. Cardiovascular physiology. In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. Elsevier, St. Louis, Missouri; 2017:142-154.
Finnegan E, Davidson S, Harford M, et al. Pulse arrival time as a surrogate of blood pressure. Sci Rep. 2021;11(1):22767.
Slack J, Durandot MM, Belcher CN, et al. Intraoperator, intraobserver and interoperator variability of echocardiographic measurements in healthy foals. Equine Vet J Suppl. 2012;41:69-75. doi:10.1111/j.2042-3306.2011.00503.x
Robinson S, Ring L, Augustine DX, et al. The assessment of mitral valve disease: a guideline from the British Society of Echocardiography. Echo Res Pract. 2021;8(1):G87-G136. doi:10.1530/ERP-20-0034
Grayburn PA, Weissman NJ, Zamorano JL. Quantitation of mitral regurgitation. Circulation. 2012;126(16):2005-2017. doi:10.1161/CIRCULATIONAHA.112.12159
Olsen E, Pedersen TL, Robinson R, Haubro AP. Accuracy and precision of oscillometric blood pressure in standing conscious horses. J Vet Emerg Crit Care. 2016;26(1):85-92. doi:10.1111/vec.12411
Heliczer N, Lorello O, Casoni D, Navas de Solis C. Accuracy and precision of noninvasive blood pressure in normo-, hyper-, and hypotensive standing and anesthetized adult horses. J Vet Intern Med. 2016;30(3):866-872. doi:10.1111/jvim.13928
Underwood C, Norton JL, Nolen-Walston RD, Dallap-Schaer BL, Boston R, Slack J. Echocardiographic changes in heart size in hypohydrated horses. J Vet Intern Med. 2011;25(3):563-569. doi:10.1111/j.1939-1676.2010.0612.x

Auteurs

Alexander Dufourni (A)

Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Eva Buschmann (E)

Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Ingrid Vernemmen (I)

Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Glenn Van Steenkiste (G)

Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Gunther van Loon (G)

Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Annelies Decloedt (A)

Equine Cardioteam Ghent University, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Classifications MeSH