Publications by authors named "Tommaso Vezzosi"

17 Publications

  • Page 1 of 1

The Mitral INsufficiency Echocardiographic score: A severity classification of myxomatous mitral valve disease in dogs.

J Vet Intern Med 2021 May 5;35(3):1238-1244. Epub 2021 May 5.

Department of Cardiology, Anicura Istituto Veterinario Novara, Granozzo con Monticello, Italy.

Background: There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables.

Hypothesis/objectives: To propose an easy-to-use echocardiographic classification of severity of MMVD in dogs.

Animals: Five hundred and sixty dogs with MMVD.

Methods: This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium-to-aorta ratio, left ventricular end-diastolic diameter normalized for body weight, fractional shortening, and E-wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4-5), moderate (score: 6-7), severe (score: 8-12), late stage (score: 13-14).

Results: Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877-2810 days), moderate (1882 days, 95% CI 1341-2434 days), severe (623 days, 95% CI 432-710 days), and late stage (157 days, 95% CI 53-257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001).

Conclusions And Clinical Importance: The MINE score is a new easy-to-use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.
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http://dx.doi.org/10.1111/jvim.16131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8163114PMC
May 2021

Reference intervals for transthoracic echocardiography in the American Staffordshire Terrier.

J Vet Med Sci 2021 Apr 9;83(4):656-660. Epub 2021 Feb 9.

Department of Veterinary Medicine, University of Perugia, Via S. Costanzo 4, 06126 Perugia, Italy.

This study reports the echocardiographic reference intervals in the American Staffordshire Terrier (AST). The echocardiographic variables obtained in 57 healthy adult AST were compared with published data from the general canine population and other breeds. In the AST, the left ventricular volumes were lower than values reported in Boxers and Dobermans (P<0.0001), but higher than in small breeds (P<0.0001). The left ventricular ejection fraction was higher than Boxers and Dobermans (P<0.0001), but lower than small breed dogs (P=0.027). The aortic peak velocity values were similar to Boxers (P=0.55) but higher than the general canine population (P<0.0001). The reference intervals presented in this study are clinically useful for an accurate echocardiographic interpretation and screening in the AST.
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http://dx.doi.org/10.1292/jvms.20-0622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111344PMC
April 2021

Fatal Pulmonary Hypertension and Right-Sided Congestive Heart Failure in a Kitten Infected with .

Animals (Basel) 2020 Dec 1;10(12). Epub 2020 Dec 1.

Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy.

is considered the most important respiratory nematode of domestic cats worldwide. This parasite inhabits the alveoli, alveolar ducts, and bronchioles and causes a subacute to chronic respiratory clinical disease. Clinical signs may occur in domestic cats of any age, though they are more often described in young animals. Physical examination, echocardiography, thoracic radiography, pulmonary and cardiac pathological findings, classical, and molecular parasitological analysis of a six-month-old kitten referred at the Veterinary Teaching Hospital of the University of Pisa (Italy) led to a diagnosis of parasitic bronchopneumonia caused by , which was complicated by severe pulmonary hypertension (PH) and right-sided congestive heart failure (R-CHF) that caused the death of the animal. Cases of reversible PH associated with infection have been seldom reported in cats. This is the first report of fatal PH and R-CHF in a kitten with clinical aelurostrongylosis.
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http://dx.doi.org/10.3390/ani10122263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759851PMC
December 2020

A radiographic study of breed-specific vertebral heart score and vertebral left atrial size in Chihuahuas.

Vet Radiol Ultrasound 2021 Jan 27;62(1):20-26. Epub 2020 Oct 27.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Although echocardiography is the gold standard for the diagnosis of cardio-structural disease, thoracic radiography is a rapid, cost-effective, and widely accessible method for evaluating cardiac size in dogs. The vertebral heart score (VHS) and the vertebral left atrial size (VLAS) are established as objective measures of cardiomegaly on thoracic radiographs. However, several studies have shown significant variations in the VHS among different breeds. The Chihuahua is predisposed to both congenital and acquired cardiac diseases. The aim of this prospective, single-center, cross sectional study was thus to evaluate the VHS and the VLAS in healthy adult Chihuahua dogs. A total of 30 Chihuahuas were included. The VHS values in our sample population of Chihuahuas were 10.0 ± 0.6 (95% range, 8.9-11.0). This was significantly greater than the canine reference value of 9.7 ± 0.5 established by Buchanan and Bücheler (P = .002). The VLAS of Chihuahuas in our study was 1.8 ± 0.2 (95% range, 1.3-2.1). This was significantly lower than the values previously reported by Malcolm et al (2.07 ± 0.25; P = .0004). The VHS and the VLAS were not influenced by sex, body weight, short or long hair, and body condition score in normal Chihuahuas. Our results indicated that breed-specific reference values for radiographic VHS and VLAS are needed. In Chihuahuas, the values found in this study can be used as a normal reference in order to help avoid overinterpretation of cardiomegaly in these dogs.
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http://dx.doi.org/10.1111/vru.12919DOI Listing
January 2021

Radiographic vertebral left atrial size: A reference interval study in healthy adult dogs.

Vet Radiol Ultrasound 2020 Sep 4;61(5):507-511. Epub 2020 Jul 4.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Thoracic radiography is a useful technique for the evaluation of cardiac dimensions, especially when echocardiography is not possible. The vertebral left atrial size (VLAS) has recently been proposed as a new radiographic method for quantifying left atrial dimensions in dogs. The aims of this retrospective, reference interval, observational study were to describe values for VLAS in a group of healthy adult dogs and to compare intraobserver and interobserver agreement for VLAS versus vertebral heart score (VHS) methods. Thoracic radiographs of 80 healthy adult dogs were evaluated. Normal left atrial size was determined based on an echocardiographic left atrial-to-aorta ratio < 1.6. The VLAS and vertebral heart score values were measured from right lateral radiographs. The correlations between VLAS, the vertebral heart score, and the left atrial-to-aorta ratio were evaluated. The effects of body weight, sex, and age were also tested using regression analyses. The median value of VLAS were 1.9, with a reference interval of 1.4-2.2. A positive correlation was found between VLAS and vertebral heart score values (r = 0.53; P < .0001). No effect of body weight, sex, and age on VLAS was detected. Excellent intraobserver and interobserver agreements were found for both VLAS and vertebral heart score methods (intraclass correlation coefficients ≥ 0.91). Findings from this sample of healthy dogs indicated that VLAS is a repeatable radiographic method for quantifying left atrial size. Further studies are warranted to evaluate this measure in clinically affected dogs.
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http://dx.doi.org/10.1111/vru.12896DOI Listing
September 2020

Left atrial anteroposterior diameter in dogs: reference interval, allometric scaling, and agreement with the left atrial-to-aortic root ratio.

J Vet Med Sci 2019 Dec 14;81(11):1655-1662. Epub 2019 Oct 14.

Anicura Istituto Veterinario Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy.

Left atrial enlargement (LAE) is a well-known negative prognostic factor in dogs with myxomatous mitral valve disease (MMVD). Left atrial-to-aortic root ratio (LA/Ao) is the most commonly used method to evaluate left atrial (LA) size in dogs, while the left atrial anteroposterior diameter (LAD) has been proposed as an additional measurement of LA size in different species. The aim of this study was to establish a normal reference range of LAD normalized to body weight (LADn) in dogs using allometric scales, and to evaluate the agreement between LADn and LA/Ao in the detection of LAE in dogs with MMVD. This was a retrospective, multicenter, observational study. We included 330 healthy dogs, 30 dogs with MMVD in ACVIM stage B1, 30 dogs in ACVIM stage B2, and 30 dogs in ACVIM stage C. The reference range for the LAD, depending on body weight, was between 16.91 mm and 49.68 mm. The reference range for the LADn in healthy dogs was between 10.49 and 15.72. LADn was significantly greater in dogs with MMVD compared to healthy dogs, and a significant difference in LADn was noted between different ACVIM stages (P<0.001). The most accurate cut-off value of LADn to differentiate between dogs in groups B2 and C was 20.3 (sensitivity, 83.3%; specificity, 83.3%). There was a misclassification rate of 37% between LADn and LA/Ao in the detection of LAE in group B1. This study provides a normal reference range for LAD in dogs, which can be used as an additional tool to assess LAE in dogs with MMVD.
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http://dx.doi.org/10.1292/jvms.19-0240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895628PMC
December 2019

Two Methods for 24-hour Holter Monitoring in Horses: Evaluation of Recording Performance at Rest and During Exercise.

J Equine Vet Sci 2019 08 19;79:127-130. Epub 2019 Jun 19.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Continuous electrocardiography (ECG) monitoring is the gold standard for diagnosing arrhythmias that occur intermittently or under exercise. The aim of this study was to compare two different methods for 24-hour Holter monitoring in horses, a 7-electrode system (7-ES) versus a 4-electrode system (4-ES), assessing the recording performance at rest and during exercise. Six standardbred horses were included in the present prospective study. Two different methods for 24-hour Holter monitoring were used in each horse with a washout period of one week between each recording method. In the first 15 minutes of the 24-hour Holter monitoring, a standard exercise test was performed. Holter recordings were analyzed in terms of the number of recorded hours; the number of detached electrodes (DEs); and total duration of artifacts over the 15-minute exercise. The number of recorded hours was significantly higher in the 7-ES (24 hours, range: 23-24 hours) than the 4-ES (6.5 hours, range: 1.2-20 hours; P < .05). The number of DEs was not significantly different between the two systems. The total duration of artifacts over the 15-minute exercise was significantly higher in the 7-ES (155 seconds, range: 35-378 seconds) than in the 4-ES (25 seconds, range: 10-32 seconds; P < .05). Our results showed a better recording performance during exercise using the 4-ES because of the lower number of artifacts. The 7-ES showed a better performance in terms of recording duration. In conclusion, we suggest using the 4-ES for exercise tests and the 7-ES when a longer ECG recording at rest is required.
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http://dx.doi.org/10.1016/j.jevs.2019.06.001DOI Listing
August 2019

Combined interventional procedure and cardiopulmonary bypass surgery in a dog with cor triatriatum dexter, patent foramen ovale, and pulmonary stenosis.

J Vet Intern Med 2019 Sep 5;33(5):2227-2234. Epub 2019 Aug 5.

Istituto Veterinario di Novara, Novara, Italy.

A 2-year-old American Pit Bull dog was presented for surgical evaluation of imperforate cor triatriatum dexter (CTD) and patent foramen ovale (PFO). Echocardiography identified an imperforate CTD associated with a right-to-left shunting PFO and valvular pulmonary stenosis. A 2-step interventional and surgical approach was used. Initially, a pulmonary balloon valvuloplasty was performed, and subsequently the dog underwent a surgical correction of the atrial anomaly under cardiopulmonary bypass.
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http://dx.doi.org/10.1111/jvim.15580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766562PMC
September 2019

Left shift of the ventricular mean electrical axis in healthy Doberman Pinschers.

J Vet Med Sci 2019 Apr 11;81(4):620-625. Epub 2019 Mar 11.

Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, Novara, Italy.

In canine electrocardiography, the reference interval of the ventricular mean electrical axis (MEA) is between +40° and +100°. MEA values in dogs can be influenced by the patient position as well as by the shape of the thorax. The aim of this study was to evaluate the MEA in healthy Doberman Pinschers, hypothesizing that some present a left shift of the MEA. In this retrospective study, 41 healthy, client-owned Doberman Pinschers were included. Echocardiography and standard six-lead ECG examination were performed in all dogs. The MEA was calculated using the isoelectric method. The morphology of the QRS complex and the Q/R ratio in lead II were also evaluated. The median MEA was +45° and ranged from -45° to +90°. MEA was deviated in 16/41 dogs (39%), all presenting a left axis deviation (range, -45° to + 30°). Age was significantly associated with the MEA (P=0.008), showing a negative linear correlation. A deep Q wave in lead II was present in 26/41 (63%) dogs. The Q/R ratio was higher in dogs presenting left shift of the MEA (0.66; range, 0.28-1.35) in comparison to dogs with a MEA within reference range (0.44; range, 0.04-0.73; P<0.001). In conclusion, a significant number of healthy Doberman Pinschers present a left shift of the MEA compare to the reference range, and dogs with MEA deviation show a higher Q/R ratio in lead II. This data should be considered when electrocardiographic evaluation is performed in Doberman Pinschers.
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http://dx.doi.org/10.1292/jvms.18-0699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483916PMC
April 2019

Comparison of smartphone-based and standard base-apex electrocardiography in healthy dairy cows.

J Vet Intern Med 2019 Mar 27;33(2):981-986. Epub 2018 Dec 27.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Background: There is good diagnostic accuracy of smartphone-based ECG in the evaluation of heart rate (HR), heart rhythm, and ECG values for humans, horses, dogs, and cats.

Objectives: Assess feasibility and reliability of a smartphone ECG device to evaluate HR expressed as beats per minute and ECG values in cows.

Animals: Fifty-five healthy Holstein Friesian cows.

Methods: Prospective observational study. A standard base-apex ECG was acquired for 60 seconds in each cow. A smartphone ECG tracing was recorded simultaneously using a single-lead bipolar ECG recorder. All ECGs were reviewed by 1 blinded investigator. The following ECG variables were assessed: HR, P wave duration, PR interval, QRS complex and QT interval (milliseconds), P wave, and QRS complex polarity. Agreement between standard and smartphone ECG was evaluated by Cohen's k test and the Bland-Altman test.

Results: Smartphone ECG tracings were interpretable in 89% of the recordings. Minimal differences of no clinical relevance were found between standard and smartphone ECG tracings regarding HR and duration of ECG waves and interval. Good agreement found in the evaluation of QRS complex polarity (85%) but not for P wave polarity (k = 0.006). Artifacts were rare but of significantly higher frequency in smartphone ECG compared to standard ECG tracings (22% versus 0%; P = .005).

Conclusions And Clinical Importance: Good quality single-lead ECG tracings can be recorded by smartphone device in healthy cows. Smartphone tracings are reliable for evaluation of HR and selective ECG variables. Smartphone ECG can represent an additional tool for ECG screening in cows.
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http://dx.doi.org/10.1111/jvim.15396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430901PMC
March 2019

Home monitoring of heart rate and heart rhythm with a smartphone-based ECG in dogs.

Vet Rec 2019 Jan 17;184(3):96. Epub 2018 Dec 17.

Department of Cardiology, Istituto Veterinario di Novara, Novara, Italy.

The feasibility of the home monitoring of heart rate (HR) and rhythm through ECG tracings recorded by owners with a smartphone ECG device was evaluated in dogs. Smartphone ECG tracings were recorded by owners at home using a single-lead ECG device and sent via email for interpretation. A questionnaire was prepared to assess the owner's opinion regarding this home monitoring service. Recordings were evaluated by two operators, and agreement was evaluated for HR and rhythm diagnosis. Thirty-three dogs were included. Thirty-one owners (94 per cent) felt that the recording technique was easy to learn and that the smartphone ECG device was easy to use. A total of 15 owners (45 per cent) required a second person to hold the dog during recording. Of the 150 smartphone ECG tracings that were received, 134 (89 per cent) were interpretable. The median difference between the two operators to assess the mean HR on the smartphone tracings was 10 bpm (-10, +25 bpm). Perfect agreement (κ=1) between operators was observed in the heart rhythm evaluation. Most owners sent adequate ECG tracings for interpretation via email from their smartphone. Home monitoring of HR and heart rhythm may represent an additional tool in the management of dogs with arrhythmias.
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http://dx.doi.org/10.1136/vr.104917DOI Listing
January 2019

Echocardiographic evaluation of the right ventricular dimension and systolic function in dogs with pulmonary hypertension.

J Vet Intern Med 2018 Sep 14;32(5):1541-1548. Epub 2018 Sep 14.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Background: Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH).

Hypothesis/objectives: To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right-sided congestive heart failure (R-CHF).

Animals: 89 dogs with PH and 74 healthy dogs.

Methods: Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end-diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively).

Results: RVEDA index was higher in dogs with moderate PH (10.8 cm /m ; range, 6.2-14.4 cm /m ) and severe PH (12.4 cm /m ; range, 7.7-21.4 cm /m ) than in those with mild PH (8.4 cm /m ; range, 4.8-11.6 cm /m ) and control dogs (8.5 cm /m ; range, 2.8-11.6 cm /m ; P < .001). RVEDA index was significantly higher in dogs with R-CHF (13.7 cm /m ; range, 11.0-21.4 cm /m ) than in dogs without R-CHF (9.4 cm /m ; range, 4.8-17.1 cm /m ; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R-CHF.

Conclusions And Clinical Importance: The RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R-CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.
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http://dx.doi.org/10.1111/jvim.15253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189358PMC
September 2018

Survival estimates and outcome predictors for shelter cats with feline panleukopenia virus infection.

J Am Vet Med Assoc 2018 Jul;253(2):188-195

OBJECTIVE To determine survival estimates and outcome predictors for shelter cats with feline panleukopenia virus (FPV) infection. DESIGN Retrospective cohort study. ANIMALS 177 shelter cats with FPV infection. PROCEDURES Medical records of cats treated for FPV infection from 2011 through 2013 were reviewed to collect information pertaining to signalment; history; results of physical examination, CBC, serum biochemical analysis, and blood gas analysis; and treatments (antimicrobials, antiparasitics, antivirals, antiemetics, analgesics, crystalloid or colloid solutions, and blood products). Survival time and outcome predictors were determined by means of Kaplan-Meier estimation, logistic regression, and mixed-model ANOVA. RESULTS Median survival time after hospital admission was 3 days; 20.3% (36/177) of cats survived to discharge from the hospital. Risk of nonsurvival was greater in cats with (vs without) signs of lethargy, rectal temperature < 37.9°C (I00.2°F), or low body weight at hospital admission. Lower (vs higher) leukocyte count on days 3,4, and 7 of hospitalization, but not at admission, was associated with nonsurvival. Amoxicillin-clavulanic acid, antiparasitics, and maropitant but not interferon-ω were associated with survival, whereas glucose infusion was associated with nonsurvival. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that FPV infection carried a poor prognosis for shelter cats. Several variables measured at admission or during hospitalization were associated with outcome. Remarkably and contrary to the existing literature, leukopenia at admission had no association with outcome, possibly owing to early prevention of complications.
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http://dx.doi.org/10.2460/javma.253.2.188DOI Listing
July 2018

ECG of the Month.

J Am Vet Med Assoc 2018 Apr;252(7):808-810

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http://dx.doi.org/10.2460/javma.252.7.808DOI Listing
April 2018