Aortic remodeling in feline hypertension

VRU 2023 - 64(3): 501-510

Background: The article introduces the topic of systemic hypertension (SH) in cats, which may cause target organ damage (TOD) to the heart and aorta. It reviews the previous studies on echocardiographic and radiographic changes in cats with SH and normal blood pressure (NBP).

Study: The article describes a retrospective case-controlled study that compared the echocardiographic and radiographic parameters of the aorta in 76 cats with SH and 76 cats with NBP. The study aimed to identify aortic remodeling as a sign of TOD from SH in cats.

Methods: The article explains the selection criteria, data recording, and statistical analysis of the study. It also details the echocardiographic and radiographic measurements and evaluations that were performed by blinded reviewers.

Results: The article reports the significant differences between the cats with SH and NBP in systolic blood pressure, aortic diameter, left atrium size, LA/Ao ratio, and aortic cusps size and shape. It also reports the subjective and objective radiographic findings of aortic undulation, size disparity, and knob formation in cats with SH and NBP. It provides ROC curves and cutoff values for the VHS and aortic knob measurements to diagnose SH.

Limitations: The article acknowledges the limitations of the study, such as the retrospective design, the lack of histopathological confirmation, the variability in blood pressure measurement, and the possible malpositioning of the radiographic views.

Conclusions: The article concludes that aortic remodeling can be detected by echocardiography and radiography in cats with SH and can be used as a marker of TOD. It suggests that blood pressure monitoring and treatment for SH can help prevent further cardiovascular complications. It also proposes future studies to validate the findings and establish the clinical relevance of aortic remodeling in cats.

A, A 14-year-old DSH with a murmur presented for weight loss, with a normal systolic blood pressure of 120 mmHg. A, A two-dimensional short axis image obtained using a phased array, 12 MHz transducer of aorta and left atrium at the heart base. B, Notice the symmetrical appearance of the two-dimensional image of the aortic cusps of the cat from (A), each at 4.6 mm. C, An 8-year-old DLH cat with a murmur presented for treatment of hyperthyroidism, with a systolic blood pressure of 150 mmHg in the range for mild systemic hypertension. A two-dimensional short axis image obtained using a phased array, 12 MHz transducer of aorta and left atrium at the heart base. D, Notice the asymmetric appearance of the two-dimensional image of the aortic cusps of the cat shown in (C): right cusp 6.3 mm, left cusp 4.1 mm, and the non-coronary cusp 5.0 mm

Aortic undulation: notice the undulation of the thoracic aorta (arrows) on lateral projections of the thorax of two cats. A. Left lateral projection of an 18-year-old DSH with a murmur presented for seizures with previous diagnosis of hyperthyroidism. Systolic blood pressure was normal but > 135 mm Hg at 144 mmHg. B. Left lateral projection of an 11-year-old DSH with a murmur presented for treatment of a nasal adenocarcinoma. The systolic blood pressure was 155 mmHg in the range for mild systemic hypertension

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