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Objectives: Angiostrongylosis is a significant differential for a diverse range of clinical signs in dogs, many of whom present acutely and sometimes with fatal consequences. Point-of-care diagnostic assays include a commercially available Angiostrongylus vasorum qualitative direct lateral flow assay., Materials and Methods: Case records from one referral centre from dogs with an invalid A. vasorum lateral flow assay, comprising an absent control line alongside a visible test line, were reviewed. As control line failure was hypothesised to be due to antigen excess; where available the A. vasorum lateral flow assay was repeated using dilutions of the original serum., Results: Six dogs had an invalid A. vasorum lateral flow assay result. Five dogs had presented with acute-onset, severe clinical disease consistent with angiostrongylosis, and one dog was a clinically healthy in-contact. Clinical suspicion of angiostrongylosis was confirmed using alternative diagnostic testing and/or response to treatment. Repetition of the A. vasorum lateral flow assay, in four cases, using diluted plasma (10% to 12.5% v/v) resulted in the appearance of a control line alongside the visible test line., Clinical Significance: A heavy burden of A. vasorum infection resulting in angiostrongylosis should be suspected in dogs with compatible clinical signs and an invalid A. vasorum lateral flow assay result due to control failure alongside a visible test line. Repetition of the test with a diluted serum may be considered to account for the hook effect, also known as the postzone phenomenon, as a possible cause., (© 2024 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

Introduction/objectives: Discrete upper septal thickening (DUST) is a phenotype of elderly people. The cardiac phenotype in senior cats has been incompletely described. We aimed to characterize the echocardiographic phenotype of senior cats, specifically to determine prevalence of DUST and hypertrophic cardiomyopathy (HCM)., Animals: One hundred and forty-nine healthy, normotensive cats., Materials and Methods: Prospective cross-sectional study. Senior (≥9 years) and young (<6 years) cats were recruited from non-referral population. We defined DUST as an isolated basilar septal bulge, and HCM as left ventricular wall thickness ≥6 mm. An interventricular septum ratio (basal-to-mid septal thickness ratio) was calculated. We assessed for associations between clinical and echocardiographic variables and DUST. Data are presented as mean (±SD), median (range), or frequency (percentage)., Results: One-hundred and two senior and 47 young cats were enrolled. Aortoseptal angle (AoSA) was steeper in senior cats (137° (±14.5) vs. 145° (±12.3) in young cats, P=0.002). Eighteen cats had DUST (18/149, 12%), fourteen senior, and four young cats (P=0.4). Cats with DUST had steeper AoSA (125° (±8.3) vs. 142° (±13.7), P<0.0001) and higher interventricular septum ratio (1.4 (1.2-2.0) vs. 1.0 (0.7-1.8)). Univariable analysis showed decreased odds of DUST with greater AoSA (OR 0.9, P<0.0001), age was not associated with DUST. Twenty-nine senior cats had HCM (28.4%)., Discussion/conclusions: Prevalence of DUST was 12%. There was no association between age and DUST. Smaller/steeper AoSA was the main factor associated with DUST. There was a high prevalence of HCM in this senior population., Competing Interests: Conflict of Interest Statement The authors do not have any conflicts of interest to disclose., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Anthracycline-induced cardiotoxicity has a variable incidence, and the development of left ventricular dysfunction is preceded by elevations in cardiac troponin concentrations. Beta-adrenergic receptor blocker and renin-angiotensin system inhibitor therapies have been associated with modest cardioprotective effects in unselected patients receiving anthracycline chemotherapy., Methods: In a multicenter, prospective, randomized, open-label, blinded end-point trial, patients with breast cancer and non-Hodgkin lymphoma receiving anthracycline chemotherapy underwent serial high-sensitivity cardiac troponin testing and cardiac magnetic resonance imaging before and 6 months after anthracycline treatment. Patients at high risk of cardiotoxicity (cardiac troponin I concentrations in the upper tertile during chemotherapy) were randomized to standard care plus cardioprotection (combination carvedilol and candesartan therapy) or standard care alone. The primary outcome was adjusted change in left ventricular ejection fraction at 6 months. In low-risk nonrandomized patients with cardiac troponin I concentrations in the lower 2 tertiles, we hypothesized the absence of a 6-month change in left ventricular ejection fraction and tested for equivalence of ±2%., Results: Between October 2017 and June 2021, 175 patients (mean age, 53 years; 87% female; 71% with breast cancer) were recruited. Patients randomized to cardioprotection (n=29) or standard care (n=28) had left ventricular ejection fractions of 69.4±7.4% and 69.1±6.1% at baseline and 65.7±6.6% and 64.9±5.9% 6 months after completion of chemotherapy, respectively. After adjustment for age, pretreatment left ventricular ejection fraction, and planned anthracycline dose, the estimated mean difference in 6-month left ventricular ejection fraction between the cardioprotection and standard care groups was -0.37% (95% CI, -3.59% to 2.85%; P =0.82). In low-risk nonrandomized patients, baseline and 6-month left ventricular ejection fractions were 69.3±5.7% and 66.4±6.3%, respectively: estimated mean difference, 2.87% (95% CI, 1.63%-4.10%; P =0.92, not equivalent)., Conclusions: Combination candesartan and carvedilol therapy had no demonstrable cardioprotective effect in patients receiving anthracycline-based chemotherapy with high-risk on-treatment cardiac troponin I concentrations. Low-risk nonrandomized patients had similar declines in left ventricular ejection fraction, bringing into question the utility of routine cardiac troponin monitoring. Furthermore, the modest declines in left ventricular ejection fraction suggest that the value and clinical impact of early cardioprotection therapy need to be better defined in patients receiving high-dose anthracycline., Registration: URL: https://doi.org; Unique identifier: 10.1186/ISRCTN24439460. URL: https://www.clinicaltrialsregister.eu/ctr-search/search; Unique identifier: 2017-000896-99., Competing Interests: Disclosures Dr Mills has received personal fees from Abbott Diagnostics, Roche Diagnostics, Siemens Healthineers, and LumiraDx and has received grants awarded to the University of Edinburgh from Abbott Diagnostics and Siemens Healthineers outside the submitted work. Dr Lang has received personal fees from Akero, Roche, Pfizer, and Novartis and research grant support from Roche Diagnostics outside the submitted work. Dr Williams has given talks at meetings sponsored by Siemens Healthineers, Canon Medical Systems, and Novartis. The other authors report no conflicts.

Echocardiography is the gold standard imaging modality to diagnose hypertrophic cardiomyopathy (HCM) in cats. Echocardiographic features can predict both cats at an increased risk of developing HCM and cats with HCM at an increased risk of developing cardiovascular events or experiencing cardiac death. Left atrial dysfunction seems to be an important feature of HCM, as it is an early phenotypic abnormality and is also associated with worse outcome., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: Pacemaker implantation is the treatment of choice for clinically relevant bradyarrhythmias. Pacemaker-lead-associated thrombosis (PLAT) occurs in 23.0-45.0% of people with permanent transvenous pacemakers. Serious thromboembolic complications are reported in 0.6-3.5%. The incidence of PLAT in dogs is unknown., Animals, Materials and Methods: multicenter retrospective study of seven centers with 606 client-owned dogs undergoing permanent pacemaker implantation between 2012 and 2019. 260 dogs with a transvenous pacemaker with echocardiographic follow-up, 268 dogs with a transvenous pacemaker without echocardiographic follow-up and 78 dogs with an epicardial pacemaker., Results: 10.4% (27/260) of dogs with transvenous pacemakers and echocardiographic follow-up had PLAT identified. The median time to diagnosis was 175 days (6-1853 days). Pacemaker-lead-associated thrombosis was an incidental finding in 15/27 (55.6%) dogs. Of dogs with a urine protein:creatinine ratio measured at pacemaker implantation, dogs with PLAT were more likely to have proteinuria at pacemaker implantation vs. dogs without PLAT (6/6 (100.0%) vs. 21/52 (40.4%), P=0.007). Urine protein:creatinine ratio was measured in 12/27 (44.4%) dogs at PLAT diagnosis, with proteinuria identified in 10/12 (83.3%) dogs. Anti-thrombotic drugs were used following the identification of PLAT in 22/27 (81.5%) dogs. The thrombus resolved in 9/15 (60.0%) dogs in which follow-up echocardiography was performed. Dogs with PLAT had shorter survival times from implantation compared to those without PLAT (677 days [9-1988 days] vs. 1105 days [1-2661 days], P=0.003)., Conclusions: Pacemaker-lead-associated thrombosis is identified in 10.4% (27/260) of dogs following transvenous pacing, is associated with proteinuria, can cause significant morbidity, and is associated with reduced survival times., Competing Interests: Conflicts of Interest Statement The authors do not have any conflicts of interest to disclose., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Introduction: In order to evaluate trends in death after COVID-19 vaccination we analyzed the timing of death relative to vaccination date and the causes of death in vaccinated Utahns in 2021., Methods: We matched people in the Utah immunization registry with documented COVID-19 vaccinations between December 18, 2020 and December 31, 2021 to Utah's 2021 vital statistics death records. Vaccinated people were categorized as having one, two, or ≥ three COVID-19 vaccine doses in a time-updated metric. We examined crude mortality rates by dosing groups in two-week intervals for all deaths, and by COVID-19 versus non-COVID-19 causes, within the 44 weeks following receipt of the most recent vaccine., Results: We identified 2,072,908 individuals who received at least one dose of COVID-19 vaccine of whom 10,997 died in 2021. Only 17.5 % of the total vaccinated population was age 65+, while 80.9 % of those who died were over 65. In the four weeks following the first or second vaccination, all-cause mortality was low and then stabilized for the remainder of the evaluation period at a bi-weekly average of 33.0 and 39.0 deaths/100,000 people for one and two doses, respectively. Typical seasonal variation in death was observed among those with two doses. Small sample size precluded analysis of those with ≥ three doses, but trends were similar., Conclusions: Mortality rates in the 44 weeks following the COVID-19 vaccination did not show trends suggesting an increase in mortality related to COVID-19 vaccination, reinforcing the safety of COVID-19 vaccines. This represents an accessible approach for local evaluation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction/objectives: Thin and hypokinetic myocardial segments (THyMS) represent adverse ventricular (LV) remodeling in human hypertrophic cardiomyopathy. We describe the echocardiographic features and outcome in cats with THyMS, and in a subpopulation, the echocardiographic phenotype before LV wall thinning was detected (pre-THyMS)., Animals: Eighty client-owned cats., Materials and Methods: Retrospective multicenter study. Clinical records were searched for cats with THyMS, defined as LV segment(s) with end-diastolic wall thickness (LVWT) <3 mm and hypokinesis in the presence of ≥one LV segment(s) with LVWT >4 mm and normal wall motion. When available, echocardiograms pre-THyMS were assessed. Survival time was defined as time from first presentation with THyMS to death., Results: Mean thickest LV wall segment (MaxLVWT) was 6.1 mm (95% CI 5.8-6.4 mm) and thinnest (MinLVWT) was 1.7 mm (95% CI 1.6-1.9 mm). The LV free wall was affected in 74%, apex in 13% and septum in 5%. Most cats (85%) presented with heart failure and/or arterial thromboembolism. Median circulating troponin I concentration was 1.4 ng/mL ([range 0.07-180 ng/mL]). Prior echocardiography results were available for 13/80 cats, a mean of 2.5 years pre-THyMS. In segments subsequently undergoing thinning, initial MaxLVWT measured 6.7 mm (95% CI 5.8-7.7 mm) vs. 1.9 mm (95% CI 1.5-2.4 mm) at last echocardiogram (P<0.0001). Survival data were available for 56/80 cats, median survival time after diagnosing THyMS was 153 days (95% CI 83-223 days). Cardiac histopathology in one cat revealed that THyMS was associated with severe transmural scarring., Conclusions: Cats with THyMS had advanced cardiomyopathy and a poor prognosis., Competing Interests: Conflicts of Interest Statement The authors do not have any conflicts of interest to disclose., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: The natural history of hypertrophic cardiomyopathy (HCM) in cats has been mainly studied in cats referred for suspected heart disease, which can skew the results towards cats with clinical signs. Few data are available on factors associated with development of HCM in cats., Hypotheses: (1) Clinical variables can predict which cats will develop HCM; (2) HCM in cats not referred for suspected heart disease is associated with a low rate of cardiovascular events., Animals: One hundred seven cats from rehoming centers without a history of clinical signs of cardiac or systemic disease at the time of adoption., Methods: Prospective longitudinal study. After rehoming, shelter cats were reexamined for serial echocardiograms. Cox regression analysis was used to identify predictors of development of HCM in cats that were normal at baseline. Adverse cardiovascular events including heart failure, thromboembolism, or sudden death were recorded., Results: Cats were monitored for a median of 5.6 [1.2-9.2] years. At baseline, 68/107 cats were normal, 18/107 were equivocal and 21/107 had HCM. Nineteen cats developed HCM during the study period. The factors at baseline associated with increased hazard of developing HCM were lower left atrial fractional shortening, higher left ventricular fractional shortening, and higher body weight. Cardiovascular events were observed in 21% of cats with HCM., Conclusions and Clinical Importance: Cardiovascular events were common in cats with HCM from a rehoming center study sample. Lower left atrial systolic function appears to precede overt HCM., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Background: Anthracyclines are effective cytotoxic drugs used in the treatment of breast cancer and lymphoma but are associated with myocardial injury, left ventricular dysfunction, and heart failure. Anthracycline-induced cardiotoxicity is highly variable in severity and without a proven therapeutic intervention. β-Adrenergic receptor blockers and renin-angiotensin-system inhibitor therapies have been associated with modest cardioprotective effects in unselected patients., Methods: The Cardiac CARE trial is a multicentre prospective randomized open-label blinded end point trial of combination β-adrenergic receptor blocker and renin-angiotensin-system inhibitor therapy in patients with breast cancer and non-Hodgkin lymphoma receiving anthracycline chemotherapy that is associated with myocardial injury. Patients at higher risk of cardiotoxicity with plasma high-sensitivity cTnI (cardiac troponin I) concentrations in the upper tertile at the end of chemotherapy are randomized to standard of care plus combination candesartan and carvedilol therapy or standard of care alone. All patients undergo cardiac magnetic resonance imaging before and 6 months after anthracycline treatment. The primary end point is the change in left ventricular ejection fraction at 6 months after chemotherapy. In low-risk nonrandomized patients, left ventricular ejection fraction before and 6 months after anthracycline will be compared with define the specificity of the high-sensitivity cTnI assay for identifying low-risk participants who do not develop left ventricular systolic dysfunction., Discussion: Cardiac CARE will examine whether cardiac biomarker monitoring identifies patients at risk of left ventricular dysfunction following anthracycline chemotherapy and whether troponin-guided treatment with combination candesartan and carvedilol therapy prevents the development of left ventricular dysfunction in these high-risk patients.

Three-dimensional (3D) printed models of anatomic structures offer an alternative to studying manufactured, "idealized" models or cadaveric specimens. The utility of 3D printed models of the heart for clinical veterinary students learning echocardiographic anatomy is unreported. This study aimed to assess the feasibility and utility of 3D printed models of the canine heart as a supplementary teaching aid in final-year vet students. We hypothesized that using 3D printed cardiac models would improve test scores and feedback when compared with a control group. Students ( n = 31) were randomized to use either a video guide to echocardiographic anatomy alongside 3D printed models (3DMs) or video only (VO). Prior to a self-directed learning session, students answered eight extended matching questions as a baseline knowledge assessment. They then undertook the learning session and provided feedback (Likert scores and free text). Students repeated the test within 1 to 3 days. Changes in test scores and feedback were compared between 3DM and VO groups, and between track and non-track rotation students. The 3DM group had increased test scores in the non-track subgroup. Track students' test scores in the VO group increased, but not in the 3DM group. Students in the 3DM group had a higher completion rate, and more left free-text feedback. Feedback from 3DM was almost universally positive, and students believed more strongly that these should be used for future veterinary anatomy teaching. In conclusion, these pilot data suggest that 3D printed canine cardiac models are feasible to produce and represent an inclusive learning opportunity, promoting student engagement.

Background: Beta-blockade is sometimes used in dogs with pulmonic stenosis with the intent of reducing frequency of ventricular arrhythmias during right heart catheterization., Objectives: To evaluate if pretreatment with atenolol reduces frequency of ventricular arrhythmias, anesthetist interventions, or shortens procedure time., Animals: Thirty dogs with pulmonic stenosis scheduled for interventional procedures., Methods: Single center, prospective, randomized, open-label study. Dogs were randomized to treatment with atenolol or no treatment preoperatively for a minimum of 10 days. Variables recorded included heart rate, arrhythmias and complexity, total procedure time and administration of antiarrhythmic treatment, vasopressors, positive chronotropes, or fluid boluses., Results: Fifteen dogs were enrolled in each group. Dogs receiving atenolol had lower mean heart rates during the procedure (atenolol 100 ± 11 bpm vs untreated 115 ± 19 bpm, P = .01). There were no significant differences between the atenolol and untreated groups in the frequency of ventricular ectopic complexes (535 [6-5296] vs 553 [79-2863], P = .9), ventricular couplets (46 [0-481] vs 29 [3-121], P = .59), ventricular triplets (20 [0-265] vs 16 [1-82], P = .67), ventricular tachycardia (8 [0-224] vs 8 [1-118], P = .99), proportion exhibiting R-on-T phenomenon (11/15 vs 14/15, P = .33), proportion receiving intraoperative lidocaine (1/15 vs 3/15, P = .6), vasopressors/positive chronotropes (11/15 vs 5/15, P = .06), or fluid boluses (12/15 vs 7/15, P = .13). The procedure time was similar (atenolol 41 [23-68] min vs untreated 35 [18-98] min, P = .91)., Conclusions and Clinical Importance: No benefit of preoperative atenolol treatment was identified in this small group of dogs., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Introduction: Balloon valvuloplasty is the treatment of choice for dogs with severe type A pulmonic stenosis (PS), but less successful for dogs with annular hypoplasia and unsuitable for supravalvular stenosis or cases with a circumpulmonary coronary malformation. We report outcomes and complications of the first 15 consecutive transvalvular pulmonic stent angioplasty procedures performed by a single center in dogs with PS., Animals: Fifteen dogs with naturally occurring PS were included in the study., Materials and Methods: Dogs underwent echocardiography before and four weeks after the procedure. Transvenous approaches were used to deploy a pre-mounted, balloon-expandable metallic stent in all cases., Results: Of 15 dogs, all had annular hypoplasia, and in addition, supravalvular stenosis was diagnosed in 11 of 15 dogs, and three had R2A coronary malformation. All dogs survived to discharge. One dog died less than four weeks postoperatively (non-cardiac), but 14 of 15 dogs were re-examined at four weeks. Severity reduced in all cases; median pressure gradient reduced from 137 mmHg (range 81-202 mmHg) to 83 mmHg (range 31-155 mmHg). Clinical signs improved in all cases, and hematocrit reduced in all dogs with erythrocytosis. The median follow-up time was 280 days (range 95-896 days). Over one-year follow-up was available in six of fifteen dogs. Two dogs died because of refractory right-sided congestive heart failure signs: one at 10 months and one at 22 months postoperatively., Conclusions: Transvalvular pulmonic stent angioplasty technique was associated with an improvement in clinical signs and reduction in stenosis severity for all dogs in this population, including cases with supravalvular PS or circumpulmonary coronary malformation., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Atrial fibrillation (AF) is associated with increased risk of sudden cardiac death (SCD) in humans, independent of secondary risk factors such as thrombogenic disorders. In dogs, SCD is described in a number of heart diseases, but an association between AF and SCD is unreported., Hypothesis: (a) A higher proportion of dogs with AF will experience SCD, and (b) SCD will be associated with complex ventricular arrhythmias., Animals: One-hundred forty-two dogs with AF, and 127 dogs without AF., Methods: Retrospective, multicenter, case-control study. Dogs included in the AF group were compared to a control group of dogs in sinus rhythm, matched for echocardiographic diagnosis. Descriptive statistics were used to identify proportions of each group suffering SCD, compared using chi-squared testing. Risk factors for SCD in dogs with AF were evaluated at the univariable and multivariable level using binary logistic regression. Significance was P < .05., Results: A significantly higher proportion of dogs with AF suffered SCD than dogs in the control group (14.8% vs 5.5%; P = .01). Younger age at diagnosis, larger left atrial size, and a history of syncope all were independent predictors of SCD in dogs with AF (χ 2 , 16.3; P = .04)., Conclusions and Clinical Importance: Atrial fibrillation was associated with a higher prevalence of SCD in dogs. A history of syncope may be a useful predictor of SCD risk., (© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Introduction: Anterior mitral valve leaflet (AMVL) elongation is a recognised feature of hypertrophic cardiomyopathy (HCM). However, whether AMVL elongation precedes left ventricular hypertrophy in cats is currently unknown. The aim of this study was to explore the risk of developing an HCM phenotype in cats with an elongated AMVL., Animals: FIFTY-FIVE APPARENTLY HEALTHY CATS WITH A NORMAL BASELINE ECHOCARDIOGRAM AND A FOLLOW-UP ECHOCARDIOGRAM AT >ONE YEAR., Materials and Methods: This was a retrospective longitudinal study. Cats at the baseline were grouped based on whether or not they developed an HCM phenotype at follow-up. AMVL length and left atrial and left ventricular dimensions were measured from two-dimensional images., Results: The median follow-up period of the study population was 5.4 years (25th and 75th quartile, 2.7-6.7 years). During this time, 17 cats (30.9%) developed an HCM phenotype. At the baseline, cats that subsequently developed an HCM phenotype had greater AMVL length (9.4 mm [25th and 75th quartile, 9.0-10.6 mm] vs. 8.5 mm [25th and 75th quartile, 7.6-9.1 mm], P < 0.0001) and maximal left ventricular wall thickness (4.5 mm [25th and 75th quartile, 4.1-4.7 mm] vs. 4.0 mm [25th and 75th quartile, 3.7-4.6 mm], P = 0.007) than those that did not. Multiple logistic regression analysis confirmed that both baseline variables were independent predictors for development of an HCM phenotype., Conclusions: The AMVL length was greater in cats that subsequently developed left ventricular hypertrophy. Further studies investigating the clinical application of AMVL in the natural history of feline HCM are warranted., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: The aim of the study was to document whether a proportion of non-diabetic cats with left ventricular hypertrophy (LVH) previously diagnosed with hypertrophic cardiomyopathy (HCM) have elevated circulating insulin-like growth factor 1 (IGF-1) concentrations., Methods: A retrospective analysis of residual blood samples obtained at the time of echocardiographic diagnosis of HCM from a population of 60 non-diabetic cats were analysed for circulating IGF-1 concentrations using a validated radioimmunoassay and compared with a control group of 16 apparently healthy cats without LVH. Clinical and echocardiographic data for cats with an IGF-1 level >1000 ng/ml were compared with those with an IGF-1 level <800 ng/ml., Results: In total, 6.7% (95% confidence interval 1.8-16.2%) of cats with HCM had an IGF-1 level >1000 ng/ml. The prevalence of an IGF-1 level >1000 ng/ml in the control group was zero., Conclusions and Relevance: A small proportion of non-diabetic cats previously diagnosed with HCM had an IGF-1 concentration at a level that has been associated with feline hypersomatotropism (fHS) in the diabetic cat population. Further prospective research is required to confirm or refute the presence of fHS in non-diabetic cats with LVH and increased IGF-1.

Background: Infective endocarditis (IE) in dogs is associated with severe disease and a high case fatality rate but often presents with nonspecific clinical signs., Hypothesis/objectives: Serum concentration of cardiac troponin-I (cTnI) is elevated in dogs with IE and can differentiate dogs with IE from dogs with other diseases with similar clinical features. Concentration of serum cTnI is negatively correlated with survival time in dogs with IE., Animals: Seventy-two client-owned dogs; 29 with IE, 27 with stage-B myxomatous mitral valve disease (MMVD), and 16 with immune-mediated disease (IMD)., Methods: Retrospective clinical cohort study. Concentration of serum cTnI was measured in all dogs at time of diagnosis. Clinical findings and echocardiographic interpretation were also recorded. Statistical analyses included Kruskal-Wallis test, pairwise Mann-Whitney U tests, receiver operator characteristic, and Cox proportional hazards., Results: Serum concentration of cTnI was significantly higher in the IE group (0.69 ng/mL [0.03-80.8]) than in the MMVD (0.05 ng/mL [0.02-0.11], P < .001) and IMD groups (0.05 ng/mL [0.03-0.57], P < .001). Increased cTnI was a moderately accurate predictor of IE (area under the curve 0.857 (95% confidence interval [CI] 0.745-0.968, P < .001). A cTnI cutoff of 0.625 ng/mL had 100% specificity (95% CI 90%-100%) and 52% sensitivity (95% CI 33%-70%) in this study sample. There was no association between cTnI concentration and survival time in dogs with IE (hazard ratio 1.013, 95% CI 0.993-1.034, P = .2)., Conclusions and Clinical Importance: Cardiac troponin-I concentrations are higher in dogs with IE compared to dogs with preclinical MMVD or IMD. In dogs with a compatible clinical presentation, serum cTnI concentrations >0.625 ng/mL are supportive of IE., (© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Background: N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) are biomarkers commonly evaluated in cats with suspected heart disease. Many cats with hypertrophic cardiomyopathy (HCM) have systolic anterior motion of the mitral valve (SAM), but its influence on circulating NT-proBNP or cTnI concentrations is currently unknown., Hypothesis/objectives: Cats with HCM and SAM (HCM SAM+ ) have higher NT-proBNP and cTnI concentrations than do cats with HCM but without SAM (HCM SAM- )., Animals: One hundred forty cats with HCM: 70 with SAM and 70 without SAM., Methods: Retrospective case-to-case study. Cats were recruited if diagnosed with HCM by echocardiography and results were available for NT-proBNP or cTnI concentrations or both. Cats with SAM were matched to those without SAM for clinical presentation, left atrial (LA) size and left ventricular (LV) fractional shortening., Results: A total of 119 NT-proBNP and 123 cTnI results were available. The HCM SAM+ cats had higher median concentrations than did HCM SAM- cats for NT-proBNP (729 pmoL/L; interquartile range [IQR], 275-1467 versus 65 pmoL/L; IQR, 25-271; P < .001) and cTnI (0.27 ng/mL; IQR, 0.10-0.81 versus 0.07 ng/mL; IQR, 0.01-0.43; P = .002). In general linear models for both NT-proBNP and cTnI, the independent explanatory variables were SAM, congestive heart failure, maximal LV wall thickness, and LA size., Conclusions and Clinical Importance: For cats with HCM and equivalent LA size and LV systolic function, those with SAM had higher NT-proBNP and cTnI concentrations than did those without SAM. Presence of SAM should be considered when interpreting biomarker concentrations in cats with HCM., (© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Objectives: First, to investigate the biological variability of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in healthy Labrador retrievers and compare this with current laboratory recommendations for dilated cardiomyopathy screening. Second, to calculate a breed-specific reference interval and validate it in a retrospective cohort., Materials and Methods: Plasma NT-proBNP was measured in 51 clinically healthy Labrador retrievers at 0, 2, 4, 6 and 8 weeks. Coefficient of variation for individual dogs over time, the coefficient of variation for the group at each time point and the index of individuality were calculated. A reference interval was derived and tested on a clinical dataset available from four UK cardiology referral centres., Results: Median NT-proBNP was 865 pmol/L (315 to 2064 pmol/L). Mean individual coefficient of variation was 19% (95% CI: 16 to 21%) and group coefficient of variation was 43% (95% CI: 41 to 46%), with index of individuality at 0.44. The breed-specific reference interval was 275 to 2100 pmol/L. In the validation group, 93% of NT-proBNP measurements from healthy dogs were within the reference interval. NT-proBNP measurements exceeded the reference interval in 82% of dogs with dilated cardiomyopathy. The upper bound of the reference interval (2100 pmol/L) had a positive predictive value of 90% and a negative predictive value of 87% for identification of dilated cardiomyopathy in this population., Clinical Significance: Breed-specific reference intervals might improve the diagnostic accuracy of NT-proBNP measurement. Applying the currently recommended general cut-off value to Labradors is likely to result in frequent false positives and diagnosis would be improved by application of the new breed-specific reference interval calculated here., (© 2020 The Authors Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

The goal of care when treating fingertip injuries is to minimize the risk of infection while maximizing function, tactile sensation, digit length, pulp padding, and appearance. This outcome can be achieved with careful soft-tissue coverage and, if possible, nail-bed preservation. When replantation for a fingertip amputation is not possible for anatomic or logistical reasons, local or regional flap reconstruction can be a useful alternative to gain early soft-tissue coverage and allow more functional rehabilitation. Reviewing current fingertip soft-tissue coverage procedures and demonstrating key anatomic and technical points with cadaveric dissections provides a foundation for the incorporation of these techniques into practice.

Background: Epidemiologic knowledge regarding noncardiovascular and all-cause mortality in apparently healthy cats (AH) and cats with preclinical hypertrophic cardiomyopathy (pHCM) is limited, hindering development of evidence-based healthcare guidelines., Objectives: To characterize/compare incidence rates, risk, and survival associated with noncardiovascular and all-cause mortality in AH and pHCM cats., Animals: A total of 1730 client-owned cats (722 AH, 1008 pHCM) from 21 countries., Methods: Retrospective, multicenter, longitudinal, cohort study. Long-term health data were extracted by medical record review and owner/referring veterinarian interviews., Results: Noncardiovascular death occurred in 534 (30.9%) of 1730 cats observed up to 15.2 years. Proportion of noncardiovascular death did not differ significantly between cats that at study enrollment were AH or had pHCM (P = .48). Cancer, chronic kidney disease, and conditions characterized by chronic weight-loss-vomiting-diarrhea-anorexia were the most frequently recorded noncardiovascular causes of death. Incidence rates/risk of noncardiac death increased with age in AH and pHCM. All-cause death proportions were greater in pHCM than AH (65% versus 40%, respectively; P < .001) because of higher cardiovascular mortality in pHCM cats. Comparing AH with pHCM, median survival (study entry to noncardiovascular death) did not differ (AH, 9.8 years; pHCM, 8.6 years; P = .10), but all-cause survival was significantly shorter in pHCM (P = .0001)., Conclusions and Clinical Importance: All-cause mortality was significantly greater in pHCM cats due to disease burden contributed by increased cardiovascular death superimposed upon noncardiovascular death., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

A man without cardiac symptoms was found to have a slow irregular pulse, and an electrocardiogram revealed sinus bradycardia with escape-capture bigeminy. He was taking verapamil, clonidine, and hydralazine for hypertension. The verapamil was discontinued; he returned to normal sinus rhythm and was discharged on the second hospital day., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: Ultra-small superparamagnetic particles of iron oxide (USPIO)-enhanced MRI can detect cellular inflammation within tissues and may help non-invasively identify cardiac transplant rejection. Here, we aimed to determine the normal reference values for USPIO-enhanced MRI in patients with a prior cardiac transplant and examine whether USPIO-enhanced MRI could detect myocardial inflammation in patients with transplant rejection., Methods: Ten volunteers and 11 patients with cardiac transplant underwent T2, T2* and late gadolinium enhancement 1.5T MRI, with further T2* imaging at 24 hours after USPIO (ferumoxytol, 4 mg/kg) infusion, at baseline and 3 months., Results: Ten patients with clinically stable cardiac transplantation were retained for analysis. Myocardial T2 values were higher in patients with cardiac transplant versus healthy volunteers (53.8±5.2 vs 48.6±1.9 ms, respectively; p=0.003). There were no differences in the magnitude of USPIO-induced change in R2* in patients with transplantation (change in R2*, 26.6±7.3 vs 22.0±10.4 s -1 in healthy volunteers; p=0.28). After 3 months, patients with transplantation (n=5) had unaltered T2 values (52.7±2.8 vs 52.12±3.4 ms; p=0.80) and changes in R2* following USPIO (29.42±8.14 vs 25.8±7.8 s -1 ; p=0.43)., Conclusion: Stable patients with cardiac transplantation have increased myocardial T2 values, consistent with resting myocardial oedema or fibrosis. In contrast, USPIO-enhanced MRI is normal and stable over time suggesting the absence of chronic macrophage-driven cellular inflammation. It remains to be determined whether USPIO-enhanced MRI may be able to identify acute cardiac transplant rejection., Trial Registration Number: NCT02319278349 (https://clinicaltrials.gov/ct2/show/NCT02319278) Registered 03.12.2014 EUDraCT 2013-002336-24., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)

Aortic stenosis affects 0.028% of cats in a shelter population, with valvular aortic stenosis compromising almost half of these cases. Of congenital heart diseases reported in cats, aortic stenosis is the second most common one, affecting 17% of these cases. Existing literature on valvular aortic stenosis is scant, and thus, presentation and prognosis of affected animals is poorly understood. In this case series, we describe three cats with confirmed valvular aortic stenosis. All cases were diagnosed echocardiographically, and all three had visible aortic valve leaflet fusion and a poststenotic dilation of the ascending aorta. Congestive heart failure developed in all three cases, and prognosis was poor. This case report highlights the existence of aortic valve dysplasia in cats and may allow clinicians a better understanding of the clinical presentation of this congenital abnormality., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Introduction: Hypertrophic cardiomyopathy (HCM) has a variable prognosis; left atrial size, presence of clinical signs and left ventricular systolic function have been shown to predict outcomes. Mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) assess longitudinal ventricular systolic function and are decreased in cats with HCM. The aim of the study was to ascertain whether MAPSE and TAPSE have prognostic value in HCM and if cats with pleural effusion have lower MAPSE and TAPSE than cats with pulmonary oedema., Animals: One hundred eighty-four client-owned cats diagnosed with HCM., Methods: This is a retrospective study. Echocardiography was used to diagnose HCM (end-diastolic left ventricular wall thickness ≥ 6 mm) and to measure MAPSE and TAPSE. Survival information was obtained., Results: No multivariable model including MAPSE or TAPSE could be generated in this population. Cats with pleural effusion ± pulmonary oedema had lower MAPSE measured at the interventricular septum (MAPSE IVS) and TAPSE, compared with cats with pulmonary oedema only. MAPSE IVS was the only factor predicting pleural effusion on multivariable regression model., Conclusions: Lower MAPSE and TAPSE were not independently associated with outcomes on multivariable analysis. Cats with pleural effusion ± pulmonary oedema had lower TAPSE and MAPSE IVS than cats with pulmonary oedema, and MAPSE IVS was the only predictive factor associated with the development of pleural effusion in this population., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved., Hypothesis/objectives: Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH)., Animals: One thousand seven hundred and thirty client-owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH)., Methods: Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long-term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death., Results: During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean ± standard deviation, 1.3 ± 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9-15 years., Conclusions and Clinical Importance: Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality., (Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

A high degree of accuracy is required when using echocardiography to diagnose hypertrophic cardiomyopathy (HCM) in cats, as variation in measurements of 0.5 mm may affect classification of individuals as 'abnormal'. This study in adult cats examined at different time points inter-observer variability between two Board certified echocardiographers in veterinary cardiology. Twenty-four female European shorthair cats were examined at 12, 18 and 24 months of age by observer 1. Two dimensional (2D) echocardiographic images were collected in conscious cats to measure left ventricular, aortic and left atrial dimensions. Measurements were repeated by observer 2 on stored images, and analysed for effect of time, observer and time-observer interaction. Based on end-diastolic left ventricular wall thickness, cats were diagnosed as 'normal' or 'abnormal'. Linear mixed models (generalized when appropriate) were performed. A significant difference between observers was found for all septal (IVSd) and free wall (LVFWd) thickness measurements and left ventricular internal diameters but not for aortic or left atrial measurements. All measurement coefficients of variation (CV) were < 10%. The CV for IVSd was higher than the CV for LVFWd. There was a significant effect of time on IVSd, aortic measurements and left ventricular internal diameter measurements. No significant time-observer interaction was found for any parameter. Diagnosis of cats as 'abnormal' (>5 mm in cats > 6 kg bodyweight) was significantly different between observers for IVSd but not LVFWd. Caution is warranted when diagnosing as 'abnormal' or interpreting small changes based on IVSd, due to significant inter-observer differences in this measurement., (© 2018 The Authors. Published by Elsevier Ltd.)

During the Deepwater Horizon blowout, unprecedented volumes of dispersant were applied both on the surface and at depth. Application at depth was intended to disperse the oil into smaller microdroplets that would increase biodegradation and also reduce the volumes buoyantly rising to the surface, thereby reducing surface exposures, recovery efforts, and potential stranding. In forensically examining 5300 offshore water samples for the Natural Resource Damage Assessment (NRDA) effort, profiles of deep-plume oil droplets (from filtered water samples) were compared with those also containing dispersant indicators to reveal a previously hypothesized but undocumented, accelerated dissolution of the polycyclic aromatic hydrocarbons (PAH) in the plume samples. We interpret these data in a fate-and-transport context and conclude that dispersant applications were functionally effective at depth., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Forensic chemistry assessments documented the presence of Macondo (MC252) oil from the Deepwater Horizon (DWH) spill in offshore water samples collected under Natural Resource Damage Assessment (NRDA) protocols. In ocean depths, oiled water was sampled, observed, photographed, and tracked in dissolved oxygen (DO) and fluorometry profiles. Chemical analyses, sensor records, and observations confirmed the shifting, rising oil plume above the wellhead while smaller, less buoyant droplets were entrapped in a layer at ~1000-1400 m and advected up to 412 km southwest. Near-surface oil samples showed substantial dissolution weathering from oil droplets rising through the water column, as well as enhanced evaporative losses of lighter n-alkanes and aromatic hydrocarbons. Dispersant effects from surface applications and injected at the wellhead were seen in oil profiles as enhanced weathering patterns (increased dissolution), thus implying dispersants were a functionally effective mediation treatment. Forensic assessment methods are detailed in the Supplemental information (SI)., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: To report the efficacy of Human Botulism Immune Globulin Intravenous (BIG-IV) in the first 12 years following its licensure in 2003 and to characterize its use nationwide in treating patients with infant botulism., Study Design: Medical records and billing information were collected for US patients treated with BIG-IV from 2003 to 2015. Length of hospital stay (LOS) and hospital charge information for treated patients were compared with the BIG-IV Pivotal Clinical Trial Placebo Group to quantify decreases in LOS and hospital charges., Results: The use of BIG-IV reduced mean LOS from 5.7 to 2.2 weeks. This shortened hospital stay resulted in a mean decrease in hospital charges of $88 900 per patient. For all US patients 2003-2015, total decreases in LOS and hospital charges were 66.9 years and $86.2 million, respectively. The decrease in mean LOS was time dependent: BIG-IV treatment on hospital days 0-3 reduced mean LOS by 3.7 weeks (P <.001 vs the BIG-IV Pivotal Clinical Trial Placebo Group), on hospital days 4-7 by 2.6 weeks (P <.001 vs the BIG-IV Pivotal Clinical Trial Placebo Group) and on hospital days 8-10 by just 1 week (P = NS). Since licensure, 1192 patients in 48 states and Washington, DC, have been treated with BIG-IV., Conclusions: The use of BIG-IV since its licensure in 2003 treated approximately 93% of US patients with laboratory-confirmed infant botulism, and prevented >65 years in hospital stay and >$85 million in hospital charges from occurring. The greatest LOS reduction was achieved when BIG-IV was administered soon after hospital admission. Effective and appropriate use of BIG-IV in the US has continued in the postlicensure period., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To ascertain the actual diagnoses of 76 patients (2005-2015) whose clinical presentations so closely resembled infant botulism that the patients were treated with Human Botulism Immune Globulin Intravenous (BIG-IV; BabyBIG), but whose illnesses subsequently were not laboratory confirmed as infant botulism ("clinical mimics" of infant botulism)., Study Design: The California Department of Public Health produces BIG-IV and distributes it nationwide as a public service (ie, not-for-profit) orphan drug to treat patients hospitalized with suspected infant botulism. During the study period, admission records and discharge summaries for all patients treated with BIG-IV but who lacked a laboratory-confirmed diagnosis of infant botulism were collected and abstracted. The patients' discharge diagnoses were identified, categorized, and compared with previously reported clinical mimics categories for 32 patients (1992-2005)., Results: From 2005 to 2015, 76 clinical mimic illnesses were identified. These illnesses were distributed into the 5 categories previously reported of (1) probable infant botulism lacking confirmatory testing (26.3%); (2) spinal muscular atrophy (19.7%); (3) miscellaneous (15.8%); (4) metabolic disorders (11.8%); and (5) other infectious diseases (10.6%). Of the 76 clinical mimic illnesses, 15.8% had no alternate diagnosis established and were therefore categorized as undetermined., Conclusions: Over the 23 years 1992-2015, patients presenting with illnesses so clinically similar to infant botulism that they were treated with BIG-IV had actual diagnoses that were distributed into 5 main categories. These categories and their individual components constitute a working bedside differential diagnosis of infant botulism., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: Ultrasmall superparamagnetic particles of iron oxide (USPIO)-enhanced MRI can detect tissue-resident macrophage activity and identify cellular inflammation within tissues. We hypothesised that USPIO-enhanced MRI would provide a non-invasive imaging technique that would improve the diagnosis and management of patients with acute myocarditis., Methods: Ten volunteers and 14 patients with suspected acute myocarditis underwent T2, T2* and late gadolinium enhancement (LGE) 3T MRI, with further T2* imaging at 24 hours after USPIO (ferumoxytol, 4 mg/kg) infusion, at baseline and 3 months. Myocardial oedema and USPIO enhancement were determined within areas of LGE as well as throughout the myocardium., Results: Myocarditis was confirmed in nine of the 14 suspected cases of myocarditis. There was greater myocardial oedema in regions of LGE in patients with myocarditis when compared with healthy volunteer myocardium (T2 value, 57.1±5.3 vs 46.7±1.6 ms, p<0.0001). There was no demonstrable difference in USPIO enhancement between patients and volunteers even within regions displaying LGE (change in R2*, 35.0±15.0 vs 37.2±9.6 s -1 , p>0.05). Imaging after 3 months in patients with myocarditis revealed a reduction in volume of LGE, a reduction in oedema measures within regions displaying LGE and improvement in ejection fraction (mean -19.7 mL, 95% CI (-0.5 to -40.0)), -5.8 ms (-0.9 to -10.7) and +6% (0.5% to 11.5%), respectively, p<0.05 for all)., Conclusion: In patients with acute myocarditis, USPIO-enhanced MRI does not provide additional clinically relevant information to LGE and T2 mapping MRI. This suggests that tissue-resident macrophages do not provide a substantial contribution to the myocardial inflammation in this condition.Clinical trial registration NCT02319278; Results., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

From 1976 to 2016, neurotoxigenic Clostridium baratii type F caused 18 (<0.5%) reported US infant botulism cases. Six cases occurred during 2012-2013; no common source was identified. Type F infant botulism mostly occurs in very young infants and typically presents more rapidly and severely than illness caused by types A and B botulinum neurotoxin., (Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Olefin-based synthetic-based drilling mud (SBM) was released into the Gulf of Mexico as a result of the Deepwater Horizon (DWH) disaster in 2010. We studied the composition of neat SBM and, using conventional GC-FID, the extent, concentration, and chemical character of SBM-derived olefins in >3600 seafloor sediments collected in 2010/2011 and 2014. SBM-derived (C 14 -C 20 ) olefins occurred (up to 10cm deep) within a 6.5km 2 "footprint" around the well. The olefin concentration in most sediments decreased an order of magnitude between 2010/2011 and 2014, at least in part due to biodegradation, evidenced by the preferential loss C 16 and C 18 linear (α- and internal) versus branched olefins. Based on their persistence for 4-years in sediments around the Macondo well, and 13-years near a former unrelated drill site (~62km away), weathered SBM-derived olefins released during the DWH disaster are anticipated to persist in deep-sea sediment for (at least) a comparable duration., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Left ventricular (LV) systolic dysfunction is associated with increased risk of death in cats with hypertrophic cardiomyopathy (HCM). Mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE, respectively) are measures of longitudinal systolic function and are reduced in human patients with HCM., Hypotheses: Cats with HCM have lower MAPSE and TAPSE compared to control cats; lower MAPSE and TAPSE are associated with the presence of congestive heart failure (CHF) and reduced survival time., Animals: 64 cats with HCM and 27 healthy cats. Forty-five cats with HCM were not showing clinical signs, and 19 had CHF., Methods: Retrospective study. Anatomic M-mode from the left apical 4-chamber view was used to record MAPSE from the free wall (MAPSE FW) and septum (MAPSE IVS) and TAPSE., Results: Compared to controls, cats with HCM had lower MAPSE IVS (controls 5.2 [4.6-5.6] mm, asymptomatic HCM 4.7 [4.1-5.2] mm, HCM with CHF 2.6 [2.5-3.2] mm, P < .001), MAPSE FW (controls 5.9 [5.3-6.2] mm, asymptomatic HCM 4.7 [4.1-5.1] mm, HCM with CHF 2.8 [2.4-3.2] mm) and TAPSE (controls 8.6 [7.4-10.2] mm, asymptomatic HCM 7.2 [6.3-8.2] mm, HCM with CHF 4.6 [4.1-5.4] mm), with the lowest in the CHF group. Univariate survival analysis showed a shorter survival in cats displaying lower MAPSE IVS, MAPSE FW, and TAPSE., Conclusions and Clinical Importance: MAPSE and TAPSE were lower in cats with HCM than in control cats and were lowest in CHF, suggesting that systolic longitudinal dysfunction is present in cats with HCM. MAPSE and TAPSE have potential prognostic significance., (Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

The extraction of unconventional oil and natural gas from shale energy reservoirs has raised concerns regarding upstream and midstream activities and their potential impacts on air quality. Here we present in situ measurements of ambient methane concentrations near multiple natural gas compressor stations in New York and Pennsylvania using cavity ring-down laser spectrometry coupled with global positioning system technology. These data reveal discernible methane plumes located proximally to compressor stations, which exhibit high variability in their methane emissions depending on the weather conditions and on-site activities. During atmospheric temperature inversions, when near-ground mixing of the atmosphere is limited or does not occur, residents and properties located within 1 mile of a compressor station can be exposed to rogue methane from these point sources. These data provide important insight into the characterization and potential for optimization of natural gas compressor station operations., (Copyright © 2016 Elsevier B.V. All rights reserved.)

An oil droplet size model was developed for a variety of turbulent conditions based on non-dimensional analysis of disruptive and restorative forces, which is applicable to oil droplet formation under both surface breaking-wave and subsurface-blowout conditions, with or without dispersant application. This new model was calibrated and successfully validated with droplet size data obtained from controlled laboratory studies of dispersant-treated and non-treated oil in subsea dispersant tank tests and field surveys, including the Deep Spill experimental release and the Deepwater Horizon blowout oil spill. This model is an advancement over prior models, as it explicitly addresses the effects of the dispersed phase viscosity, resulting from dispersant application and constrains the maximum stable droplet size based on Rayleigh-Taylor instability that is invoked for a release from a large aperture., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Mean systolic blood pressure in apparently healthy cats has been reported as approximately 125 mmHg using direct assessment, but there is greater variability in reported values using indirect assessment. Increasing age and the white-coat effect are associated with increased systolic blood pressure., Hypothesis/objectives: To report Doppler-derived blood pressure measurements from a large population of apparently healthy cats and to assess epidemiologic factors associated with recorded blood pressures., Animals: A total of 780 cats in rehoming centers enrolled in a screening program for heart murmurs and cardiac disease., Methods: Cats were considered healthy based on history and physical examination. Cats with known hypertension, hyperthyroidism, or clinical signs of systemic disease and pregnant or nursing queens were excluded. After an acclimatization period, systolic blood pressure was measured using the Doppler sphygmomanometry method following the recommendations of the ACVIM Consensus Statement. General linear model analysis was performed to identify factors associated with variation in systolic blood pressure., Results: Median (interquartile range, IQR) systolic blood pressure for the group was 120.6 (110.4-132.4) mmHg. Factors significantly associated with higher systolic blood pressure in a general linear model were increased age, increased nervousness, male sex, neutering, or history of being a stray. The model explained 29.2% of the variation in systolic blood pressure., Conclusions and Clinical Importance: The age, demeanor, sex, neuter status and history of being a stray should be taken into account when assessing systolic blood pressure in apparently healthy cats., (Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Following the Deepwater Horizon oil spill, the spilled Macondo oil was severely weathered during its transport within the deep-sea plume as discrete particles, which were subsequently deposited on the seafloor. The Macondo oil deposited in deep-sea sediments was distinguished from ambient (background) hydrocarbons and naturally-seeped and genetically-similar oils in the Mississippi Canyon region using a forensic method based upon a systematic, multi-year study of 724 deep-sea sediment cores collected in late 2010 and 2011. The method relied upon: (1) chemical fingerprinting of the distinct features of the wax-rich, severely-weathered Macondo oil; (2) hydrocarbon concentrations, considering a core's proximity to the Macondo well or to known or apparent natural oil seeps, and also vertically within a core; and (3) results from proximal cores and flocculent material from core supernatants and slurp gun filters. The results presented herein establish the geographic extent of "fingerprintable" Macondo oil recognized on the seafloor in 2010/2011., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Chemical analysis of sediment cores collected up to 8km from the Macondo well in 2010/2011 demonstrates the extent of weathering of the Macondo oil deposited in deep-sea sediments following the Deepwater Horizon disaster. On average, dissolution and biodegradation of the oil on the seafloor increased with distance from the well indicating that weathering occurred rapidly and overwhelmingly during the oil's transport as dispersed oil droplets within the deep-sea plume. Beyond about 5km from the well, the oil deposited on the seafloor had lost most mass below C25, was relatively enriched in n-C25+ n-alkanes and C3- and C4-alkylated benz[a]anthracenes/chrysenes, the latter owing to 95% depletion of total PAHs. Biodegradation of C28 and C29 tricyclic terpanes, C34 and C35 17α(H),21β(H)-homohopanes, C27 13β(H),17α(H)-dia and C27 14β(H),17β(H)-steranes and dissolution of C26 to C28 triaromatic steroids occurred. The results provide a means to distinguish Macondo oil in deep-sea sediments from naturally-occurring seep oils and pervasive ambient background hydrocarbons., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Ultrasmall superparamagnetic particles of iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI) can detect tissue-resident macrophage activity and identify cellular inflammation. Clinical studies using this technique are now emerging. We aimed to report a range of normal R2* values at 1.5 and 3 T in the myocardium and other tissues following ferumoxytol administration, outline the methodology used and suggest solutions to commonly encountered analysis problems., Methods: Twenty volunteers were recruited: 10 imaged each at 1.5 T and 3 T. T2* and late gadolinium enhanced (LGE) MRI was conducted at baseline with further T2* imaging conducted approximately 24 h after USPIO infusion (ferumoxytol, 4 mg/kg). Regions of interest were selected in the myocardium and compared to other tissues., Results: Following administration, USPIO was detected by changes in R2* from baseline (1/T2*) at 24 h in myocardium, skeletal muscle, kidney, liver, spleen and blood at 1.5 T, and myocardium, kidney, liver, spleen, blood and bone at 3 T (p < 0.05 for all). Myocardial changes in R2* due to USPIO were 26.5 ± 7.3 s-1 at 1.5 T, and 37.2 ± 9.6 s-1 at 3 T (p < 0.0001 for both). Tissues showing greatest ferumoxytol enhancement were the reticuloendothelial system: the liver, spleen and bone marrow (216.3 ± 32.6 s-1, 336.3 ± 60.3 s-1, 69.9 ± 79.9 s-1; p < 0.0001, p < 0.0001, p = ns respectively at 1.5 T, and 275.6 ± 69.9 s-1, 463.9 ± 136.7 s-1, 417.9 ± 370.3 s-1; p < 0.0001, p < 0.0001, p < 0.01 respectively at 3 T)., Conclusion: Ferumoxytol-enhanced MRI is feasible at both 1.5 T and 3 T. Careful data selection and dose administration, along with refinements to echo-time acquisition, post-processing and analysis techniques are essential to ensure reliable and robust quantification of tissue enhancement., Trial Registration: ClinicalTrials.gov Identifier - NCT02319278 . Registered 03.12.2014.

In-situ burning during the Deepwater Horizon oil spill generated tens of thousands of barrels of in-situ burn (ISB) residues in the northern Gulf of Mexico (GoM), most or all of which eventually sank to the seafloor. Chemical analyses showed that floating and sunken (~1400m deep) ISB residues (1) exhibited distinct n-alkanes and UCM profiles inconsistent with vapor-pressure driven evaporation, (2) were relatively enriched in pyrogenic PAHs, particularly less stable (mostly) linear PAH isomers formed during burning, and (3) had lost petroleum biomarkers, relative to their volatility. PAH concentrations in ISB residues indicate that between 26,800 and 37,800kg of total PAHs (TPAH51) and 2880 and 4060kg of 16 Priority Pollutant PAHs were potentially deposited on the seafloor in discrete ISB residue particles. Despite this additional benthic impact, ISB reduced the total mass loadings of PAH from the burned oil to the GoM by 89% (ignoring any re-deposition from atmospheric emissions)., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Uncoupling proteins (UCPs) regulate mitochondrial function, and thus cellular metabolism. Angiotensin-converting enzyme (ACE) is the central component of endocrine and local tissue renin-angiotensin systems (RAS), which also regulate diverse aspects of whole-body metabolism and mitochondrial function (partly through altering mitochondrial UCP expression). We show that ACE expression also appears to be regulated by mitochondrial UCPs. In genetic analysis of two unrelated populations (healthy young UK men and Scandinavian diabetic patients) serum ACE (sACE) activity was significantly higher amongst UCP3-55C (rather than T) and UCP2 I (rather than D) allele carriers. RNA interference against UCP2 in human umbilical vein endothelial cells reduced UCP2 mRNA sixfold (P < 0·01) whilst increasing ACE expression within a physiological range (<1·8-fold at 48 h; P < 0·01). Our findings suggest novel hypotheses. Firstly, cellular feedback regulation may occur between UCPs and ACE. Secondly, cellular UCP regulation of sACE suggests a novel means of crosstalk between (and mutual regulation of) cellular and endocrine metabolism. This might partly explain the reduced risk of developing diabetes and metabolic syndrome with RAS antagonists and offer insight into the origins of cardiovascular disease in which UCPs and ACE both play a role., (© 2016 The Authors. BioEssays published by WILEY Periodicals, Inc.)

Chemical analysis of large populations of floating (n=62) and stranded (n=1174) Macondo oils collected from the northern Gulf of Mexico sea surface and shorelines during or within seven weeks of the end of the Deepwater Horizon oil spill demonstrates the range, rates, and processes affecting surface oil weathering. Oil collected immediately upon reaching the sea surface had already lost most mass below n-C8 from dissolution of soluble aliphatics, monoaromatics, and naphthalenes during the oil's ascent with further reductions extending up to n-C13 due to the onset of evaporation. With additional time, weathering of the floating and stranded oils advanced with total PAH (TPAH50) depletions averaging 69±23% for floating oils and 94±3% for stranded oils caused by the combined effects of evaporation, dissolution, and photo-oxidation, the latter of which also reduced triaromatic steroid biomarkers. Biodegradation was not evident among the coalesced floating oils studied, but had commenced in some stranded oils., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: Hypertrophic cardiomyopathy (HCM) appears to be common in cats and, based on pilot data, a prevalence of 15% has been hypothesized. The objectives were to screen a large population of apparently healthy adult cats for cardiac disease, and identify factors associated with a diagnosis of HCM., Animals: A total of 1007 apparently healthy cats ≥ 6 months of age., Methods: In this prospective, cross-sectional study, the inclusion criteria were: apparently healthy cats, aged ≥ 6 months, available for rehoming over a 17-month period from two rehoming centres. Hypertensive or hyperthyroid cats were excluded. Body weight, body condition score, auscultation, systolic blood pressure and two-dimensional (2-D) echocardiography were evaluated. Cats with left ventricular end-diastolic wall thickness ≥ 6 mm on 2-D echocardiography were considered to have HCM., Results: Complete data were obtained in 780 cats. Heart murmur prevalence was 40.8% (95% confidence interval (CI) 37.3-44.3%), 70.4% of which were considered functional. The prevalence of HCM was 14.7% (95% CI 12.3-17.4%), congenital disease 0.5% (95% CI 0.1-1.3%), and other cardiomyopathies 0.1% (95% CI 0.0-0.7%). The HCM prevalence increased with age. The positive predictive value of a heart murmur for indicating HCM was 17.9-42.6% (higher in old cats), and the negative predictive value was 90.2-100% (higher in young cats). The factors associated with a diagnosis of HCM in binary logistic regression models were male sex, increased age, increased body condition score and a heart murmur (particularly grade III/VI or louder)., Conclusions: Hypertrophic cardiomyopathy is common in apparently healthy cats, in contrast with other cardiomyopathies. Heart murmurs are also common, and are often functional., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objectives: To evaluate risk factors associated with different types of cardiac death in cats with hypertrophic cardiomyopathy (HCM)., Animals: Two hundred fifty-five cats with HCM referred to a veterinary teaching hospital., Methods: This is a retrospective study. Cats with HCM were identified that had either died within 2 years of diagnosis or were known to be alive 2 years after initial examination. Signalment, physical exam, electrocardiographic and echocardiographic data were analyzed separately for association with death due to congestive heart failure (CHF) vs. aortic thromboembolism (ATE) vs. sudden death., Results: Within 2 years of follow-up, 23/255 (9.0%) cats had died with ATE, 44/255 (17.3%) cats had died with CHF and 12/255 (4.7%) cats had experienced a sudden death, with 141/255 (55.3%) cats still alive at the end of 2 years. Presence of CHF at presentation and reduced left ventricular fractional shortening (FS%) were independently associated with a CHF death within 2 years of diagnosis. Presence of ATE and reduced left atrial fractional shortening (LA-FS%) were independently associated with dying with ATE within 2 years. No multivariable models were generated for risks of dying a sudden death owing to the low event rate, but syncope at presentation and arrhythmias on auscultation were associated with sudden death on univariable analysis., Conclusions: Asymptomatic cats have a reduced risk of all three types of death. Reduced FS% and a history of CHF independently predict CHF death, and reduced LA-FS% and history of ATE independently predict ATE death. Sudden death is less commonly reported but is associated with syncope., (Copyright © 2015 Elsevier B.V. All rights reserved.)