department of anatomy, physiology and biochemistry solutions from veterinary medicine transferred to...
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Department of Anatomy, Physiology and Biochemistry
Solutions from veterinary medicine transferred to human health care
Katja Höglund
From boxers to babies
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Evaluation of heart murmursEvaluation of heart murmurs
Innocent or pathologic?Innocent or pathologic?
From: The science and practice of pediatric cardiology, 1998
Digital analysis of cardiac acoustic signals in childrenMilad El-Segaier. Thesis 2007
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Country Nr of dogs Murmurs Reference
Italy 500 53% Bussadori et al. 2001
Great Britain 319 50% Luis Fuentes 1993
Norway/Sweden 231 77% Heiene et al. 2000
Denmark 55 73% Linde & Koch 2006
Sweden 59 71% Höglund 2007
Heart murmurs in boxer dogsHeart murmurs in boxer dogs
Heart murmurs Heart disease 50-80% 1%
Children
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Echocardiographicexamination
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No heart disease Aortic stenosis
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Phonocardiographic examination
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Digital heart sound analysisDigital heart sound analysis
Time-frequency properties
Separation of innocent murmurs from murmurs caused by mild heart disease
Significantly higher in dogs with heart disease compared to dogs with innocent murmurs.
Murmur complexity (T2)
Murmur duration >200 Hz
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Complexity (T2) vs. duration > 200 Hz
Sensitivity 94 %94 %Specificity 82 %82 %
= dogs with heart disease
* = dogs with innocent murmurs
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ConclusionsConclusions
Duration of murmur frequency > 200 Hz can be used for differentiation between dogs with mild heart disease and dogs with innocent murmurs.
Combining murmur duration with complexity analysis (T2) may bea useful method to diagnose heart disease in dogs.
Höglund K, Ahlstrom C, Häggström J et al. Am J Vet Res. 2007 Sep;68(9):962-9
Höglund K. Systolic ejection murmurs and the left ventricular outflow tract in boxer dogs. Physiology and clinical evaluation. Thesis 2007.
Assessing the severity of aortic stenosis using sample entropy of the phonocardiographic signal Ahlstrom C, Höglund K, Hult P et al. Submitted
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Ongoing study
Digital heart sound analyses for assessment of severity of heart murmurs caused by mitral valve disease
Ingrid Ljungvall, PhD-project
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The study team
Katja Höglund, SLU, UppsalaClarence Kvart, SLU, UppsalaJens Häggström, SLU, UppsalaIngrid Ljungvall, SLU, UppsalaChrister Ahlström, Linköping UniversityPer Ask, Linköping UniversityPeter Hult, Linköping University
Future implications
Digital heart sound analyses are promising techniques for clinical evaluation of heart murmurs.This could be beneficial both for dogs and humans.
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TFP and T2 analysis group denomination
A1 A2 B1 B2
Number of dogs 8 8 5 6
Mean aortic flow velocity (m/s) 1.65 0.09 2,02 0.19 2.82 0.36 4.58 0.57
Aortic flow velocity, range (m/s) 1.52-1.73 1.84-2.41 2.40-3.20 4.00-5.50
Degree of heart murmur (I-VI) I-II I-II II-IV III-V
2D morphological aortic stenosis No No Yes Yes
Group denomination paper III
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20
30
40
50
60
SV
/BS
A
1 2 3 4 5 6
Us nr
2000
3000
4000
5000
6000
7000
CO
/BS
A
1 2 3 4 5 6
Us nr
Indexed stroke volume
Indexed cardiac output
(ml/m2)
(ml/min/m2)
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Clinical evaluation of heart murmursClinical evaluation of heart murmurs
Cardiacauscultation
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AA=aortic arch