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J Vet Intern Med. 2018 May;32(3):930-943. doi: 10.1111/jvim.15122. Epub 2018 Apr 16.

International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study.

Author information

1
Department of Cardiology and Caspary Research Institute, The Animal Medical Center, New York, New York, U.S.A.
2
Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, U.S.A.
3
Lamb Consulting, Minneapolis, Minnesota, U.S.A.
4
Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, U.S.A.
5
Alfort Cardiology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort Cedex, France.
6
Department of Veterinary Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom.
7
Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany.
8
Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, U.S.A.
9
Department of Statistics, North Carolina State University, Raleigh, North Carolina, U.S.A.
10
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
11
Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, U.S.A.
12
Advanced Veterinary Care Center, Lawndale, California, U.S.A.
13
William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, U.S.A.
14
Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, U.S.A.
15
Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, U.S.A.
16
Royal (Dick) SVS Hospital for Small Animals, The University of Edinburgh, Roslin, Midlothian, United Kingdom.
17
Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria.
18
Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, U.S.A.
19
Animal CardioPulmonary Consultancy, Masta, Stavelot, Belgium.
20
Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.
21
Department of Clinical Sciences, Tufts University, Cummings School of Veterinary Medicine, North Grafton, Massachusetts, U.S.A.
22
Tufts Veterinary Emergency Treatment & Specialties, Walpole, Massachusetts, U.S.A.
23
Department of Cardiology, Clinica Veterinaria Malpensa, Varese, Italy.
24
Fachtieraerztin fur Kleintiere, Wissen and Bonn, Germany.
25
Veterinary Specialty and Emergency Center, Levittown, Pennsylvania, U.S.A.
26
Department of Cardiology, Clinica Veterinaria Gran Sasso, Milan, Italy.
27
Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, U.S.A.
28
Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida.
29
Department of Clinical Sciences, The Koret School of Veterinary Medicine, Rehovot, Israel.
30
Departamento de Medicina y Cirugía Animal, Universidad de Murcia, Murcia, Spain.
31
Veterinary Medical Specialists of Houston, Houston, Texas, U.S.A.
32
Department of Internal Medicine, University of São Paulo, São Paulo, Brazil.
33
Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada.
34
Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, U.S.A.
35
Department of Veterinary Medicine, University of Milan, Milan, Italy.
36
Department of Clinical Sciences, Cornell University, Ithaca, New York, U.S.A.
37
Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, U.S.A.
38
Department of Medical Sciences, University of Wisconsin School of Veterinary Medicine, Madison, Wisconsin, U.S.A.
39
Department of Veterinary Sciences, University of Parma, Parma, Italy.
40
Cabinet Vétérinaire et Centre d'Imagerie, Geneva, Switzerland.
41
Department of Internal Medicine, University of Veterinary Medicine, Budapest, Hungary.
42
Cardiospecial Veterinary Hospital, Taipei, Taiwan.
43
Bryanston Veterinary Hospital, Bryanston, South Africa.
44
University College Dublin Veterinary Hospital, University College Dublin, Dublin, Ireland.
45
Department of Clinical Studies, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
46
Veterinary Clinic Beliy Klyk, Moscow, Russia.
47
Azabu University, Sagamihara, Kanagawa, Japan.
48
Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, U.S.A.
49
Jasmine Animal Cardiovascular Center, Yokohama, Kanagawa, Japan.
50
Department of Medicine, Surgery and Zootechnics for Small Species, Universidad Nacional Autónoma de México, Mexico City, Mexico.

Abstract

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.

KEYWORDS:

arterial thromboembolism; asymptomatic; congestive heart failure; epidemiology; incidence; outcome; survival

PMID:
29660848
PMCID:
PMC5980443
DOI:
10.1111/jvim.15122
[Indexed for MEDLINE]
Free PMC Article

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