title: Prognostic value of echocardiographic and Doppler parameters in horses admitted for colic complicated by systemic inflammatory response syndrome.
abstract: OBJECTIVE
  To assess the prognostic value of echocardiographic parameters of left ventricular (LV) function in horses with systemic inflammatory response syndrome (SIRS).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Veterinary teaching hospital.
  
  
  METHODS
  Forty-one horses admitted for colic with clinical evidence of SIRS.
  
  
  METHODS
  All horses underwent Doppler echocardiographic examination on admission. LV echocardiographic parameters, including pulsed-wave tissue Doppler imaging parameters, were compared between nonsurvivors (n = 29) and horses that survived to discharge (n = 12).
  
  
  RESULTS
  With comparable heart rate and LV preload estimate, LV stroke volume index, the velocity time integral, deceleration time, ejection time of Doppler aortic flow, and peak early diastolic myocardial velocity were lower in the nonsurviving than in the surviving horses, while pre-ejection period to ejection time ratio (PEP/ET) of Doppler aortic flow and the peak early diastolic filling velocity to peak early diastolic myocardial velocity ratio (E/Em) were higher (P < 0.05). A cut-off value of 0.26 for PEP/ET predicted mortality with 100% sensitivity and 42% specificity (area under the receiver operating characteristic curve: 0.71), whereas a cut-off value of 2.67 for E/Em predicted mortality with 100% sensitivity and 83% specificity (area under the receiver operating characteristic curve: 0.89).
  
  
  CONCLUSIONS
  Echocardiography may provide prognostic information in colic horses with clinical evidence of SIRS. Especially, PEP/ET and E/Em could be useful markers of systolic and diastolic dysfunction, respectively, to detect horses with a high risk of death requiring more intensive cardiovascular monitoring as it has been reported in human patients with septic shock.
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20, B41, 4000, Liège, Belgium.
authors.forename: Laura
authors.initials: L
authors.lastname: Borde
authors.forename: Hélène
authors.initials: H
authors.lastname: Amory
authors.forename: Sigrid
authors.initials: S
authors.lastname: Grulke
authors.forename: Aurélia A
authors.initials: AA
authors.lastname: Leroux
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Houben
authors.forename: Johanne
authors.initials: J
authors.lastname: Detilleux
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sandersen
mesh_terms: D000818:Animals; D003085:Colic / Q000150:complications / Q000000981:diagnostic imaging / Q000662:veterinary*; D004452:Echocardiography / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D006736:Horses; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000662:veterinary*; D018608:Ultrasonography, Doppler / Q000662:veterinary
keywords: Endotoxemia; equine intensive care; hemodynamics; prognosis