Transcript Bild 1 - Uppsala BIO

Solutions from veterinary medicine
transferred to human health care
From boxers to babies
Katja Höglund
Department of Anatomy, Physiology and Biochemistry
Evaluation of heart murmurs
From: The science and practice of pediatric cardiology, 1998
Innocent or pathologic?
Digital analysis of cardiac acoustic signals in children
Milad El-Segaier. Thesis 2007
Heart murmurs in boxer dogs
Country
Nr of dogs
Murmurs
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
Children
Heart murmurs
50-80%
Reference
Heart disease
1%
Echocardiographic
examination
No heart disease
Aortic stenosis
Phonocardiographic examination
Digital heart sound analysis
Time-frequency properties
Murmur duration >200 Hz
Separation of innocent murmurs
from murmurs caused by mild
heart disease
Murmur complexity (T2)
Significantly higher in dogs with
heart disease compared to dogs
with innocent murmurs.
Complexity (T2) vs. duration > 200 Hz
Sensitivity 94 %
Specificity 82 %
= dogs with heart disease
*
= dogs with innocent murmurs
Conclusions
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 be
a 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
Digital heart sound analyses for assessment of severity
of heart murmurs caused by mitral valve disease
Ingrid Ljungvall, PhD-project
Ongoing study
Future implications
Digital heart sound analyses are promising
techniques for clinical evaluation of heart murmurs.
This could be beneficial both for dogs and humans.
The study team
Katja Höglund, SLU, Uppsala
Clarence Kvart, SLU, Uppsala
Jens Häggström, SLU, Uppsala
Ingrid Ljungvall, SLU, Uppsala
Christer Ahlström, Linköping University
Per Ask, Linköping University
Peter Hult, Linköping University
Thanks for your interest!
Contact: [email protected]
Group denomination paper III
TFP and T2 analysis group denomination
A1
A2
B1
B2
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
Number of dogs
Indexed stroke volume
(ml/m2)
(ml/min/m2)
Indexed cardiac output
Clinical evaluation of heart murmurs
Cardiac
auscultation
AA=aortic arch