Department of Anatomy, Physiology and Biochemistry

Solutions from veterinary medicine transferred to human health care

Katja Höglund

From boxers to babies

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

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

Echocardiographicexamination

No heart disease Aortic stenosis

Phonocardiographic examination

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

Complexity (T2) vs. duration > 200 Hz

Sensitivity 94 %94 %Specificity 82 %82 %

= dogs with heart disease

* = dogs with innocent murmurs

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

Ongoing study

Digital heart sound analyses for assessment of severity of heart murmurs caused by mitral valve disease

Ingrid Ljungvall, PhD-project

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.

Thanks for your interest!

Contact: Katja.Hoglund@afb.slu.se

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

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)

Clinical evaluation of heart murmursClinical evaluation of heart murmurs

Cardiacauscultation

AA=aortic arch