Cardiac Power Output during Dobutamine Stress Test in Horses

Abstract 

Although echocardiography has greatly improved the diagnostic possibilities in equine medicine, determining the prognosis remains a difficult task. In humans, maximal cardiac power output (CPO) has been described as a powerful indicator of exercise capability and outcome in heart disease. The aim of the study is to describe the measurement of CPO by echocardiography and by thermodilution in healthy horses. Six healthy horses were studied. Cardiac output (CO) was measured by thermodilution and Doppler echocardiography at rest and during a pharmacologic stress test consisting of 35 μg/kg atropine followed by incremental steps 2, 4, 6, and 8 μg/kg/min of dobutamine infusion. Mean arterial pressure (MAP) was measured invasively by a catheter introduced into the transverse facial artery. CPO was calculated as the product of CO and MAP. Baseline CPO measured by thermodilution and by Doppler echocardiography was 10.7 ± 3.3 and 13.7 ± 4.5 watts, respectively. CPO increased significantly with pharmacologic stimulation and reached maximal CPO of 66.4 ± 3.6 and 60.4 ± 5.1 watts when measured by thermodilution and Doppler echocardiography, respectively. This study describes an estimation of CPO in horses. Further studies should demonstrate the usefulness of CPO as a predictive indicator in horses suffering from cardiac disease.

Keywords: Horse, Heart disease, Stress echocardiography, Thermodilution, Dobutamine, Atropine