Right ventricular function during acute exacerbation of severe equine asthma.
Authors: Decloedt A, Borowicz H, Slowikowska M, Chiers K, van Loon G, Niedzwiedz A
Journal: Equine veterinary journal
Summary
# Right ventricular dysfunction in severe equine asthma: structural changes persist beyond clinical recovery Severe equine asthma causes pulmonary hypertension, yet little was known about its mechanical consequences for the right heart until Decloedt and colleagues examined this relationship directly. Six susceptible horses underwent experimental induction of acute asthma exacerbation, with comprehensive assessment during the clinical episode (day 7), recovery (one month later) and comparison against ten healthy controls—measurements encompassed echocardiography, intracardiac pressures, cardiac biomarkers, and myocardial biopsies. Right ventricular function deteriorated acutely as expected, with tissue Doppler and speckle tracking revealing significant functional impairment alongside elevated right heart pressures; critically, even after clinical remission, asthmatic horses retained structural remodelling including right ventricular wall thickening and reduced longitudinal strain compared with controls. The persistence of these changes suggests that subclinical right ventricular compromise may linger long after an acute episode resolves, which has important implications for rehabilitation protocols and athletic clearance decisions in asthmatic horses. Clinicians should consider that apparent recovery from an acute asthma exacerbation may mask ongoing myocardial dysfunction, warranting cautious return-to-work strategies and potentially echocardiographic monitoring in high-performance animals.
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Practical Takeaways
- •Severe equine asthma causes structural and functional changes to the right heart that may persist even after clinical recovery; echocardiographic monitoring can detect these changes
- •Asthmatic horses are at risk of developing pulmonary hypertension with secondary right ventricular dysfunction during acute episodes
- •Even when in remission, horses with severe asthma history show measurable changes in right heart structure and function that warrant ongoing clinical consideration
Key Findings
- •Right heart pressures increased significantly during acute exacerbation of severe equine asthma
- •Altered right ventricular function detected by tissue Doppler and speckle tracking echocardiography during clinical episode
- •Asthmatic horses showed persistent right ventricular wall thickening and decreased longitudinal strain even in remission compared to controls
- •Focal neutrophil infiltration present in 2 of 6 right ventricular myocardial biopsies but cardiac troponin did not increase significantly