Download PDF
Tierarztl Prax Ausg K Kleintiere Heimtiere 2015; 43(04): 231-237
DOI: 10.15654/TPK-140152
Original Article
Schattauer GmbH

Contrast echocardiography for analysis of heart anatomy in tortoises

Kontrast-Echokardiographie zur Analyse der Herzanatomie von Landschildkröten
M. Prütz
1   Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover
,
S. Hungerbühler
2   Small Animal Clinic, University of Veterinary Medicine Hannover
,
M. Laß
1   Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover
,
M. Fehr
1   Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover
2   Small Animal Clinic, University of Veterinary Medicine Hannover
,
P. Günther
1   Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover
,
K. Mathes
1   Clinic for Pets, Reptiles, Pet and Feral Birds, University of Veterinary Medicine Hannover
› Author AffiliationsThe authors especially thank Iris Maibaum and Birgit Leopold-Temmler for the English translation.
Further Information

Publication History

Received: 19 February 2014

Accepted after revision: 29 January 2015

Publication Date:
08 January 2018 (online)

    Permissions and Reprints

Summary

Objective

The cardiac anatomy in tortoises depicted on B-mode and color-Doppler should be better differentiated by additional contrastechocardiography.

Material and methods

An intravenous contrast agent (INN-sulphur hexafluoride [SonoVue®]) was injected in four tortoises (three Testudo hermanni, one Agrionemys horsfieldii), via the coccygeal vein, with parallel B-mode echocardiographic examination. The results of the contrast-enhanced echocardiography were compared with the contrast-free B-mode recordings and color-Doppler ultrasound.

Results

The use of SonoVue® enabled clearer distinction of the cardiac structures, differentiation of the arising major arteries, identification of wash-out-shunts, and visualization of blood flow patterns throughout the tortoise heart.

Conclusion and clinical relevance

This study enables the accurate depiction and differentiation of cardiac anatomy in tortoises through the use of a combination of B-mode, color-Doppler and contrast-echocardiography. Basic knowledge of blood flow in the reptile heart is essential to understand echocardiographic anatomy. Blood-flow-patterns and anatomy of the tortoise heart as found in this study will help to establish a basis for further echocardiographic examinations of these animals.

Zusammenfassung

Ziel

der Studie war die bessere Differenzierung der mittels B-Mode und Farb-Doppler-Echokardiographie dargestellten kardialen Anatomie der Landschildkröte durch zusätzliche Kontrast-Echokardiographie.

Material und Methoden

Bei vier Landschildkröten unterschiedlicher Spezies (drei Testudo hermanni, eine Agrionemys horsfieldii) erfolgte eine intravenöse Kontrastmittelapplikation (Schwefelhexafluorid [SonoVue®]) in die dorsale Schwanzvene (V. coccygealis dorsalis) mit gleichzeitiger B-Mode-Darstellung des Herzens. Die Resultate der kontrastverstärkten Echokardiographie wurden mit den B-Mode-Aufnahmen ohne Kontrast und denen einer Farb-Doppler-Untersuchung verglichen.

Ergebnisse

Die kardialen Strukturen konnten durch SonoVue® deutlicher abgegrenzt, die ausführenden Gefäße differenziert, Auswasch-Shunts nachgewiesen und ein Muster des Blutflusses durch das Schildkrötenherz ausgearbeitet werden.

Schlussfolgerung und klinische Relevanz

Mit einer Kombination von B-Mode, Farb-Doppler-und Kontrast-Echokardiographie ermöglicht diese Studie die genaue Darstellung und Differenzierung der Herzanatomie von Landschildkröten. Das Wissen über den Blutfluss im Reptilienherzen ist für das Verständnis der echokardiographischen Anatomie unerlässlich. Diese Ergebnisse über das Blutflussmuster und den Aufbau des Herzens von Landschildkröten können als Grundlage für nachfolgende echokardiographische Untersuchungen dieser Tiere dienen.

Keywords

Reptile - tortoise - ultrasonography - heart - contrast-enhanced ultrasound

Schlüsselwörter

Reptil - Landschildkröte - Ultraschall - Herz - kontrastverstärkter Ultraschall
 

  • References

  • 1 American society of echocardiography. Recommendations for chamber quantification: A report from the american society of echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the european sssociation of echocardiography, a branch of the european society of cardiology. J Am Soc Echocardiogr 2005; 18: 1440-1463.
    CrossrefPubMedGoogle Scholar
  • 2 Böhmeke T, Schmidt A. Checkliste Echokardiographie – Kontrastechokardiographie, 4. Aufl. Stuttgart: Thieme; 2008: 49-50.
    Google Scholar
  • 3 Boon JA. Veterinary Echocardiography. 2nd. edn. Oxford: Blackwell; 2011
    Google Scholar
  • 4 Claudon M, Cosgrove DO, Albrecht T. et al. Leitlinien und Empfehlungen für die gute klinische Praxis zur Durchführung von Kontrastmittel-Ultraschall (KMUS) – Update 2008. Ultraschall Med 2008; 29: 28-44.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Cosgrove D. Ultrasound contrast agents: An overview. Eur J Radiol 2006; 60 (03) 324-330.
    CrossrefPubMedGoogle Scholar
  • 6 Gabelmann M, Geibel A. Kontrast-Echokardiographie – klinischer Einsatz in der Intensivund Notfallmedizin. Intensivmed Notfmed 1999; 36 (07) 662-670.
    PubMedGoogle Scholar
  • 7 Galema TW, Geleijnse ML, Vletter WB. et al. Clinical usefulness of Sono-Vue contrast echocardiography: the Thoraxcentre experience. Neth Heart J 2007; 15 (02) 55-60.
    CrossrefPubMedGoogle Scholar
  • 8 Greis C, Dietrich CF. Ultraschallkontrastmittel und kontrastverstärkte Sonographie. In: Endosonographie: Leitfaden und Atlas. Dietrich CF. Hrsg. Stuttgart: Thieme; 2008: 47-59.
    Google Scholar
  • 9 Greis C. Ultrasound contrast agents as markers of vascularity and microcirculation. Clin Hemorheol Microcirc 2009; 43 (1–2): 1-9.
    CrossrefPubMedGoogle Scholar
  • 10 Hicks JW, Comeau SG. Vagal regulation of intracardiac shunting in the turtle Pseudemys scripta . J Exp Biol 1994; 186 (01) 109-126.
    PubMedGoogle Scholar
  • 11 Holland MF, Hernandez-Divers S, Frank PM. Ultrasonographic appearance of the coelomic cavity in healthy green iguanas. J Am Vet Med Assoc 2008; 233 (04) 590-596.
    CrossrefPubMedGoogle Scholar
  • 12 Holz P, Barker IK, Burger JP. et al. The effect of the renal portal system on pharmacokinetic parameters in the red-earded slider (Trachemys scripta elegans). J Zoo Wildl Med 1997; 28 (04) 386-393.
    PubMedGoogle Scholar
  • 13 Isaza R, Ackerman N, Jacobson ER. Ultrasound imaging of the coelomic structures in the boa constrictor (Boa constrictor). Vet Radiol Ultrasound 1993; 34 (06) 445-450.
    CrossrefPubMedGoogle Scholar
  • 14 Jensen B, Larsen CK, Nielsen JM. et al. Change of cardiac function, but not form, in postprandial pythons. Comparative Biochemistry and Physiology – Part A: Molecular & Integrative Physiology 2011; 160 (01) 35-42.
    CrossrefPubMedGoogle Scholar
  • 15 Jones TR. Chapter XXVII Reptilia. In: General outline of the organization of the animal kingdom: and manual of comparative anatomy. London: J Van Voorst; 1861: 696-698.
    Google Scholar
  • 16 Kalantarinia K, Okusa MD. Ultrasound contrast agents in the study of kidney function in health and disease. Drug Discov Today Dis Mech 2007; 04 (03) 153-158.
    CrossrefPubMedGoogle Scholar
  • 17 Kunert M, Ulbricht LJ. Praktische Echokardiographie – Kontrastechokardiographie, 2. Aufl. Köln: Deutscher Ärzteverlag; 2006: 12-14.
    Google Scholar
  • 18 Lang J. Imaging the Heart. In: Diagnostic Ultrasound in Small Animal Practice. Mannion P, Redrobe S, Lang J. eds. Oxford: Blackwell; 2006: 188-215.
    Google Scholar
  • 19 Malvin GM, Hicks JW, Greene ER. Central vascular flow patterns in the alligator Alligator mississipiensis . Am J Physiol 1995; 269 (05) R1133-1139.
    CrossrefPubMedGoogle Scholar
  • 20 Martorell J, Espada Y, Ruiz de RGopegui. Normal echoanatomy of the redeared slider terrapin (Trachemys scripta elegans). Vet Rec 2004; 155 (14) 417-420.
    CrossrefPubMedGoogle Scholar
  • 21 Murray MJ. Cardiopulmonary anatomy and physiology. In: Reptile Medicine and Surgery. 2nd. edn. Mader DR. ed. Philadelphia: Saunders; 2005: 124-134.
    Google Scholar
  • 22 Nardini G, Rossi F, Paganelli I. et al. Evaluation of liver perfusion in iguanas using contrast enhanced ultrasound. International Conference on Reptile and Amphibian Medicine. Cremona, Italy: 2012: 73-74.
    Google Scholar
  • 23 Nyman HT, Kristensen AT, Kjelgaard-Hansen M. et al. Contrast-enhanced ultrasonography in normal canine liver. Evaluation of imaging and safety parameters. Vet Radiol Ultrasound 2005; 46 (03) 243-250.
    CrossrefPubMedGoogle Scholar
  • 24 O’Brien RT, Iani M, Matheson J. et al. Contrast harmonic ultrasound of spontaneous liver nodules in 32 dogs. Vet Radiol Ultrasound 2004; 45 (06) 547-553.
    CrossrefPubMedGoogle Scholar
  • 25 O’Malley B. Allgemeine Anatomie und Physiologie der Reptilien. In: Klinische Anatomie und Physiologie bei kleinen Heimtieren, Vögeln, Reptilien und Amphibien, 1. Aufl. München: Urban & Fischer in Elsevier; 2008: 21-50.
    Google Scholar
  • 26 Parker HW, Bellairs A. Die Amphibien und die Reptilien. Editions Rencontre. 1972
    PubMedGoogle Scholar
  • 27 Penninck DG, Stewart JS, Paul-Murphy J. et al. Ultrasonography of the California desert tortoise (Xerobates agassizi): anatomy and application. Vet Radiol 1991; 32 (03) 112-116.
    CrossrefPubMedGoogle Scholar
  • 28 Poser H, Russello G, Zanella A. et al. Two-Dimensional and Doppler echocardiographic findings in healthy non-sedated red-eared slider terrapins (Trachemys scripta elegans). Vet Res Commun 2011; 35 (08) 511-520.
    CrossrefPubMedGoogle Scholar
  • 29 Poulsen-Nautrup C, Tobias R. Atlas und Lehrbuch der Ultraschalldiagnostik bei Hund und Katze, 4. Aufl. Schlütersche. 2007
    PubMedGoogle Scholar
  • 30 Schilliger L, Tessier D, Pouchelon JL. et al. Proposed standardization of the two-dimensional echocardiographic examination in snakes. J Herpetol Med Surg 2006; 16 (03) 90-102.
    PubMedGoogle Scholar
  • 31 Schneider M, Arditi M, Barrau MB. et al. BR1: a new ultrasonographic contrast agent based on sulfur hexafluoride-filled microbubbles. Invest Radiol 1995; 30 (08) 451-457.
    CrossrefPubMedGoogle Scholar
  • 32 Schneider M. SonoVue, a new ultrasound contrast agent. Eur Radiol 1999; 09 (03) 347-348.
    CrossrefPubMedGoogle Scholar
  • 33 Schroff S, Starck JM, Krautwald-Junghans M-E. et al. Echokardiographische Untersuchungen bei Boiden: Darstellung und Blutflussmessungen. Tierärztl Prax 2012; 40 (K): 180-190.
    PubMedGoogle Scholar
  • 34 Snyder PS, Shaw NG, Heard DJ. Two-dimensional echocardiographic anatomy of the snake heart (Python molorus bivittatus). Vet Radiol Ultrasound 1999; 40 (01) 66-72.
    CrossrefPubMedGoogle Scholar
  • 35 Spörle H, Kramer M, Göbel T. et al. Sonoanatomy of snakes. Proc 4th Int Colloq Pathol Rept Amphib. Bad Nauheim, Germany: 1991: 139-143.
    Google Scholar
  • 36 Starck JM. Functional morphology and patterns of blood flow in the heart of Python regius . J Morphol 2009; 270 (06) 673-687.
    CrossrefPubMedGoogle Scholar
  • 37 Streitberger A, Hocke V, Modler P. Measurement of pulmonary transit time in healthy cats by use of ultrasound contrast media “Sonvue®”: Feasibility; reproducibility, and values in 42 cats. J Vet Cardiol 2013; 15: 181-187.
    CrossrefPubMedGoogle Scholar
  • 38 Tenhu H, Schildger BJ, Geyer B. Ultrasonographic anatomy of monitors (Varanus gouldii and V. indicus). 5th Int Colloq Pathol Rept Amphib. Alphen aan den Rijn. The Netherlands: 1995: 293-296.
    Google Scholar
  • 39 Thomson JS. Anatomy of the Tortoise. Bibliomania! Salt Lake City, Utah. (Originally published in the 1932 Scientific Proceedings of the Royal Dublin Society 20 [28]: 359-462, plates 19-43). 2006
    PubMedGoogle Scholar
  • 40 Valente AL, Parga ML, Espada Y. et al. Evaluation of Doppler ultrasonography for the measurement of blood flow in young loggerhead sea turtles (Caretta caretta) . Vet J 2008; 176 (03) 385-392.
    CrossrefPubMedGoogle Scholar
  • 41 White FN. Functional anatomy of the heart of reptiles. Am Zool 1968; 08 (02) 211-219.
    CrossrefPubMedGoogle Scholar
  • 42 Zwart P, Ippen R. Anatomy of major blood vessels in tails of reptiles, with reference to blood sampling. Proc 5th Int Colloq Pathol Rept Amphib. Alphen aan den Rijn. The Netherlands: 1995: 265-269.
    Google Scholar