Atrial fibrillation as a risk factor for exercise-induced pulmonary haemorrhage following a standardised exercise test

Atrial fibrillation as a risk factor for exercise-induced pulmonary haemorrhage following a standardised exercise test

Atrial fibrillation (AF) has been proposed as a risk factor for exercise-induced pulmonary haemorrhage (EIPH) due to increased pressure in the left atrium. To evaluate if AF was associated with EIPH following a standardised exercise test (SET) to fatigue. Two-arm controlled experiment. Ten untrained...

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Bibliographic Details
Published in:Equine veterinary journal Vol. 56; no. 3; pp. 552 - 561
Main Authors: Hansen, Sanni, Otten, Nina D, Nissen, Sarah D, Carstensen, Helena, Hopster-Iversen, Charlotte, Fjeldborg, Julie, Staun, Sophie H, Fenner, Merle, Hesselkilde, Eva M, Buhl, Rikke
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01-05-2024
Subjects:
Cardiac arrhythmia
Fitness equipment
Horses
horse
performance
equine asthma
bronchoalveolar lavage
arrhythmia
epistaxis
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Summary:Atrial fibrillation (AF) has been proposed as a risk factor for exercise-induced pulmonary haemorrhage (EIPH) due to increased pressure in the left atrium. To evaluate if AF was associated with EIPH following a standardised exercise test (SET) to fatigue. Two-arm controlled experiment. Ten untrained Standardbred mares mean (standard deviation [SD]) age 6 (2) years performed a SET on the treadmill in sinus rhythm (SR) (SET1) and 25-44 days after induction of self-sustained AF (SET2). AF was induced by tachypacing using a pacing device. Endoscopy, including tracheal wash and bronchoalveolar lavage (BAL), was performed 48-72 h before and 24 h after the two SETs. In addition, endoscopic grading of tracheal blood was performed 2 h after each SET. After SET1, none of the horses showed blood in the trachea, and two horses showed erythrophagocytosis. Following SET2, two horses had grade 1 blood in the trachea and free erythrocytes and erythrophagocytosis in the BAL, while another two horses had erythrophagocytosis in the BAL. In SET2, the overall performance on the treadmill was decreased with a lower maximum velocity (SET1 10.3 ± 0.8 m/s vs. SET2 8.9 ± 0.9 m/s, p = 0.004), a higher heart rate (284 ± 21 vs. 221 ± 18 bpm, p = 0.003) and more abnormal QRS complexes (p < 0.001) compared with SET1. Two horses showed signs of EIPH, resulting in visible blood in the trachea, when exercising in AF compared with SR. However, a possible link between EIPH, pulmonary pressure and AF needs to be further elucidated.
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ISSN:0425-1644
2042-3306
DOI:10.1111/evj.13995