Going Foward with Heart Testing: The Lifetime Cardiac Study II and the OFA's New Cardiac Database

The IWF study comparing Echocardiographic and Electrocardiographic Screening Methods (Echo/EKG Study) was complete with the clinic at the IWCA National Specialty. Almost simultaneously the OFA announced a new “Advanced Cardiac Database” and there were some changes to the LCSII forms. Those who had their dogs tested at the National Specialty met with the new forms and procedures. Some of you might also have noted that we were a little less organized than usual, if that is possible. Fortunately, Dr. Steven Rosenberg was there to help Drs. Tyrrell and Dentino deal with the new processes. Bill’s daughter Ella helped us prepare the OFA forms (in triplicate) in time for the clinic. We tested about 89 dogs in two days and the data is still in the works.

Changes to the LCSII questionnaire included a short survey on nutrition provided by Dr. Lisa Freeman of Tufts University. Dr. Freeman is a noted expert in canine nutrition and is interested in the relationship of diet to cardiac disease. She is a friend of Dr. Tyrrell’s. One more change is coming to the LCSII form. The only question in the Echocardiographic Study form that was not in the LCSII form was a list of medications so that is being incorporated into LCSII and future clinics will involve only two forms, LCSII and OFA Advanced Cardiac Database form.

The OFA Advanced Cardiac Database (ACA) represents several improvements in record keeping and is more appropriate for the types of cardiac disease seen with Irish Wolfhounds, and many other breeds. First, the implementation of the three part form (similar to eye testing) means all dogs tested will be recorded in the statistical database and provides much more detail for collecting data on breed specific measurements. The measurements are similar to what the IWF had collected under the Echo/EKG study. The owner still has control over submission to the open database. A dog can be cleared for congenital defects and for adult onset cardiac disease, a clearance that is good for one year. There is also a class for equivocal findings.

The ACA also records EKG, echo and holter data if those measurements are made. All examinations, however, need to be done by a ACVIM board certified cardiologist. This is where a couple of changes will probably have to be made to the IWF process for LCSII. The cost of having a cardiologist do an EKG and auscultation will increase the price the IWF charges for EKGs (when a cardiologist is present). This allows us to store the data in both the OFFA research database and the IWF LCSII database that is linked to the IWF DNA collection. The IWF was planning on doing EKGs and sending them to a cardiologist for reading for the LCSII. Finally, since the OFA forms will no longer be available on the internet (the three part forms are sent only to cardiologists) we will be asking for some additional information so that we can have someone fill out the forms for Dr. Tyrrell. Fortunately this same information allows me to fill out the basic dog and owner information on the LCSII forms. This should save everyone time. Forms for preregistered dogs will be brought to the clinic so the owner can check the information, fill out the health information and take them into the clinic for the cardiologist to complete. LCSII data is entered into a database by an independent contractor for use by our researchers.

Since there is no longer any IWF study requiring echo data on healthy, young dogs, the IWF will no longer be subsidizing the cost of such echoes. Owners can still get an echo on a healthy 2-7 year old if they wish, at the IWF cost of $200/dog. The IWF will continue to subsidize dogs over 8 and dogs with atrial fibrillation or previously diagnosed heart disease. We are asking that owners contribute $120 towards echoes for those dogs. We need more data on affected dogs and how heart disease progresses and we also feel these dogs need more detailed follow up. A study in that area is being designed and will be announced shortly.

Mary and I are also making some changes to the on-line signup form so that I will not have to send quite as many e-mails asking for additional information on your dog. We are trying to avoid having to attach forms. For you who managed the filling out and attaching of forms, thanks! You have no idea how much time it saves, and how many errors are avoided. This process should make it even easier.

Finally, in cooperation with the IWCA, we have changed the CHIC requirements to bring them in line with some of the recommendations from the Echo/EKG study for cardiac testing. Hounds will need to be tested annually but, for most dogs, that will be an EKG and auscultation only. Dogs need to be 24 months old. Echoes may still be required to clear up equivocal findings on auscultation. It is important to remember that CHIC stands for Canine Health Information Center and the information in that database is only a part of the information a breeder needs to make decisions. Most of our breed will eventually go into atrial fibrillation and we cannot afford to eliminate all of these dogs from our gene pool.

The data from the original Lifetime Cardiac Study is still providing new insights but the only reason is because dedicated owners took the time to get their dogs tested and to fill out questionnaires, year after year, even on the dogs that were no longer going to shows.

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