International collaborative study to assess cardiovascular risk and evaluate long‐term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study
Authors: Fox Philip R. , Keene Bruce W. , Lamb Kenneth , Schober Karsten A. , Chetboul Valerie , Luis Fuentes Virginia , Wess Gerhard , Payne Jessie Rose , Hogan Daniel F. , Motsinger‐Reif Alison , Häggström Jens , Trehiou‐Sechi Emilie , Fine‐Ferreira Deborah M. , Nakamura Reid K. , Lee Pamela M. , Singh Manreet K. , Ware Wendy A. , Abbott Jonathan A. , Culshaw Geoffrey , Riesen Sabine , Borgarelli Michele , Lesser Michael B. , Van Israël Nicole , Côté Etienne , Rush John E. , Bulmer Barret , Santilli Roberto A. , Vollmar Andrea C. , Bossbaly Maribeth J. , Quick Nadine , Bussadori Claudio , Bright Janice M. , Estrada Amara H. , Ohad Dan G. , Fernández‐Del Palacio Maria Josefa , Lunney Brayley Jenifer , Schwartz Denise S. , Bové Christina M. , Gordon Sonya G. , Jung Seung Woo , Brambilla Paola , Moïse N. Sydney , Stauthammer Christopher D. , Stepien Rebecca L. , Quintavalla Cecilia , Amberger Christophe , Manczur Ferenc , Hung Yong‐Wei , Lobetti Remo , De Swarte Marie , Tamborini Alice , Mooney Carmel T. , Oyama Mark A. , Komolov Andrey , Fujii Yoko , Pariaut Romain , Uechi Masami , Tachika Ohara Victoria Yukie 
Published: April 2018

Background

Hypertrophic cardiomyopathy is the most prevalent heart disorder in cats and principal cause of cardiovascular morbidity and mortality. Yet, the impact of preclinical disease is unresolved.

Hypothesis/Objectives

Observational study to characterize cardiovascular morbidity and survival in cats with preclinical nonobstructive (HCM) and obstructive (HOCM) hypertrophic cardiomyopathy and in apparently healthy cats (AH).

Animals

One thousand seven hundred and thirty client‐owned cats (430 preclinical HCM; 578 preclinical HOCM; 722 AH).

Methods

Retrospective multicenter, longitudinal, cohort study. Cats from 21 countries were followed through medical record review and owner or referring veterinarian interviews. Data were analyzed to compare long‐term outcomes, incidence, and risk for congestive heart failure (CHF), arterial thromboembolism (ATE), and cardiovascular death.

Results

During the study period, CHF, ATE, or both occurred in 30.5% and cardiovascular death in 27.9% of 1008 HCM/HOCM cats. Risk assessed at 1, 5, and 10 years after study entry was 7.0%/3.5%, 19.9%/9.7%, and 23.9%/11.3% for CHF/ATE, and 6.7%, 22.8%, and 28.3% for cardiovascular death, respectively. There were no statistically significant differences between HOCM compared with HCM for cardiovascular morbidity or mortality, time from diagnosis to development of morbidity, or cardiovascular survival. Cats that developed cardiovascular morbidity had short survival (mean ± standard deviation, 1.3 ± 1.7 years). Overall, prolonged longevity was recorded in a minority of preclinical HCM/HOCM cats with 10% reaching 9‐15 years.

Conclusions and Clinical Importance

Preclinical HCM/HOCM is a global health problem of cats that carries substantial risk for CHF, ATE, and cardiovascular death. This finding underscores the need to identify therapies and monitoring strategies that decrease morbidity and mortality.