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Institut für Veterinärpathologie

Pathophysiologie des Herzens

Cardiac Pathophysiology

The Veterinary Cardiac Pathophysiology Consortium (VCPC) is an interdisciplinary group of veterinarians at the Universities of Zurich (Switzerland), Guelph (Canada), Helsinki (Finland), Naples (Italy) and Valencia (Spain). The group consists of clinical cardiologists and pathologists that combine their complementary expertise to gain further insight into the pathophysiology of cardiac diseases in animals.

Current research projects focus on acquired cardiac diseases in dogs and cats and the influence of systemic diseases on the heart. We also have an interest in the effect of sex and age on the constitutive expression of inflammatory and remodelling mediators as a basis for the reactive status of the myocardium and its resultant response to systemic influences. Most recently we also developed an interest in the myocardial vasculature during the remodelling processes.  

Common acquired cardiac diseases in dogs are degenerative valvular disease and dilated cardiomyopathy (DCM), cats frequently present with hypertrophic cardiomyopathy (HCM). All these diseases are of adult onset, a genetic aetiology with incomplete penetrance is suspected, and mutations have been identified for some dog and cat breeds. Similar to human medicine, these mutations affect sarcomere function and energy metabolism. However, the pathogenesis of the diseases is not yet completely understood. The association between mutation, the observed functional defects and the development of microscopic changes characteristic for the diseases and the factors involved in disease development, presentation and progression is so far unknown.

Furthermore, the role of sex, and the influence of systemic diseases, such as kidney diseases, diabetes mellitus, systemic hypertension, and obesity, known comorbidities in human cardiology, and common in the aging pet population, on cardiac function and disease has not been studied in the veterinary patient population.

Combining clinical and pathological aspects of cardiac and systemic diseases allows a diversified approach to investigate the relevance of clinical findings for the progression of cardiac diseases and the influence of systemic diseases on cardiac structure and function.

Current research projects include:

  • Studies on the pathogenesis of canine DCM and feline HCM,
  • Cardiac inflammation and extracellular matrix remodelling in dogs and cats with cardiac and systemic diseases,
  • The role of adhesion molecules in canine and feline cardiac diseases,
  • The relevance of heart fatty acid binding protein (HFABP) as potential marker for canine DCM and degenerative valvular disease,
  • Age- and sex-related structural and functional myocardial variations in cats,
  • Functional and structural changes in the myocardium and cardiac biomarkers in systemic inflammatory conditions, infectious diseases such as Leishmania infantum and viral infections,
  • The role of adipokines (i.e. leptin) in canine and feline cardiac disease;
  • The expression of miRNA in feline HCM.

The VCPC group leaders are:

Sonja Fonfara, Dr med vet, PhD, PGCertHE, FHEA, MRCVS, CertVC, DECVIM-CA (Cardiology), a cardiologist with strong interest in age and disease associated myocardial changes and how these translate into clinical practice. Sonja Fonfara is Associate Professor at the University of Guelph where she is a member of the Centre for Cardiovascular Investigations (CCVI, and collaborates with other members of the CCVI (Drs. John Dawson, Shari Raheb), the Department of Pathobiology (Dr. Jeff Caswell) and Bioinformatics (Drs Aeysha Ali, Andreas Heyland).

Anja Kipar, Prof. Dr. med. vet., DiplECVP, FRCPath, FVH & FTA (Pathologie), a veterinary pathologist with a strong interest in the immunopathological effect of infectious and non-infectious diseases on the myocardium, while Udo Hetzel, Dr.rer.nat., FTA (Pathologie), an expert ultrastructural pathologist with a strong interest also in the embryology and congenital alterations of the heart. The team in Zurich works mainly on the pathomorphological aspects of companion animal cardiac diseases and currently focusses on the pathomechanisms underlying feline HCM.

Tony Glaus, Prof. Dr. med. vet., DACVIM (saim), DECVIM-CA (internal medicine and cardiology), Head of the Cardiology Division at the Vetsuisse Faculty Zurich ( He has his research focus on canine pulmonary hypertension and pharmacological treatment of myxomatous mitral valve disease. A recent interest is canine endomyocardial fibroelastosis and its aetiology, and feline transient myocardial thickening. His colleague Marco Baron Toaldo, DVM, PhD, DECVIM-CA (cardiology) is a cardiologist is interested in clinical research in small animals focusing on imaging modalities, like echocardiography, advanced software-based imaging analysis, and cardiac MRI. Other areas of interest are prognostic factors for cardiac diseases, treatment strategies, and feline arrhythmology.

Docent Maria Wiberg, PhD, a specialist in small animal cardiology and internal medicine in Helsinki. Her group works on the development of clinical markers for DCM of Doberman Pinschers and Salukis and investigates the pathophysiological mechanisms of the disease in these breeds. She further studies breed variations of stress and neuroendocrine factors and their potential involvement in cardiac disease development and progression. 

Orlando Paciello, PhD, Ms Infectious Diseases, Full Professor of Autopsy and Diagnostic Techniques at the University of Naples Federico II (Italy), is an expert in muscle pathology in animals and human and is currently working on the pathogenesis of idiopathic inflammatory myopathies and cardiomyopathies in animals also as models for the human diseases. He has joined the VCPC to investigate the involvement of the myocardium in FIV myopathy.

Domingo Casamian Sorrosal, DVM, CertSAM, DECVIM-CA, DVC MRCVS is a double diplomate and specialist in Cardiology and Internal Medicine and the Head of Cardiology, Respiratory Medicine and Interventional Cardiology at the Catholic University of Valencia (UCV; Spain). One of Domingo´s recent main work and interests within the group involve the study of the cardiovascular effects of the protozoal parasite Leishmania infantum.

The group is complemented by seven postgraduate students, Josep Monné Rodríguez and Nora Schreiber in Zurich, Jessica Joshua, Michelle Colpitts, Ananda Pires and Andrew Chong in Guelph, and Francesco Prisco in Naples. In Zurich and Guelph, the VCPC also offers Master projects for veterinary under- and postgraduate students with an interest in cardiac pathology.

Our research has received financial support from the Natural Sciences and Engineering Council of Canada (NSERC), Pet Trust at the University of Guelph and the Center for Applied Biotechnology and Molecular Medicine (CABMM) at the University of Zurich. Francesco Prisco held an exchange student grant within the framework of the Swiss-European Mobility Programme from the University of Zurich for a research stay at the IVPZ

Relevant recent publications

Baron Toaldo M, Mazzoldi C, Romito G, Poser H, Contiero B, Cipone M, Guglielmini C, 2020. Echocardiographic predictors of first onset of atrial fibrillation in dogs with myxomatous mitral valve disease. J Vet Intern Med. Aug 7;34(5):1787-93. doi: 10.1111/jvim.15860. Online ahead of print.

Prisco F, Papparella S, Paciello O, 2020. Correlation between cardiac and skeletal muscle pathology in animal models of idiopathic inflammatory myopathies Acta Myol 39 (4): 000-000 eCollection 2020 Dec.

Baron Toaldo M, Pollesel M, Diana A, 2020. Effect of pimobendan on left atrial function: an echocardiographic pilot study in 11 healthy cats. J Vet Cardiol 28, 37-47.

Borgarelli M, Ferasin L, Lamb K, Bussadori C, Chiavegato D, D'Agnolo G, Migliorini F, Poggi M, Santilli RA, Guillot E, Garelli-Paar C, Toschi Corneliani R, Farina F, Zani A, Dirven M, Smets P, Guglielmini C, Oliveira P, Di Marcello M, Porciello F, Crosara S, Ciaramella P, Piantedosi D, Smith S, Vannini S, Dall'Aglio E, Savarino P, Quintavalla C, Patteson M, Silva J, Locatelli C, Baron Toaldo M, 2020. Delay of appearance of symptoms of canine degenerative mitral valve disease treated with Spironolactone and Benazepril: the DELAY Study. J Vet Cardiol 27, 34-53.

Gasparini S, Fonfara S, Kitz S, Hetzel U, Kipar A, 2020. Canine dilated cardiomyopathy: diffuse remodeling, focal lesions and the involvement of macrophages and new vessel formation. Vet Pathol 57(3), 397-408.

Wiberg M, Niskanen JE, Hytönen M, Dillard K, Hagner K, Anttila M, Lohi H, 2020. Ventricular arrhythmia and sudden cardiac death in young LeonbergersJ Vet Cardiol. 2020 Feb;27:10-22. doi: 10.1016/j.jvc.2019.11.006.

Malbon A, Fonfara S, Meli ML, Hahn S, Egberink E, Kipar A, 2019. Feline infectious peritonitis as a systemic inflammatory disease: contribution of liver and heart to the pathogenesis. Viruses 11(12): 1144; doi:10.3390/v11121144.

Lahdenoja O, Hurnanen T, Kaisti M, Koskinen J, Tuominen J, Vähä-Heikkilä M, Parikka L, Wiberg M, Koivisto T, Pänkäälä M, 2019. Cardiac monitoring of dogs via smartphone mechanocardiography: a feasibility study. Biomed Eng Online. 2019 Apr 23;18(1):47. doi: 10.1186/s12938-019-0667-9.

Kitz S, Fonfara S, Hahn S, Hetzel U, Kipar A, 2019. Feline hypertrophic cardiomyopathy, the consequence of cardiomyocyte initiated and macrophage driven remodeling processes? Vet Pathol 56(4), 565-575.

Giraut S, Häggström J, Koskinen LLE, Lohi H, Wiberg M, 2019. Breed-specific reference ranges for standard echocardiographic measurements in salukis. J Small Anim Pract 60(6), 374-378.

Lam C, Casamian-Sorrosal D, Monteith G, Fonfara S, 2019. Heart-fatty acid binding protein in dog with degenerative valvular disease and dilated cardiomyopathy. Vet J 244, 16-22.

Novo Matos J, Pereira N, Glaus T, Wilkie L, Borgeat K, Loureiro J, Silva J, Law V, Kranjc A, Connolly DJ, Luis Fuentes V, 2018. Transient Myocardial Thickening in Cats Associated with Heart Failure. J Vet Intern Med 32(1), 48-56.

Watson N, Murray JK, Fonfara S, Hibbert A, 2018. Clinicopathological features and comorbidities of cats with mild, moderate or severe hyperthyroidism: a radioiodine referral population. J Fel Med Sur 20(12), 1130-1137.

Romito G, Guglielmini C, Mazzarella MO, Cipone M, Diana A, Contiero B, Baron Toaldo M, 2018. Diagnostic and prognostic utility of surface electrocardiography in cats with left ventricular hypertrophy. J Vet Cardiol 20(5), 364-375.

Baron Toaldo M, Romito G, Guglielmini C, Diana A, Pelle NG, Contiero B, Cipone M, 2018. Prognostic value of echocardiographic indices of left atrial morphology and function in dogs with myxomatous mitral valve disease. J Vet Intern Med 32(3), 914-921.

Fonfara S, Kitz S, Hetzel U, Kipar A, 2017. Myocardial leptin transcription in feline hypertrophic cardiomyopathy. Res Vet Sci 112, 105-108.

Pereira NJ, Novo Matos J, Baron Toaldo M, Bartoszuk U, Summerfield N, Riederer A, Reusch C, Glaus TM, 2017. Cats with diabetes mellitus have diastolic dysfunction in the absence of structural heart disease. Vet J 225, 50-55.

Costagliola A, Piegari G, Otrocka-Domagala I, Ciccarelli D, Iovane V, Oliva G, Russo V, Rinaldi L, Papparella S, Paciello O, 2016. Immunopathological features of canine myocarditis associated with Leishmania infantum infection. Biomed Res Int 2016:8016186.

Fonfara, S., Hetzel, U, Hahn, S., Kipar A, 2015. Age- and gender-dependent myocardial transcription patterns of cytokines and extracellular matrix remodelling enzymes in cats with non-cardiac diseases. Exp Gerontol 72, 117-123.

Schiattarella GG, Cerulo G, De Pasquale V, Cocchiaro P, Paciello O, Avallone L, Belfiore MP, Iacobellis F, Di Napoli D, Magliulo F, Perrino C, Trimarco B, Esposito G, Di Natale P, Pavone LM, 2015. The murine model of mucopolysaccharidosis IIIB develops cardiopathies over time leading to heart failure. PLoS One 10(7):e0131662.

Fonfara, S., Hetzel, U, Oyama, MA., Kipar A, 2014. The potential role of myocardial 2B receptor expression in canine dilated cardiomyopathy. Vet J 199, 406-412.

Linney CJ, Dukes-McEwan J, Stephenson HM, López-Alvarez J, Fonfara S, 2014. Left atrial size, atrial function and left ventricular diastolic function in cats with hypertrophic cardiomyopathy. J Sm Anim Pract 55(4), 198-206.

Casamian-Sorrosal D, Chong SK, Fonfara S, Helps C, 2014. Prevalence and demographics of the MYBPC3 mutations in Ragdoll and Maine Coons in the British Isles. J Sm Anim Pract 55(5), 269-273.