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Next steps in monitoring heart disease in great apes

Satu, a 17-year-old male Bornean orangutan at Zoo Atlanta, has received an Implantable Loop Recorder (ILR) as part of a cutting-edge new chapter in the capabilities of the Great Ape Heart Project headquartered at Zoo Atlanta. This technology will help experts better understand the causes of cardiac disease, which is a leading cause of mortality among great apes in zoological care.

Satu, who has a family history of heart disease, presented with an irregular heartbeat during an awake echocardiogram, one of many procedures for which he is trained to participate in voluntarily. To facilitate ongoing monitoring of any changes in his heart rhythm, he was implanted with an ILR on July 19, 2021. The implant team consisted of Ilana Kutinsky, D.O., a human cardiologist from Beaumont Michigan Heart Rhythm Group, and the Zoo Atlanta Veterinary Team. In her years collaborating with the Great Ape Heart Project, Dr. Kutinsky has assisted in implanting ILRs in gorillas, chimpanzees, and an orangutan at other zoological facilities. Satu is the first great ape at Zoo Atlanta to receive the device and was implanted with a Medtronic Reveal LINQ Miniature Cardiac Monitor – the same device used in monitoring heart rhythm in humans.

“The Great Ape Heart Project was formed to address a specific need in the zoological community. It has since become an effort on a multi-institutional scope that is able to use advanced technology to continue to collect data that has been previously unavailable. This data can help to save lives,” said Hayley Murphy, DVM, Deputy Director at Zoo Atlanta and the Director of the Great Ape Heart Project. “This is just the beginning of what the project is capable of, with a goal of improving the health of all great apes in human care.”

Launched in 2010, the Great Ape Heart Project is the world’s first coordinated clinical approach targeting cardiovascular disease in all four non-human great ape taxa – gorillas, orangutans, chimpanzees, and bonobos – living in zoological environments. The disease is a primary cause of mortality among great apes in zoos but, until recently, had been a poorly understood area of zoological veterinary care. Its examination requires advanced understanding of diagnosis, treatment, and monitoring of affected individuals, as well as adaptation of techniques already in use in humans and domestic animals.

A 2020 winner of the prestigious Research Award with Top Honors from the Association of Zoos and Aquariums (AZA), the Great Ape Heart Project is a four-time recipient of the distinguished National Leadership Grant, including a 2019 award from the Institute of Museum and Library Services (IMLS). Over the past decade, the project has produced and continues to populate a central ape heart-health database that includes more than 90% of the individual great apes in AZA institutions, as well as 10 peer-reviewed articles and book chapters. The Great Ape Heart Project research and database are managed by Zoo Atlanta’s Marietta Danforth, PhD, and primary grant collaborators include Karen Terio, DVM, PhD, DACVP of the College of Veterinary Medicine at University of Illinois at Urbana-Champaign and Rita McManamon, DVM of the College of Veterinary Medicine at University of Georgia.

Information from the project database aids in real-time consultation on individual great ape cases, providing a vital service that benefits zoos throughout AZA and internationally. As such, the project has become a model for subsequent multi-institutional networks to address health needs in zoological settings.

All four great ape taxa are endangered or critically endangered in the wild. Great apes are a longtime area of excellence for Zoo Atlanta, which is home to some of North America’s largest populations of gorillas and orangutans. In 2009, Zoo Atlanta became the first zoological organization in the world to obtain voluntary blood pressure readings from a gorilla. Voluntary procedures such as blood pressure checks and cardiac ultrasounds reduce the frequency of anesthetic events while providing cardiovascular data that is not influenced by anesthetic drugs, thus providing more frequent opportunities to diagnose and monitor heart health of the great apes in human care.

Learn more about the Great Ape Heart Project here on


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