Romito G, Darida S, Valente C, Poser H, Contiero B, Cipone M, Guglielmini C. Prevalence and prognostic role of L wave and selected clinical and echocardiographic variables in dogs with atrial fibrillation.
Vet Med (Auckl) 2022;
37:47-57. [PMID:
36480559 PMCID:
PMC9889615 DOI:
10.1111/jvim.16584]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND
Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited.
HYPOTHESIS/OBJECTIVES
To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF.
ANIMALS
Fifty-five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy.
METHODS
Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all-cause mortality using Cox proportional hazards regression models.
RESULTS
L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI] = 47%-72%) but their presence did not influence outcome. Increased left ventricular end-systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR] = 4.41, 95% CI = 1.18-16.54; P = .03) and all-cause mortality (HR = 9.39, 95% CI = 2.49-35.32; P < .001). Heart rate assessed during echocardiography (Echo-HR) represented an additional significant predictor of cardiac death (HR = 1.01, 95% CI = 1.00-1.01; P = .04) and all-cause mortality (HR = 1.01, 95% CI = 1.00-1.01; P = .04).
CONCLUSIONS AND CLINICAL IMPORTANCE
L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo-HR represented independent predictors of negative outcome in these animals.
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