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Jeong Y, Kim B, Kim SS, Lee K, Yoon H. Changes in echocardiographic indices and left ventricular strain values by two-dimensional speckle-tracking echocardiography following pre-anesthetic oral pimobendan administration compared with intravenous pimobendan in dogs. Front Vet Sci 2024; 11:1394896. [PMID: 38895712 PMCID: PMC11184225 DOI: 10.3389/fvets.2024.1394896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction The effects of pre-anesthetic single-dose oral pimobendan during inhalational anesthesia, including the comparison with the effects of single intravenous pimobendan under anesthesia, remain unexplored. Therefore, this study aimed to determine changes in hemodynamic and echocardiographic parameters induced by pre-anesthetic administration of oral pimobendan under isoflurane general anesthesia and to compare them with those induced by intravenous pimobendan. Methods Thirteen clinically normal dogs (4 laboratory and 9 client-owned dogs) with no clinical signs and not on any medical treatment were included. Anesthesia was performed three times: no pimobendan (Control), oral pimobendan (PIMO PO, 0.3 mg/kg), and intravenous pimobendan (PIMO IV, 0.15 mg/kg). Echocardiographic and hemodynamic parameters were monitored at 30-min intervals in all groups. Results Compared to the Control group, end-systolic volume index (ESVI) and normalized left ventricular internal diameter at end-systole (LVIDSN) were significantly lower, and fractional shortening (FS) and ejection fraction (EF) were significantly higher in the PIMO PO and IV groups (p < 0.001). Global radial strain (GRS) was significantly higher in the PIMO PO and IV groups (p = 0.015). Conclusion Under general anesthesia, oral pimobendan preserved LV systolic and myocardial function in a manner comparable to intravenous pimobendan. Pre-anesthetic administration of oral pimobendan can be used to compensate for cardiac systolic function in dogs who require therapeutic and diagnostic procedures under general anesthesia with potential risk of circulatory failure.
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Affiliation(s)
- Yijin Jeong
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
- VIP Animal Medical Center, Seoul, Republic of Korea
| | - Bumseok Kim
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Sung-Soo Kim
- VIP Animal Medical Center, Seoul, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
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McManamey AK, DeFrancesco TC, Meurs KM, Papich MG. Pharmacokinetics of pimobendan after oral administration to dogs with myxomatous mitral valve disease. J Vet Intern Med 2023; 37:2003-2010. [PMID: 37776546 PMCID: PMC10658550 DOI: 10.1111/jvim.16891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Pimobendan is an important therapy for dogs with myxomatous mitral valve disease (MMVD). The pharmacokinetics are reported in healthy dogs but not in dogs with heart disease. HYPOTHESIS/OBJECTIVES To determine if dog characteristics such as age, breed, body condition score, ACVIM stage of heart disease or biochemical laboratory value alter the pharmacokinetics of orally administered pimobendan and its metabolite in a cohort of dogs with naturally occurring MMVD. ANIMALS Fifty-seven client-owned dogs with MMVD ACVIM Stage B2, C, or D and administered pimobendan to steady state blood concentrations. METHODS Prospective, observational study. Samples were collected using a sparse-sampling protocol at specific intervals after administration of pimobendan. Plasma pimobendan and the active metabolite (O-desmethyl-pimobendan, ODMP) concentrations were determined via high-pressure liquid chromatography and fluorescence detection. Data was analyzed via a population pharmacokinetic approach and nonlinear mixed effects modeling (NLME). Numerous covariates were examined in the NLME model. RESULTS The absorption and elimination half-lives (t1/2 ) were approximately 1.4 and 1 hour for pimobendan and 1.4 and 1.3 hours for ODMP, respectively. Pharmacokinetic parameters were highly variable, especially the values for pimobendan absorption and elimination rate, and absorption rate of ODMP with coefficients of variation of 147.84%, 64.51% and 64.49%, respectively. No covariate evaluated was a significant source of variability. CONCLUSIONS AND CLINICAL IMPORTANCE The pharmacokinetic parameters were highly variable among this group of dogs with MMVD. The variability was not associated with the dog's age, body weight or condition score, stage of heart disease, dose, serum creatinine, or alkaline phosphatase.
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Affiliation(s)
- Anna K. McManamey
- Department of Veterinary Clinical SciencesPurdue University College of Veterinary MedicineWest LafayetteIndianaUSA
| | - Teresa C. DeFrancesco
- Department of Clinical SciencesNorth Carolina State University, College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Kathryn M. Meurs
- Department of Clinical SciencesNorth Carolina State University, College of Veterinary MedicineRaleighNorth CarolinaUSA
| | - Mark G. Papich
- Department of Molecular Biomedical SciencesNorth Carolina State University, College of Veterinary MedicineRaleighNorth CarolinaUSA
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Takahashi A, Takeuchi S, Chen A, Uechi M. A survey on dogs with valvular disease flying to Japan for operation. Sci Rep 2023; 13:4675. [PMID: 36973265 PMCID: PMC10043261 DOI: 10.1038/s41598-023-29476-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/06/2023] [Indexed: 03/29/2023] Open
Abstract
In small-breed dogs, myxomatous mitral valve disease (MMVD) is a common disease which may lead to chronic heart failure. Mitral valve repair is an optimal surgical treatment that is currently available in limited veterinary facilities globally because it requires a special surgery team and specific devices. Therefore, some dogs must travel overseas to undergo this surgery. However, a question arises regarding the safety of dogs when traveling by air with a heart disease. We aimed to evaluate the effect of flight journey on dogs with mitral valve disease, including survival rates, symptoms during the trip, laboratory test results, and operational outcomes. All dogs stayed near the owner in the cabin during the flight. The survival rate after the flight was 97.5% in 80 dogs. The surgical survival rates (96.0% and 94.3%) and hospitalization periods (7 days and 7 days) were similar between overseas and domestic dogs. This report shows that taking air flights in the cabin may not have a significant effect on dogs with MMVD, on the premise that their overall conditions are stable under cardiac medication.
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Affiliation(s)
- Arane Takahashi
- JASMINE Veterinary Cardiovascular Medical Center, 1-8-37 Nakagawa Tsuzuki-ku, Yokohama, Kanagawa, 224-0001, Japan
| | - Sayaka Takeuchi
- JASMINE Veterinary Cardiovascular Medical Center, 1-8-37 Nakagawa Tsuzuki-ku, Yokohama, Kanagawa, 224-0001, Japan
| | - Ayaka Chen
- JASMINE Veterinary Cardiovascular Medical Center, 1-8-37 Nakagawa Tsuzuki-ku, Yokohama, Kanagawa, 224-0001, Japan
| | - Masami Uechi
- JASMINE Veterinary Cardiovascular Medical Center, 1-8-37 Nakagawa Tsuzuki-ku, Yokohama, Kanagawa, 224-0001, Japan.
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N-terminal pro-B-type natriuretic peptide levels in normotensive and hypertensive dogs with myxomatous mitral valve disease stage B. Ir Vet J 2023; 76:3. [PMID: 36755290 PMCID: PMC9906826 DOI: 10.1186/s13620-023-00233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/29/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Systemic hypertension affects the heart, and to the best of our knowledge, no study has investigated the effects of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in dogs with myxomatous mitral valve disease (MMVD) stage B and systemic hypertension. This study aimed to investigate the blood level of NT-proBNP and assess the selected echocardiographic variables in dogs with MMVD stage B according to the presence of systemic hypertension or normal blood pressure and in dogs without MMVD. RESULTS The study group comprised 37 dogs with stage B MMVD (normotensive group, n = 30; systemic hypertension group, n = 7) and 13 dogs without MMVD. We evaluated NT-proBNP, blood pressure, complete blood count (CBC), and serum chemistry in all 50 dogs. We performed electrocardiography, radiography, and echocardiography on 44 dogs (37 dogs with MMVD and 7 dogs without MMVD). The NT-proBNP concentrations showed significant intergroup differences (p < 0.001). Normotensive dogs with MMVD stage B (median [interquartile range]: 1083.5 [574.8-1912.8] pmol/L) and hypertensive dogs with MMVD stage B (2345.0 [1812.5-2533.0] pmol/L) showed significantly higher NT-proBNP concentrations than dogs without MMVD (504 [430-774] pmol/L, p = 0.009 and p < 0.001, respectively), and dogs in the systemic hypertension group showed significantly higher NT-proBNP concentrations than those in the normotensive group (p = 0.046). Mitral valve regurgitation velocity was significantly higher in dogs in the systemic hypertension group (6.11 [6.07-6.24] m/s) than in those in the normotensive group (5.53 [5.17-5.95] m/s, p = 0.006). The left atrial to aortic root ratio (LA/Ao), E-peak velocity, and left ventricular end-diastolic internal diameter corrected for body weight (LVIDDN) were significantly lower in dogs without MMVD than in dogs with MMVD stage B. CONCLUSIONS These findings suggest that NT-proBNP concentrations are higher in dogs with MMVD stage B with systemic hypertension than in normotensive dogs with MMVD stage B. Therefore, clinicians should be aware that NT-proBNP could be elevated in the presence of systemic hypertension.
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Lee D, Yun T, Koo Y, Chae Y, Ku D, Chang D, Kang BT, Yang MP, Kim H. Change of Vertebral Left Atrial Size in Dogs with Preclinical Myxomatous Mitral Valve Disease prior to the Onset of Congestive Heart Failure. J Vet Cardiol 2022; 42:23-33. [DOI: 10.1016/j.jvc.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
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Bagardi M, Zamboni V, Locatelli C, Galizzi A, Ghilardi S, Brambilla PG. Management of Chronic Congestive Heart Failure Caused by Myxomatous Mitral Valve Disease in Dogs: A Narrative Review from 1970 to 2020. Animals (Basel) 2022; 12:ani12020209. [PMID: 35049831 PMCID: PMC8773235 DOI: 10.3390/ani12020209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Myxomatous mitral valve disease (MMVD) is the most common acquired cardiovascular disease in dogs. The progression of the disease and the increasing severity of valvular regurgitation cause a volume overload of the left heart, leading to left atrial and ventricular remodeling and congestive heart failure (CHF). The treatment of chronic CHF secondary to MMVD in dogs has not always been the same over time. In the last fifty years, the drugs utilized have considerably changed, as well as the therapeutic protocols. Some drugs have also changed their intended use. An analysis of the literature concerning the therapy of chronic heart failure in dogs affected by this widespread degenerative disease is not available; a synthesis of the published literature on this topic and a description of its current state of art are needed. To the authors’ knowledge, a review of this topic has never been published in veterinary medicine; therefore, the aim of this study is to overview the treatments of chronic CHF secondary to MMVD in dogs from 1970 to 2020 using the general framework of narrative reviews. Abstract The treatment of chronic congestive heart failure (CHF), secondary to myxomatous mitral valve disease (MMVD) in dogs, has considerably changed in the last fifty years. An analysis of the literature concerning the therapy of chronic CHF in dogs affected by MMVD is not available, and it is needed. Narrative reviews (NRs) are aimed at identifying and summarizing what has been previously published, avoiding duplications, and seeking new study areas that have not yet been addressed. The most accessible open-access databases, PubMed, Embase, and Google Scholar, were chosen, and the searching time frame was set in five decades, from 1970 to 2020. The 384 selected studies were classified into categories depending on the aim of the study, the population target, the pathogenesis of MMVD (natural/induced), and the resulting CHF. Over the years, the types of studies have increased considerably in veterinary medicine. In particular, there have been 43 (24.29%) clinical trials, 41 (23.16%) randomized controlled trials, 10 (5.65%) cross-over trials, 40 (22.60%) reviews, 5 (2.82%) comparative studies, 17 (9.60%) case-control studies, 2 (1.13%) cohort studies, 2 (1.13%) experimental studies, 2 (1.13%) questionnaires, 6 (3.40%) case-reports, 7 (3.95%) retrospective studies, and 2 (1.13%) guidelines. The experimental studies on dogs with an induced form of the disease were less numerous (49–27.68%) than the studies on dogs affected by spontaneous MMVD (128–72.32%). The therapy of chronic CHF in dogs has considerably changed in the last fifty years: in the last century, some of the currently prescribed drugs did not exist yet, while others had different indications.
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TRPV1 Receptor Identification in Bovine and Canine Mitral Valvular Interstitial Cells. Vet Sci 2021; 8:vetsci8090183. [PMID: 34564577 PMCID: PMC8473199 DOI: 10.3390/vetsci8090183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/19/2022] Open
Abstract
Myxomatous mitral valve degeneration (MMVD) is the most common acquired cardiac disease in canine species, and valvular interstitial cells (VICs) are considered the main responsible for the development of this pathology. The scientific interest is focused on isolating and characterizing these cells. The aims of the present study were to verify a novel VICs mechanical isolation method and to characterize isolated cells using immunocytochemistry and immunofluorescence, with parallel histological and immunohistochemistry assays on bovine and canine healthy and MMVD mitral valves. Antibodies against vimentin (VIM), smooth muscle actin (SMA), von Willebrand (vW) factor, Transforming Growth Factor (TGF) β1, and Transient Receptor Potential Vanilloid 1 (TRPV1) were used. The isolation method was considered reliable and able to isolate only VICs. The different assays demonstrated a different expression of SMA in healthy and MMVD mitral valves, and TRPV1 was isolated for the first time from bovine and canine VICs and the correspondent mitral valve leaflets. The novelties of the present study are the new isolation method, that may allow correlations between laboratory and clinical conditions, and the identification of TRPV1, which will lead to further investigations to understand its function and possible role in the etiology of MMVD and to the design of new therapeutic strategies.
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Kuleš J, Bilić P, Horvatić A, Kovačević A, Guillemin N, Ljubić BB, Galan A, Jović I, Torti M, Rubić I, Eckersall PD, Mrljak V. Serum proteome profiling in canine chronic valve disease using a TMT-based quantitative proteomics approach. J Proteomics 2020; 223:103825. [PMID: 32422277 DOI: 10.1016/j.jprot.2020.103825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Chronic valve disease (CVD) is the most common clinically significant heart disease of dogs, affecting 20 to 40% of dogs. The aim of this study was to evaluate the serum protein profile of healthy and CVD affected dogs, by means of an isobaric tandem mass tag (TMT) label-based high-resolution quantitative proteomic approach. Additionally, conventional cardiac biomarkers were measured in the serum, functional bioinformatics analysis was employed for elucidating molecular mechanisms and pathways associated with CVD, and validation of proteomic results was performed by immunoassays and Western blotting. Of 290 identified and quantified proteins, 15 proteins showed significantly different abundances (p < .05), including antithrombin-III, alpha-2-antiplasmin, tetranectin, apolipoprotein M, adiponectin, inter-alpha-trypsin inhibitor heavy chain H1, gelsolin and apolipoprotein B-100. The identified proteins with differently abundances are involved in a number of pathways, such as complement and coagulation cascades, haemostasis, regulation of actin cytoskeleton, lipid metabolism and transport. We found comparative similarities with human disease in terms of identified proteins and GO pathways, which confirmed similar pathophysiology of this disease, but also differences, mainly in lipid metabolism. SIGNIFICANCE: There have been few investigations of canine serum proteome despite the potential for biomarker discovery and comparative disease analysis. Establishing serum proteomic signatures in healthy dogs and dogs with CVD will benefit for understanding the aetiology of disease in dogs, identify putative biomarkers and provide models of comparative human disease. Circulating biomarkers are important for understanding of the mechanisms of cardiovascular disease and high incidence of CVD in dogs prioritizes the search for novel biomarkers.
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Affiliation(s)
- Josipa Kuleš
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Petra Bilić
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Anita Horvatić
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Alan Kovačević
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Switzerland
| | - Nicolas Guillemin
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Blanka Beer Ljubić
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Asier Galan
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Ines Jović
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Marin Torti
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Ivana Rubić
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia
| | - Peter David Eckersall
- College of Veterinary, Medical and Life sciences, School of Veterinary Medicine, University of Glasgow, UK
| | - Vladimir Mrljak
- Clinic for Internal Diseases, Faculty of Veterinary Medicine, University of Zagreb, Croatia.
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Effect of temperature variation on hospital admissions and outcomes in dogs with myxomatous mitral valve disease and new onset pulmonary edema. PLoS One 2020; 15:e0227807. [PMID: 31935277 PMCID: PMC6959981 DOI: 10.1371/journal.pone.0227807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 12/31/2019] [Indexed: 01/26/2023] Open
Abstract
The effect of seasonal variation on hospital admissions and outcomes in humans with cardiovascular disease and congestive heart failure (CHF) has been described. This study evaluates the effect of temperature variation on admissions and outcomes in dogs with myxomatous mitral valve disease (MMVD) and first onset CHF. Ninety-three client-owned dogs with MMVD and a first occurrence of pulmonary edema were included in this retrospective clinical cohort study. Recorded clinical and echocardiographic variables were accumulated and analyzed with dogs allocated into groups in a temperature-wise manner that considered the mean of the average (Tave) and maximum ambient temperature (Tmax) of the 14 days preceding hospital admission. A survival analysis was also performed. No difference was found in the percentage of dogs decompensating in three different temperature periods (i.e., cold, intermediate, and hot temperature) according to both Tave and Tmax. Dogs developing CHF during the intermediate temperatures according to Tmax died earlier from cardiac-related causes (median survival time 280 days, 95% CI = 147–486 days) compared to those decompensating during hot temperatures (median survival time 518 days, 95% CI = 344–819 days, P = 0.039). However, an effect of the ambient temperature on survival was not confirmed by Cox proportional hazard analysis. In conclusion, this study failed to show that ambient temperature has an effect on the first occurrence of CHF and outcomes in dogs with MMVD.
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Kim J, Kim S, Lee Y, Yoon H, Eom K. Contrast Echocardiography in two-dimensional left ventricular measurements: comparison with 256-row multi-detector computed tomography as a reference standard in Beagles. J Vet Sci 2020; 20:e45. [PMID: 31565888 PMCID: PMC6769328 DOI: 10.4142/jvs.2019.20.e45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/20/2019] [Accepted: 07/17/2019] [Indexed: 12/30/2022] Open
Abstract
Unenhanced echocardiography (UE), commonly used in veterinary practice, is limited by left ventricular (LV) foreshortening and observer dependency. Contrast echocardiography (CE) was used to compare two-dimensional (2D) LV measurements made using UE and 256-row multi-detector computed tomography (MDCT) as a reference standard. Seven healthy beagle dogs were evaluated in this study. Measurements obtained using CE, including LV wall thickness, internal diameter, and longitudinal and transverse length, were significantly greater than those obtained using UE. Measurements of LV internal dimension in diastole (LVIDd) and systole (LVIDs) were significantly larger with CE compared UE. Regardless of the cardiac cycle, LV longitudinal (LVLd and LVLs) and transverse diameter (LVTDd and LVTDs) measurements were significantly different with CE and approximated values from MDCT. Among automatically calculated parameters, LV end-systolic volume and the relative wall thickness were significantly different between UE and CE. In CE, the correlation coefficients of 4 major parameters (r = 0.87 in LVIDd; 0.91 in LVIDs; 0.87 in LVLd; and 0.81 in LVLs) showed higher values compared to the UE (r = 0.68 in LVIDd, 0.71 in LVIDs, 0.69 in LVLd, and 0.35 in LVLs). Inter-observer agreement was highest for MDCT and higher for CE than UE. In conclusion, CE is more accurate and reproducible than UE in assessing 2D LV measurements and can overcome the limitations of UE including LV foreshortening and high observer dependency.
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Affiliation(s)
- Jaehwan Kim
- Helix Animal Medical Center, Seoul 06546, Korea
| | - Soyoung Kim
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Yeonhea Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Kidong Eom
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.
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Li Q, Heaney A, Langenfeld-McCoy N, Boler BV, Laflamme DP. Dietary intervention reduces left atrial enlargement in dogs with early preclinical myxomatous mitral valve disease: a blinded randomized controlled study in 36 dogs. BMC Vet Res 2019; 15:425. [PMID: 31775756 PMCID: PMC6882217 DOI: 10.1186/s12917-019-2169-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/07/2019] [Indexed: 12/20/2022] Open
Abstract
Background Myxomatous mitral valve disease (MMVD), the most common naturally-occurring heart disease in dogs, is associated with alterations in energy metabolism, oxidative stress and inflammation. Energy deprivation plays a causal role in the development of heart failure. This study was designed to determine if a cardiac protection blend (CPB) of nutrients containing medium-chain triglycerides as an alternative energy source, fish oil to reduce inflammation, antioxidants, and other key nutrients important to cardiac health and function could slow or prevent MMVD progression. Nineteen dogs with early stage MMVD and 17 breed-, age-, and sex-matched healthy dogs were enrolled for a 6-month blinded, placebo-controlled study. Dogs in each cardiac health group were randomly assigned to either control diet (CON) or CPB-supplemented diet. Echocardiography was performed at baseline, 3 months and 6 months. Results No changes were found in healthy dogs. While MMVD-CON dogs had an average 10% increase over baseline in left atrial diameter (LAD) and left atrial to aortic root ratio (LA/Ao) at 6 months, MMVD-CPB dogs showed 3% decreases, resulting significant diet by time interactions (P = 0.037, P = 0.005, respectively). More MMVD-CON dogs progressed from stage B1 to B2 during the study. A positive correlation was found between 6-month changes in LAD and blood pressures in MMVD-CPB dogs (systolic: P = 0.050, diastolic: P = 0.035) but not MMVD-CON dogs. Conclusions Our results demonstrated efficacy of CPB-based dietary intervention in reducing LA size and mitral regurgitation, and in slowing or preventing the progression of early MMVD in dogs.
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Keene BW, Atkins CE, Bonagura JD, Fox PR, Häggström J, Fuentes VL, Oyama MA, Rush JE, Stepien R, Uechi M. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med 2019; 33:1127-1140. [PMID: 30974015 PMCID: PMC6524084 DOI: 10.1111/jvim.15488] [Citation(s) in RCA: 343] [Impact Index Per Article: 68.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/13/2019] [Indexed: 01/25/2023] Open
Abstract
This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.
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Affiliation(s)
- Bruce W Keene
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Clarke E Atkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - John D Bonagura
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - Philip R Fox
- The Elmer and Mamdouha Bobst Hospital, The Animal Medical Center, New York, New York
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Virginia Luis Fuentes
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Mark A Oyama
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Rebecca Stepien
- Department of Medical Sciences, University of Wisconsin, Madison, Wisconsin
| | - Masami Uechi
- Jasmine Veterinary Cardiovascular Medical Center, Yokohama, Japan
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Brüler B, Jojima F, Dittrich G, Giannico A, Sousa M. QT instability, an indicator of augmented arrhythmogenesis, increases with the progression of myxomatous mitral valve disease in dogs. J Vet Cardiol 2018; 20:254-266. [DOI: 10.1016/j.jvc.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/29/2018] [Accepted: 06/13/2018] [Indexed: 01/12/2023]
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Chapel EH, Scansen BA, Schober KE, Bonagura JD. Echocardiographic Estimates of Right Ventricular Systolic Function in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med 2017; 32:64-71. [PMID: 29224256 PMCID: PMC5787149 DOI: 10.1111/jvim.14884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/01/2017] [Accepted: 10/19/2017] [Indexed: 01/01/2023] Open
Abstract
Background Right ventricular (RV) dysfunction independently predicts outcomes in human myxomatous mitral valve disease (MMVD). There is limited information regarding RV systolic function in dogs with MMVD. Hypothesis Right ventricular systolic function differs among stages of disease, decreasing in decompensated MMVD. Animals Thirty‐sixclient‐owned dogs with MMVD not receiving oral cardiovascular medications. Methods Prospective clinical study. Dogs were categorized according to disease severity as ACVIM Stage B1, B2, or C. Seven echocardiographic indices of RV systolic function were measured. Groups were compared by 1‐way ANOVA and Tukey's HSD test. Frequencies of cases with cardiac remodeling falling outside previously established reference intervals were compared using Fisher's exact test. Intra‐ and interobserver measurement variability was calculated for each RV function index. Results The indices TAPSE (P = 0.029), RV StL (P = 0.012), and RV StRL (P = 0.041) were significantly different between groups. A greater proportion of B2 dogs (7 of 12) had TAPSE values above reference intervals compared with B1 (2 of 12) or C (2 of 12) dogs (P = 0.027). Measurement variability of TAPSE, RV S', and RV StG was clinically acceptable. Conclusions and Clinical Importance Right ventricular systolic function differs between stages of MMVD, increasing in stage B2, and declining in stage C. The prognostic importance of RV function indices, particularly TAPSE, might be worth evaluating in dogs with MMVD.
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Affiliation(s)
- E H Chapel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - B A Scansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - K E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - J D Bonagura
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
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Pirintr P, Saengklub N, Limprasutr V, Sawangkoon S, Kijtawornrat A. Sildenafil improves heart rate variability in dogs with asymptomatic myxomatous mitral valve degeneration. J Vet Med Sci 2017; 79:1480-1488. [PMID: 28717064 PMCID: PMC5627316 DOI: 10.1292/jvms.17-0016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Myxomatous mitral valve degeneration (MMVD) causes an imbalance of sympathovagal activity resulted in poor cardiac outcomes. Phosphodiesterase-5 inhibitors have been revealed cardioprotective effect in patients with heart diseases. This study aimed to 1) compare the heart rate variability (HRV) between asymptomatic MMVD and healthy dogs and 2) assess long-term effects of sildenafil and enalapril on time- and frequency-domains analyzes. Thirty-four dogs with MMVD stage B1 or B2 and thirteen healthy dogs were recruited into the study. MMVD dogs were divided into 3 subgroups: control (n=13), sildenafil (n=12) and enalapril (n=9). HRV was analyzed from 1-hr Holter recording at baseline (D0) in all dogs and at 30, 90 and 180 days after treatment. The results showed that MMVD dogs had significant higher heart rate (HR), systemic blood pressures, the ratio of low to high frequency (LF/HF) and had significant decreased standard deviation of all normal to normal RR intervals (SDNN) and the percentage of the number of normal-to-normal sinus RR intervals with differences >50 msec computed over the entire recording (pNN50) when compared with healthy dogs (P<0.05). Neither time nor frequency domain parameters were different among subgroups of MMVD dogs at D0. After treatment with sildenafil for 90 days, both time- and frequency-domain parameters were significantly increased when compared with control and enalapril groups. This study demonstrated that sildenafil improves HRV in asymptomatic MMVD dogs suggesting that sildenafil should be used in the MMVD dogs to restore the sympathovagal balance.
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Affiliation(s)
- Prapawadee Pirintr
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Road, Pathumwan, Bangkok 10330, Thailand.,Department of Veterinary Bioscience and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Mae Hia, Muang, Chiang Mai 50100, Thailand
| | - Nakkawee Saengklub
- Department of Physiology, Faculty of Pharmacy, Mahidol University, Sri Ayudhya Road, Rajathevi, Bangkok 10400, Thailand
| | - Vudhiporn Limprasutr
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Road, Pathumwan, Bangkok 10330, Thailand
| | - Suwanakiet Sawangkoon
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Road, Pathumwan, Bangkok 10330, Thailand
| | - Anusak Kijtawornrat
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Henri Dunant Road, Pathumwan, Bangkok 10330, Thailand.,Research Clusters: Research Study and Testing of Drug's Effect Related to Cardiovascular System in Laboratory Animal, Chulalongkorn University, Henri Dunant Road, Pathumwan, Bangkok 10330, Thailand
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16
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Reimann MJ, Møller JE, Häggström J, Martinussen T, Zatrazemi SSC, Svanholm L, Nielsen LBM, Pedersen HD, Olsen LH. Mitral Regurgitation Severity and Left Ventricular Systolic Dimension Predict Survival in Young Cavalier King Charles Spaniels. J Vet Intern Med 2017; 31:1008-1016. [PMID: 28573754 PMCID: PMC5508320 DOI: 10.1111/jvim.14759] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/17/2017] [Accepted: 04/26/2017] [Indexed: 11/30/2022] Open
Abstract
Background Development and progression of myxomatous mitral valve disease (MMVD) in dogs are difficult to predict. Identification at a young age of dogs at high risk of adverse outcome in the future is desirable. Hypothesis/Objectives To study the predictive value of selected clinical and echocardiographic characteristics associated with MMVD obtained at a young age for prediction of long‐term cardiac and all‐cause mortality in Cavalier King Charles Spaniels (CKCS). Animals 1125 privately owned CKCS. Methods A retrospective study including CKCS examined at the age of 1–3 years. Long‐term outcome was assessed by telephone interview with owners. The value of variables for predicting mortality was investigated by Cox proportional hazard and Kaplan‐Meier analyses. Results Presence of moderate to severe mitral regurgitation (MR) (hazard ratio (HR) = 3.03, 95% confidence interval (95% CI) = 1.48–6.23, P = 0.0025) even intermittent moderate to severe MR (HR = 2.23, 95% CI = 1.48–6.23, P = 0.039) on color flow Doppler echocardiography was significantly associated with increased hazard of cardiac death. An interaction between MR and sex was significant for all‐cause mortality (P = 0.035), showing that males with moderate to severe MR had a higher all‐cause mortality compared to males with no MR (HR = 2.38, 95% CI = 1.27–4.49, P = 0.0071), whereas no difference was found between female MR groups. The risk of cardiac (HR = 1.37, 95% CI = 1.14–1.63, P < 0.001) and all‐cause (HR = 1.13, 95% CI = 1.02–1.24, P = 0.016) mortality increased with increasing left ventricular end‐systolic internal dimension normalized for body weight (LVIDSN). Conclusions and clinical importance Moderate to severe MR, even if intermittent, and increased LVIDSN in dogs <3 years of age were associated with cardiac death later in life in CKCS.
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Affiliation(s)
- M J Reimann
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - J E Møller
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - T Martinussen
- Department of Public Health, University of Copenhagen, København K, Denmark
| | - S S C Zatrazemi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - L Svanholm
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - L B M Nielsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - H D Pedersen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - L H Olsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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17
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Lee CM, Jeong DM, Kang MH, Kim SG, Han JI, Park HM. Correlation between serum homocysteine concentration and severity of mitral valve disease in dogs. Am J Vet Res 2017; 78:440-446. [PMID: 28345991 DOI: 10.2460/ajvr.78.4.440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To measure serum homocysteine concentrations in dogs with myxomatous mitral valve disease (MMVD) and identify any association between this variable and stage of MMVD. ANIMALS 53 client-owned dogs with MMVD and 10 healthy control Beagles. PROCEDURES Dogs with MMVD were allocated to 3 groups in accordance with the staging system for chronic valvular heart disease in dogs and cats of the American College of Veterinary Internal Medicine. Blood samples were collected from all dogs, and serum homocysteine and cardiac troponin 1 concentrations were measured by enzyme immunoassay and chemiluminescence immunoassay, respectively. Analyte values were tested for associations with each other and with stage of MMVD. RESULTS A significant correlation was identified between serum homocysteine concentration and stage of MMVD. Mean ± SD concentrations were 6.72 ± 1.65 μmol/L for control dogs, 13.37 ± 4.16 μmol/L for dogs with stage B MMVD, 18.86 ± 6.73 μmol/L for dogs with stage C disease, and 28.26 ± 4.48 μmol/L for dogs with stage D disease. In addition, serum homocysteine concentration was correlated with serum cardiac troponin 1 (r = 0.34) and creatinine (r = 0.46) concentrations, systolic blood pressure (r = 0.57), and left atrium-to-aortic root ratio (r = 0.28), all of which were positively correlated with stage of MMVD. CONCLUSIONS AND CLINICAL RELEVANCE Serum homocysteine concentrations of dogs with MMVD were significantly higher than those of control dogs, and significant correlations were identified between these values and several risk factors for heart failure. Measurement of serum homocysteine concentration may be useful in the prediction of severity of disease in dogs with MMVD.
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18
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Kijtawornrat A, Komolvanich S, Saengklub N, Pirintr P, Boonpala P, Buranakarl C. Long-term effect of sildenafil on echocardiographic parameters in dogs with asymptomatic myxomatous mitral valve degeneration. J Vet Med Sci 2017; 79:788-794. [PMID: 28302926 PMCID: PMC5402203 DOI: 10.1292/jvms.16-0372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Sildenafil is a selective phosphodiesterase-5 inhibitor that has been demonstrated to
delay ventricular remodeling in humans and experimental animals. The aim of this
prospective study was to assess the chronic effects of sildenafil administration on
echocardiographic indices and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in
dogs with naturally occurring, asymptomatic myxomatous mitral valve degeneration. Thirty
client-owned dogs with ACVIM class B1 or B2 were enrolled. Dogs were randomly assigned to
treatment (sildenafil 1–3 mg/kg, PO, BID for 180 days) or control groups. A total of 12
dogs completed the 180 days trial in the sildenafil group, whereas 10 dogs remained in
control group. When comparing the difference from baseline values obtained over time
between groups, the stroke volume (SV) at day 30 was significantly higher in the
sildenafil group (P=0.038). The LA/Ao and the MR jet area were
significantly lower beginning at day 30 (only MR jet area; P=0.006), day
90 (P=0.006 and P=0.027, respectively) and day 180
(P=0.029 and P=0.032, respectively). The 2D-LA was
significantly lower at day 90 when compared with control group (P=0.028).
The differences of NTproBNP from baseline were significantly lower when compared with
control group at the same timepoint (D90, P=0.017 and D180,
P=0.013). In conclusion, this study suggested that long-term treatment
with sildenafil prevented aggravation of disease progression as suggested by several
echocardiographic indices (i.e. SV, LA/Ao, MR jet area, 2D-LA) and reduced NTproBNP level
at the indicated timepoints in dogs with asymptomatic mitral valve degeneration.
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Affiliation(s)
- Anusak Kijtawornrat
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand.,Research clusters: Research study and testing of drug's effect related to cardiovascular system in Laboratory Animal, Chulalongkorn University, Bangkok 10330, Thailand
| | - Siripen Komolvanich
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Nakkawee Saengklub
- Department of Physiology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
| | - Prapawadee Pirintr
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand
| | - Pakit Boonpala
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chollada Buranakarl
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
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19
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Sakarin S, Rungsipipat A, Surachetpong S. Galectin-3 in cardiac muscle and circulation of dogs with degenerative mitral valve disease. J Vet Cardiol 2016; 18:34-46. [DOI: 10.1016/j.jvc.2015.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 10/06/2015] [Accepted: 10/16/2015] [Indexed: 10/22/2022]
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20
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López-Alvarez J, Elliott J, Pfeiffer D, Chang YM, Mattin M, Moonarmart W, Hezzell MJ, Boswood A. Clinical severity score system in dogs with degenerative mitral valve disease. J Vet Intern Med 2015; 29:575-81. [PMID: 25818211 PMCID: PMC4895509 DOI: 10.1111/jvim.12544] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/18/2014] [Accepted: 12/23/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Several risk factors already have been determined for dogs with degenerative mitral valve disease (DMVD). Risk factors often have been considered in isolation and have not always taken into account additional information provided by the history and physical examination (PE). HYPOTHESIS/OBJECTIVES Data obtained from history and PE of dogs with DMVD provide prognostic information and can be used for risk stratification. ANIMALS Client-owned dogs (n = 244) with DMVD recruited from first opinion practice. METHODS Prospective longitudinal follow-up of dogs with DMVD. History and PE data were obtained at 6-month intervals and analyzed with time-dependent Cox models to derive relative risk of cardiac death. Independent hazard ratios were used to derive a clinical severity score (CSS), the prognostic value of which was evaluated by analyzing the median survival times for different risk groups and ROC analysis. Analysis of the progression of CSS over time also was undertaken. RESULTS History of cough, exercise intolerance, decreased appetite, breathlessness (difficulty breathing) and syncope with PE findings of heart murmur intensity louder than III/VI and absence of respiratory sinus arrhythmia were independently associated with outcome and allowed development of the CSS. Clinical severity score distinguished groups of dogs with significantly different outcomes. CONCLUSIONS AND CLINICAL IMPORTANCE Routinely obtained clinical findings allow risk stratification of dogs with DMVD. Results of ancillary diagnostic tests may be complementary to history and PE findings and always should be interpreted in conjunction with these findings.
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Affiliation(s)
- J López-Alvarez
- Department of Clinical Sciences and Services, Royal Veterinary College, London, UK
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21
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Marcondes-Santos M, Mansur AP, Fragata FS, Strunz CMC. Short-term follow-up of exercise training program and beta-blocker treatment on quality of life in dogs with naturally acquired chronic mitral valve disease. ACTA ACUST UNITED AC 2015; 48:886-94. [PMID: 26445331 PMCID: PMC4617114 DOI: 10.1590/1414-431x20154568] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 04/27/2015] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the effects of carvedilol treatment and a regimen of supervised aerobic exercise training on quality of life and other clinical, echocardiographic, and biochemical variables in a group of client-owned dogs with chronic mitral valve disease (CMVD). Ten healthy dogs (control) and 36 CMVD dogs were studied, with the latter group divided into 3 subgroups. In addition to conventional treatment (benazepril, 0.3-0.5 mg/kg once a day, and digoxin, 0.0055 mg/kg twice daily), 13 dogs received exercise training (subgroup I; 10.3 ± 2.1 years), 10 dogs received carvedilol (0.3 mg/kg twice daily) and exercise training (subgroup II; 10.8 ± 1.7 years), and 13 dogs received only carvedilol (subgroup III; 10.9 ± 2.1 years). All drugs were administered orally. Clinical, laboratory, and Doppler echocardiographic variables were evaluated at baseline and after 3 and 6 months. Exercise training was conducted from months 3-6. The mean speed rate during training increased for both subgroups I and II (ANOVA, P>0.001), indicating improvement in physical conditioning at the end of the exercise period. Quality of life and functional class was improved for all subgroups at the end of the study. The N-terminal pro-brain natriuretic peptide (NT-proBNP) level increased in subgroup I from baseline to 3 months, but remained stable after training introduction (from 3 to 6 months). For subgroups II and III, NT-proBNP levels remained stable during the entire study. No difference was observed for the other variables between the three evaluation periods. The combination of carvedilol or exercise training with conventional treatment in CMVD dogs led to improvements in quality of life and functional class. Therefore, light walking in CMVD dogs must be encouraged.
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Affiliation(s)
| | - A P Mansur
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
| | - F S Fragata
- Hospital Veterinário Sena Madureira, São Paulo, SP, BR
| | - C M C Strunz
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
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22
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Alpha-smooth muscle actin and serotonin receptors 2A and 2B in dogs with myxomatous mitral valve disease. Res Vet Sci 2015; 100:197-206. [DOI: 10.1016/j.rvsc.2015.03.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 01/28/2015] [Accepted: 03/14/2015] [Indexed: 11/23/2022]
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23
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Lu CC, Liu MM, Culshaw G, Clinton M, Argyle DJ, Corcoran BM. Gene network and canonical pathway analysis in canine myxomatous mitral valve disease: a microarray study. Vet J 2015; 204:23-31. [PMID: 25841900 DOI: 10.1016/j.tvjl.2015.02.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 02/18/2015] [Accepted: 02/28/2015] [Indexed: 12/18/2022]
Abstract
Myxomatous mitral valve disease (MMVD) is the single most common acquired heart disease of the dog and is particularly common in small pedigree breed dogs such as the Cavalier King Charles spaniel (CKCS). There are limited data on the mitral valve transcriptome and the aim of this study was to use the microarray technology in conjunction with bioinformatics platforms to analyse transcript changes in MMVD in CKCS compared to normal dogs (non-CKCS). Differentially expressed genes (n = 5397) were identified using cut-off settings of fold change, false discovery rate (FDR) and P <0.05. In total, 4002 genes were annotated to a specific transcript in the Affymetrix canine database, and after further filtering, 591 annotated canine genes were identified: 322 (55%) were up-regulated and 269 (45%) were down-regulated. Canine microRNAs (cfa-miR; n = 59) were also identified. Gene ontology and network analysis platforms identified between six and 10 significantly different biological function clusters from which the following were selected as relevant to MMVD: inflammation, cell movement, cardiovascular development, extracellular matrix organisation and epithelial-to-mesenchymal (EMT) transition. Ingenuity Pathway Analysis identified three canonical pathways relevant to MMVD: caveolar-mediated endocytosis, remodelling of epithelial adherens junctions, and endothelin-1 signalling. Considering the biological relevance to MMVD, the gene families of importance with significant difference between groups included collagens, ADAMTS peptidases, proteoglycans, matrix metalloproteinases (MMPs) and their inhibitors, basement membrane components, cathepsin S, integrins, tight junction cell adhesion proteins, cadherins, other matrix-associated proteins, and members of the serotonin (5-HT)/transforming growth factor -β signalling pathway.
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Affiliation(s)
- C-C Lu
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Easter Bush, Roslin, Mid-Lothian, Scotland EH25 9RG, UK
| | - M-M Liu
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Easter Bush, Roslin, Mid-Lothian, Scotland EH25 9RG, UK
| | - G Culshaw
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Easter Bush, Roslin, Mid-Lothian, Scotland EH25 9RG, UK
| | - M Clinton
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Easter Bush, Roslin, Mid-Lothian, Scotland EH25 9RG, UK
| | - D J Argyle
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Easter Bush, Roslin, Mid-Lothian, Scotland EH25 9RG, UK
| | - B M Corcoran
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Easter Bush, Roslin, Mid-Lothian, Scotland EH25 9RG, UK.
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24
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Silva A, Muzzi R, Muzzi L, Ferreira D, Oberlender G, Oliveira M, Nogueira R, Ticle L. Use of discriminant analysis based on echocardiography for classification of congestive heart failure in dogs with myxomatous mitral valve disease. ARQ BRAS MED VET ZOO 2014. [DOI: 10.1590/1678-6800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mixomatous mitral valve disease (MMVD) is one of the most common cardiac abnormalities in dogs and humans that can lead to cardiac heart failure (CHF). Its diagnosis remains based on echocardiography and clinical signs. However, the early diagnose of MMVD can contribute to a better prognosis and avoid CHF. The aim of this study was to evaluate the clinical, radiographic and echocardiographic presence of CHF in dogs with MMVD in combination with a statistical model as a mathematical tool. For this purpose, dogs were divided into three groups (healthy; MMVD without CHF; and MMVD with CHF), according the clinical, radiographic and echocardiographic evaluation findings. Thus, linear discriminant functions were obtained by analyzing the variables weight, body surface area, aortic diameter, the ratio of the left atrium/aortic diameter, the ratio between the mitral regurgitation jet area and the left atrial area, vena contracta diameter and mitral valve proximal isovelocity surface area. Then, mathematical equations were established for each group of dogs. Statistical functions obtained in this study enabled to classify the dogs, regarding the presence of CHF with a probability of correct classification of 90.4%. Thus the statistical model demonstrated that it could be used as an auxiliary method for identifying CHF in dogs with MMVD.
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25
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Eriksson AS, Häggström J, Pedersen HD, Hansson K, Järvinen AK, Haukka J, Kvart C. Increased NT-proANP predicts risk of congestive heart failure in Cavalier King Charles spaniels with mitral regurgitation caused by myxomatous valve disease. J Vet Cardiol 2014; 16:141-54. [DOI: 10.1016/j.jvc.2014.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 05/08/2014] [Accepted: 05/09/2014] [Indexed: 12/11/2022]
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26
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Strong association between activated valvular interstitial cells and histopathological lesions in porcine model of induced mitral regurgitation. Int J Cardiol 2014; 174:443-6. [DOI: 10.1016/j.ijcard.2014.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/02/2014] [Indexed: 11/22/2022]
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27
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Oliveira M, Muzzi R, Araújo R, Muzzi L, Ferreira D, Silva E. Heart rate variability and arrhythmias evaluated with Holter in dogs with degenerative mitral valve disease. ARQ BRAS MED VET ZOO 2014. [DOI: 10.1590/1678-41626097] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cardiac diseases promote alterations in the autonomic control of the heart, leading to an increase in heart rate and, as a result, a decrease in heart rate variability (HRV).The aim of this study was to evaluate if the development of heart failure secondary to degenerative mitral valve disease (DMVD) concurs with changes in autonomic modulation of heart rhythm which are assessed by long electrocardiography examination (Holter). Dogs were evaluated by clinical examination and echocardiography in order to be categorized into the following groups: Control (healthy; n=6), DMVD (disease without heart failure; n=8), and DMVD heart failure (disease with heart failure; n=13). Arrhythmias and frequency domain HRV were determined by Holter. Diseased animals, when compared to healthy, had significantly lower total power, which indicates overall HRV. DMVD heart failure dogs also showed other disturbances such as high incidence of supraventricular arrhythmias, high heart rate, little amount of pauses (2.0s long between consecutive heartbeats), longer time in tachycardia, shorter time in bradycardia, low high frequency (parasympathetic control), and high low frequency (sympathetic and parasympathetic control) when compared to control (p<0.05). In DMVD dogs, Holter-derived variables changed with the development of heart failure.
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28
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López-Alvarez J, Boswood A, Moonarmart W, Hezzell MJ, Lotter N, Elliott J. Longitudinal electrocardiographic evaluation of dogs with degenerative mitral valve disease. J Vet Intern Med 2014; 28:393-400. [PMID: 24494591 PMCID: PMC4857969 DOI: 10.1111/jvim.12311] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 11/25/2013] [Accepted: 12/19/2013] [Indexed: 11/28/2022] Open
Abstract
Background Increased heart rate (HR) and decreased heart rate variability (HRV) are evident in some dogs with degenerative mitral valve disease (DMVD). Objectives Evaluation of the factors influencing HR and HRV (assessed by the vasovagal tonus index; VVTI) and their change over time in dogs with DMVD. Animals Client‐owned dogs (n = 257) with DMVD recruited from first opinion practice. Methods Prospective longitudinal follow‐up at six‐monthly intervals of dogs with DMVD. Dogs followed up for at least 18 months (n = 102) were grouped according to their outcome as dogs dying/euthanized because of cardiac disease (n = 28; Group 1), noncardiac disease (n = 40; Group 2) and dogs alive (n = 34; Group 3). HR and VVTI were measured on 1‐minute ECG recordings. Repeated measures linear models were constructed to investigate the factors that influence HR and VVTI and their changes over time. Results Heart rate and VVTI were affected by disease severity and were different in Cavaliers compared to other breeds. Group 1 and Group 2 dogs underwent an increase in HR and decrease in VVTI, evident at least 18 months before death. Group 1 had a further decrease in VVTI followed by an increase in HR approximately 1 year and 6 months before death, respectively. Conclusions and Clinical Importance Dogs with DMVD have an increase in HR and decrease in HRV over a year before death, with greater changes in those dogs dying/euthanized because of cardiac disease. Both HR and VVTI can potentially be regarded as biomarkers for all‐cause mortality.
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Affiliation(s)
- J López-Alvarez
- Department of Clinical Science and Services, Royal Veterinary College, London, UK
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Szilvási V, Vörös K, Manczur F, Reiczigel J, Novák I, Máthé Á, Fekete D. Comparison of traditional and sensor-based electronic stethoscopes in beagle dogs. Acta Vet Hung 2013; 61:19-29. [PMID: 23439287 DOI: 10.1556/avet.2012.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study was to compare the auscultatory findings using traditional and electronic sensor-based stethoscopes. Thirty-three adult healthy Beagles (20 females, 13 males, mean age: 4.8 years, range 1.4-8 years) were auscultated by four investigators with different experiences (INVEST-1, -2, -3 and -4) independently with both stethoscopes. Final cardiological diagnoses were established by echocardiography. Mitral murmurs were heard with both stethoscopes by all investigators and echocardiography revealed mild mitral valve insufficiency in 7 dogs (21%, 4 females, 3 males). The statistical sensitivity (Se) in recognising cardiac murmurs proved to be 82% using the traditional stethoscope and 75% using the electronic one in the mean of the four examiners, whilst statistical specificity (Sp) was 99% by the traditional and 100% by the electronic stethoscope. The means of the auscultatory sensitivity differences between the two stethoscopes were 0.36 on the left and 0.59 on the right hemithorax, demonstrating an advantage for the electronic stethoscope being more obvious above the right hemithorax (P = 0.0340). The electronic stethoscope proved to be superior to the traditional one in excluding cardiac murmurs and especially in auscultation over the right hemithorax. Mitral valve disease was relatively common in this clinically healthy research Beagle population.
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Affiliation(s)
- Viktória Szilvási
- 1 Szent István University Department and Clinic of Internal Medicine István u. 2 H-1078 Budapest Hungary
| | - Károly Vörös
- 1 Szent István University Department and Clinic of Internal Medicine István u. 2 H-1078 Budapest Hungary
| | - Ferenc Manczur
- 1 Szent István University Department and Clinic of Internal Medicine István u. 2 H-1078 Budapest Hungary
| | - Jenő Reiczigel
- 2 Szent István University Department of Biomathematics and Informatics, Faculty of Veterinary Science István u. 2 H-1078 Budapest Hungary
| | - István Novák
- 3 Aurigon-Toxicoop Research Centre Ltd. Dunakeszi Hungary
| | - Ákos Máthé
- 1 Szent István University Department and Clinic of Internal Medicine István u. 2 H-1078 Budapest Hungary
| | - Dániel Fekete
- 1 Szent István University Department and Clinic of Internal Medicine István u. 2 H-1078 Budapest Hungary
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Boyle KL, Leech E. A review of the pharmacology and clinical uses of pimobendan. J Vet Emerg Crit Care (San Antonio) 2013; 22:398-408. [PMID: 22928748 DOI: 10.1111/j.1476-4431.2012.00768.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To review the pharmacology, research developments, and clinical uses of pimobendan DATA SOURCES Original research articles and clinical studies from 1984 to August 2011. VETERINARY DATA SYNTHESIS Pimobendan is approved for use in dogs for the treatment of congestive heart failure (CHF) secondary to chronic valvular heart disease (CVHD) and dilated cardiomyopathy (DCM). Expert-based veterinary guidelines recommend the use of pimobendan in the management of acute, hospital-based therapy for patients with CHF attributable to CVHD. CONCLUSIONS The use of pimobendan, an inodilator with phosphodiesterase 3 (PDE3) inhibitory and calcium-sensitizing properties, is regarded as a component of the standard of care in the management of dogs with CHF secondary to both DCM and CVHD. Further studies are warranted to confirm the safety and efficacy of pimobendan for the off-label use of this drug in asymptomatic CVHD, pulmonary arterial hypertension, asymptomatic myocardial diseases, CHF from all other causes and in cats with CHF.
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Affiliation(s)
- Kimberly L Boyle
- VCA All-Care Animal Referral Center, Fountain Valley, CA, 92708, USA.
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31
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Saunders AB. The diagnosis and management of age-related veterinary cardiovascular disease. Vet Clin North Am Small Anim Pract 2012; 42:655-68, vi. [PMID: 22720807 DOI: 10.1016/j.cvsm.2012.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The American Veterinary Medical Association reported 81.7 million cats and 72.1 million dogs in the United States, with more than 10% over 11 years of age. Disorders of the cardiovascular system are one of the most commonly encountered disease entities in the aging pet population. This article reviews the diseases affecting older cats and dogs including how to make the diagnosis and when to treat while keeping in mind the unique aspects of comorbid conditions and polypharmacy situations encountered while managing pets with cardiovascular disease.
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Affiliation(s)
- Ashley B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA.
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Atkins CE, Häggström J. Pharmacologic management of myxomatous mitral valve disease in dogs. J Vet Cardiol 2012; 14:165-84. [PMID: 22386553 DOI: 10.1016/j.jvc.2012.02.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 01/07/2012] [Accepted: 02/07/2012] [Indexed: 01/24/2023]
Abstract
Myxomatous mitral valve disease (MMVD) causing mitral regurgitation is the most important disease of the heart in small animal cardiovascular medicine. Because MMVD is an example of a chronic disease that progresses from mild to severe over years, treatment strategies change with the stage of the disease. In this review the treatment options are compared and contrasted as they are discussed relative to the recently published ACVIM consensus statement regarding the treatment of MMVD. Results from clinical trials and evidence-based medicine are likely to provide significant improvements in the management of MMVD in the coming decades.
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Affiliation(s)
- Clarke E Atkins
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, USA.
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Pathology of myxomatous mitral valve disease in the dog. J Vet Cardiol 2012; 14:103-26. [PMID: 22386587 DOI: 10.1016/j.jvc.2012.02.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Revised: 02/03/2012] [Accepted: 02/04/2012] [Indexed: 11/20/2022]
Abstract
Mitral valve competence requires complex interplay between structures that comprise the mitral apparatus - the mitral annulus, mitral valve leaflets, chordae tendineae, papillary muscles, and left atrial and left ventricular myocardium. Myxomatous mitral valve degeneration is prevalent in the canine, and most adult dogs develop some degree of mitral valve disease as they age, highlighting the apparent vulnerability of canine heart valves to injury. Myxomatous valvular remodeling is associated with characteristic histopathologic features. Changes include expansion of extracellular matrix with glycosaminoglycans and proteoglycans; valvular interstitial cell alteration; and attenuation or loss of the collagen-laden fibrosa layer. These lead to malformation of the mitral apparatus, biomechanical dysfunction, and mitral incompetence. Mitral regurgitation is the most common manifestation of myxomatous valve disease and in advanced stages, associated volume overload promotes progressive valvular regurgitation, left atrial and left ventricular remodeling, atrial tears, chordal rupture, and congestive heart failure. Future studies are necessary to identify clinical-pathologic correlates that track disease severity and progression, detect valve dysfunction, and facilitate risk stratification. It remains unresolved whether, or to what extent, the pathobiology of myxomatous mitral valve degeneration is the same between breeds of dogs, between canines and humans, and how these features are related to aging and genetics.
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Gordon SG, Saunders AB, Hariu CD, Boggess MM, Miller MW. Retrospective review of carvedilol administration in 38 dogs with preclinical chronic valvular heart disease. J Vet Cardiol 2012; 14:243-52. [DOI: 10.1016/j.jvc.2012.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 01/13/2012] [Accepted: 01/13/2012] [Indexed: 10/28/2022]
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Parker HG, Kilroy-Glynn P. Myxomatous mitral valve disease in dogs: does size matter? J Vet Cardiol 2012; 14:19-29. [PMID: 22356836 PMCID: PMC3307894 DOI: 10.1016/j.jvc.2012.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 01/13/2012] [Accepted: 01/22/2012] [Indexed: 12/31/2022]
Abstract
Myxomatous mitral valve disease (MMVD) is the most commonly diagnosed cardiovascular disease in the dog accounting for more than 70% of all cardiovascular disease in dogs. As are most canine diseases with genetic underpinnings, risk of MMVD is greatly increased in a subset of breeds. What is uncommon is that the vast majority of the breeds at elevated risk for MMVD are small or toy breeds with average adult weights under 9 kg. These breeds appear to have little in common other than their diminutive size. In the following review we propose a number of mechanisms by which relatively unrelated small breeds may have developed a predisposition for chronic valvular disorders. Although factors such as age are key in the expression of MMVD, taking a comprehensive look at the commonalities, as well as the differences, between the susceptible breeds may assist in finding the causal variants responsible for MMVD and translating them to improved treatments for both dogs and humans.
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Affiliation(s)
- Heidi G Parker
- Cancer Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Richards JM, Farrar EJ, Kornreich BG, Moïse NS, Butcher JT. The mechanobiology of mitral valve function, degeneration, and repair. J Vet Cardiol 2012; 14:47-58. [PMID: 22366572 PMCID: PMC3586284 DOI: 10.1016/j.jvc.2012.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 12/24/2011] [Accepted: 01/17/2012] [Indexed: 12/28/2022]
Abstract
In degenerative valve disease, the highly organized mitral valve leaflet matrix stratification is progressively destroyed and replaced with proteoglycan rich, mechanically inadequate tissue. This is driven by the actions of originally quiescent valve interstitial cells that become active contractile and migratory myofibroblasts. While treatment for myxomatous mitral valve disease in humans ranges from repair to total replacement, therapies in dogs focus on treating the consequences of the resulting mitral regurgitation. The fundamental gap in our understanding is how the resident valve cells respond to altered mechanical signals to drive tissue remodeling. Despite the pathological similarities and high clinical occurrence, surprisingly little mechanistic insight has been gleaned from the dog. This review presents what is known about mitral valve mechanobiology from clinical, in vivo, and in vitro data. There are a number of experimental strategies already available to pursue this significant opportunity, but success requires the collaboration between veterinary clinicians, scientists, and engineers.
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Affiliation(s)
| | - Emily J. Farrar
- Department of Biomedical Engineering, Cornell University, Ithaca NY, USA
| | - Bruce G. Kornreich
- Department of Clinical Sciences, Section of Cardiology, College of Veterinary Medicine, Cornell University, Ithaca NY, USA
| | - N. Sydney Moïse
- Department of Clinical Sciences, Section of Cardiology, College of Veterinary Medicine, Cornell University, Ithaca NY, USA
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Differentiating the aging of the mitral valve from human and canine myxomatous degeneration. J Vet Cardiol 2012; 14:31-45. [PMID: 22364720 DOI: 10.1016/j.jvc.2011.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 11/16/2011] [Accepted: 11/30/2011] [Indexed: 12/11/2022]
Abstract
During the course of both canine and human aging, the mitral valve remodels in generally predictable ways. The connection between these aging changes and the morbidity and mortality that accompany pathologic conditions has not been made clear. By exploring work that has investigated the specific valvular changes in both age and disease, with respect to the cells and the extracellular matrix found within the mitral valve, heretofore unexplored connections between age and myxomatous valve disease can be found. This review addresses several studies that have been conducted to explore such age and disease related changes in extracellular matrix, valvular endothelial and interstitial cells, and valve innervation, and also reviews attempts to correlate aging and myxomatous disease. Such connections can highlight avenues for future research and help provide insight as to when an individual diverts from an aging pattern into a diseased pathway. Recognizing these patterns and opportunities could result in earlier intervention and the hope of reduced morbidity and mortality for patients.
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Spiljak Pakkanen M, Domanjko Petrič A, Olsen LH, Stepančič A, Schlegel TT, Falk T, Rasmussen CE, Starc V. Advanced electrocardiographic parameters change with severity of mitral regurgitation in Cavalier King Charles Spaniels in sinus rhythm. J Vet Intern Med 2011; 26:93-100. [PMID: 22168834 DOI: 10.1111/j.1939-1676.2011.00845.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 08/24/2011] [Accepted: 10/26/2011] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Multiple advanced resting ECG (A-ECG) techniques have improved the diagnostic or prognostic value of ECG in detecting human cardiac diseases even before onset of clinical signs or changes in conventional ECG. OBJECTIVE To determine which A-ECG parameters, derived from 12-lead A-ECG recordings, change with severity of mitral regurgitation (MR) caused by myxomatous mitral valve disease (MMVD) in Cavalier King Charles Spaniels (CKCSs) in sinus rhythm. ANIMALS Seventy-six privately owned CKCSs. METHODS Dogs were prospectively divided into 5 groups according to the degree of MR (estimated by color Doppler mapping as the percentage of the left atrial area affected by the MR jet) and presence of clinical signs. High fidelity approximately 5-minute 12-lead ECG recordings were evaluated using custom software to calculate multiple conventional and A-ECG parameters. RESULTS Nineteen of 76 ECG parameters were significantly different (P < .05) across the 5 dog groups. A 4-parameter model that incorporated results from 1 parameter of heart rate variability, 2 parameters of QT variability, and 1 parameter of QRS amplitude was identified that explained 82.4% of the variance with a correlation coefficient (R) of 0.60 (P < .01). When age or murmur grade was included in the statistical model the prediction value further increased the R to 0.74 and 0.85 (P < .01), respectively. CONCLUSION In CKCSs with sinus rhythm, 4 selected A-ECG parameters further improve prediction of MR jet severity beyond age and murmur grade, although the predictive increment in this study probably is not sufficient to warrant utilization in clinical veterinary practice.
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Fonfara S, de la Heras Alegret L, German AJ, Blackwood L, Dukes-McEwan J, M. Noble PJ, Burrow RD. Underlying diseases in dogs referred to a veterinary teaching hospital because of dyspnea: 229 cases (2003–2007). J Am Vet Med Assoc 2011; 239:1219-24. [DOI: 10.2460/javma.239.9.1219] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Oyama MA, Singletary GE. The use of NT-proBNP assay in the management of canine patients with heart disease. Vet Clin North Am Small Anim Pract 2010; 40:545-58. [PMID: 20610010 DOI: 10.1016/j.cvsm.2010.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The diagnosis and management of canine heart disease could be facilitated by a highly sensitive and specific laboratory test that predicts risk of morbidity and mortality, is helpful in directing therapy, easy to perform, inexpensive, and widely available. This article details if, how, and when the cardiac biomarker, N-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP), helps in the diagnosis and management of canine heart disease. Veterinary cardiac biomarkers, specifically NT-proBNP, hold great promise. The incorporation of NT-proBNP assay into successful clinical practice requires an understanding of the science behind the technology, as well as the clinical data available to date.
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Affiliation(s)
- Mark A Oyama
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, PA 19104, USA.
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41
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Borgarelli M, Haggstrom J. Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy. Vet Clin North Am Small Anim Pract 2010; 40:651-63. [PMID: 20610017 DOI: 10.1016/j.cvsm.2010.03.008] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Myxomatous mitral valve disease is a common condition in geriatric dogs. Most dogs affected are clinically asymptomatic for a long time. However, about 30% of these animals present a progression to heart failure and eventually die as a consequence of the disease. Left atrial enlargement, and particularly a change in left atrial size, seems to be the most reliable predictor of progression in some studies, however further studies are needed to clarify how to recognize asymptomatic patients at higher risk of developing heart failure. According to the published data on the natural history of the disease and the results of published studies evaluating the effect of early therapy on delaying the progression of the disease, it seems that no currently available treatment delays the onset of clinical signs of congestive heart failure (CHF). Although the ideal treatment of more severely affected dogs is probably surgical mitral valve repair or mitral valve replacement, this is not a currently available option. The results of several clinical trials together with clinical experience suggest that dogs with overt CHF can be managed with acceptable quality of life for a relatively long time period with medical treatment including furosemide, an angiotensin-converting enzyme inhibitor, pimobendan, and spironolactone.
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Affiliation(s)
- Michele Borgarelli
- Department of Clinical Sciences, Kansas State University, Manhattan, KS 66505, USA.
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Wotton P. Challenges and advances in veterinary cardiology. J Small Anim Pract 2010; 51:409-10. [DOI: 10.1111/j.1748-5827.2010.00985.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lord P, Hansson K, Kvart C, Häggström J. Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation. J Small Anim Pract 2010; 51:210-8. [DOI: 10.1111/j.1748-5827.2010.00910.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Stepien RL. Pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction in dogs. J Small Anim Pract 2009; 50 Suppl 1:34-43. [DOI: 10.1111/j.1748-5827.2009.00802.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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