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Research article - Peer-reviewed, 2020

Temporal changes in clinical and radiographic variables in dogs with preclinical myxomatous mitral valve disease: The EPIC study

Boswood, Adrian; Gordon, Sonya G.; Haggstrom, Jens; Vanselow, Martin; Wess, Gerhard; Stepien, Rebecca L.; Oyama, Mark A.; Keene, Bruce W.; Bonagura, John; MacDonald, Kristin A.; Patteson, Mark; Smith, Sarah; Fox, Philip R.; Sanderson, Karen; Woolley, Richard; Szatmari, Viktor; Menaut, Pierre; Church, Whitney M.; O'Sullivan, M. Lynne; Jaudon, Jean-Philippe;
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Background The Evaluation of pimobendan in dogs with cardiomegaly caused by preclinical myxomatous mitral valve disease (EPIC) study monitored dogs with myxomatous mitral valve disease (MMVD) as they developed congestive heart failure (CHF).Objectives To describe the changes in clinical and radiographic variables occurring as dogs with MMVD and cardiomegaly develop CHF, compared to similar dogs that do not develop CHF.Animals One hundred and thirty-five, and 73 dogs that did or did not develop CHF, respectively.Materials and methods The following variables were evaluated in 2 groups of dogs (dogs that did or did not develop CHF): Heart rate (HR), clinic respiratory rate (RR), home-measured resting respiratory rate (RRR), rectal temperature (RT), body weight (BW), and vertebral heart sum (VHS). Absolute value and rate of change of each variable were calculated for each day a dog was in study. Daily means were calculated and plotted against time. The onset of CHF or last visit before leaving the study were set as reference time points.Results The most extreme values and rate of change occurred in variables immediately before onset of CHF. Vertebral heart sum increased earliest. Heart rate, RR, and RRR also increased. Rectal temperature and BW decreased. Increases in RR and RRR were most extreme and occurred immediately before CHF.Conclusions and Clinical Importance Dogs with MMVD and cardiomegaly experience increases in HR, RR, RRR, and VHS, and decreases in BW and RT as they develop CHF. The variables with highest absolute change and rate of change were RR and RRR. These findings reinforce the value of RR and RRR as indicators of impending or incipient CHF.


canine; cardiovascular; clinical epidemiology; clinical trials; heart failure; physical examination; radiology and diagnostic imaging

Published in

Journal of Veterinary Internal Medicine
2020, volume: 34, number: 3, pages: 1108-1118
Publisher: WILEY

Authors' information

Boswood, Adrian
Royal Vet Coll
Gordon, Sonya G.
Texas AandM Univ
Swedish University of Agricultural Sciences, Department of Clinical Sciences
Vanselow, Martin
Biometrie and Stat
Wess, Gerhard
Univ Munich
Stepien, Rebecca L.
Univ Wisconsin
Oyama, Mark A.
Univ Penn
Keene, Bruce W.
North Carolina State Univ
Bonagura, John
Ohio State Univ
MacDonald, Kristin A.
Anim Care Ctr
Patteson, Mark
Anim Hosp
Smith, Sarah
Sarah Smith Cardiol
Fox, Philip R.
Anim Med Ctr
Sanderson, Karen
Rocky Mt Vet Cardiol
Woolley, Richard
Cardio Resp Pet Referrals
Szatmari, Viktor
Univ Utrecht
Menaut, Pierre
Church, Whitney M.
Desert Vet Med Specialists
O'Sullivan, M. Lynne
Univ Prince Edward Isl
Jaudon, Jean-Philippe
Clin Vet Etangs
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UKÄ Subject classification

Clinical Science

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