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Forskningsartikel - Refereegranskat, 2004

New insights into degenerative mitral valve disease in dogs

Haggstrom J, Pedersen HD, Kvart C


Degenerative mitral valve disease (DMVD) is, by far, the most commonly encountered acquired cardiac disease in adult dogs, and the condition is caused by a progressive myxomatous degeneration (MD) of the atrioventricular (AV) valves. DMVD has been given many names in the veterinary literature, including endocardiosis and chronic valvular disease [1,2]. Similar changes of the mitral valve are also seen in human beings, horses, and pigs [35]. In people, the condition with similarities to DMVD in dogs is called mitral valve prolapse (MVP) syndrome [3,6]. Clinical signs of mitral regurgitation (MR) caused by myxomatous lesions have long been recognized in veterinary medicine [7], and because of the high prevalence of DMVD in the canine population, the disease is important for the veterinary small animal practitioner. Indeed, a recent estimation of the mortality caused by cardiac disease in the general canine population indicates that about 7% of all dogs die or are euthanized because of heart failure (HF) before 10 years of age (eg, the third most common cause of death in dogs in that age group) [8]. Because many dogs develop decompensated HF because of DMVD after 10 years of age, we can assume that this proportion is even greater in dogs of all ages. MR caused by DMVD has been reported to account for 75% of the cases of heart disease in dogs [9-12] and for a considerably higher proportion in affected breeds [1,8,13]. Many of the affected dogs eventually need therapy for decompensated HF and die or are euthanized in the end because of refractory cardiac failure. The presence of MR and ongoing medical treatment for HF may negatively interact with other drugs, decisions for surgical procedures, or anesthesia. Because DMVD is characterized by chronic progression, the owner and veterinarian often have no other alternative than to observe how the valvular lesions and MR progress slowly, with little possibility of affecting the course of the disease, a fact that many find frustrating. Finally, there is a need for breeding measures in certain breeds with an exceptionally high prevalence of DMVD. This article does not cover all possible aspects of DMVD, because this subject is simply far too extensive to fit into this presentation. This presentation focuses on new information about some specific aspects of DMVD that may be controversial and of importance for the practicing veterinarian

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Veterinary Clinics of North America: Small Animal Practice
2004, Volym: 34, nummer: 5, sidor: 1209-+