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Research article2017Peer reviewedOpen access

Mitral Regurgitation Severity and Left Ventricular Systolic Dimension Predict Survival in Young Cavalier King Charles Spaniels.

Reimann, M. J.; Moller, J. E.; Haggstrom, J.; Martinussen, T.; Zatrazemi, S. S. C.; Svanholm, L.; Nielsen, L. B. M.; Pedersen, H. D.; Olsen, L. H.

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 allcause (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.

Keywords

Dog; Heart failure; Myxomatous Mitral Valve Disease; Risk factor

Published in

Journal of Veterinary Internal Medicine
2017, Volume: 31, number: 4, pages: 1008-1016

    UKÄ Subject classification

    Cardiac and Cardiovascular Systems

    Publication identifier

    DOI: https://doi.org/10.1111/jvim.14759

    Permanent link to this page (URI)

    https://res.slu.se/id/publ/83719