Prognostic value of selected one-, two- and three-dimensional and Doppler echocardiographic methods to assess severity in dogs with myxomatous mitral valve disease |
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| Institution: | 1. Anicura Albano Animal Hospital, Rinkebyvägen 21, Danderyd, Sweden;2. Department of Clinical Sciences Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden;1. Cardiac Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA;2. Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce St, Philadelphia, PA 19104, USA;1. Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell’Emilia, Italy;2. Virtual Veterinary Specialists Ltd, West Sussex, UK;3. Division of Cardiology, Vetsuisse Faculty University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland;1. Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E., Guelph, Ontario, N1G 2W1, Canada;2. Department of Pathobiology, Ontario Veterinary College, University of Guelph, 419 Gordon St., Guelph, Ontario, N1G 2W1, Canada;3. Mississauga Oakville Veterinary Emergency and Specialty Hospital, 2285 Bristol Circle, Oakville, Ontario, L6H 6P8, Canada;1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA;2. Southwest Florida Veterinary Specialists, 28400 Old 41 Road, Suite 1, Bonita Springs, FL, 34135, USA;3. College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA;4. Bulger Veterinary Hospital, 141 Winthrop Avenue, Lawrence, MA, 01843, USA;5. CVCA Vienna Cardiac Care for Pets, 140 Park St, Vienna, VA, 22180, USA;6. University of Montreal, 3200 Rue Sicotte, Saint-Hyacinthe, QC J2S 2M2, Canada;7. Nashville Veterinary Specialists, 2971 Sidco Drive, Nashville, TN, 37204, USA;8. CVCA Leesburg Cardiac Care for Pets, 165 Fort Evans Road NE, Leesburg, VA, 20176, USA |
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| Abstract: | IntroductionAlthough challenging, predicting outcomes in dogs with myxomatous mitral valve disease (MMVD) is of importance to owners and veterinarians. Our aim was to compare the prognostic value of selected one-, two-, and three-dimensional and Doppler echocardiographic methods to predict cardiac-related and all-cause mortality in MMVD dogs. We hypothesize that three-dimensional methods would better predict prognosis than one- and two-dimensional methods.AnimalsOne-hundred thirty-eight privately-owned dogs with MMVD.Materials and methodsCox proportional Hazard analyses and Kaplan–Meier curves were used to investigate the predictive value of 14 variables; left atrial (LA) volume indexed to body weight (BW) measured by real-time three-dimensional echocardiography (RT3DE) and calculated using Simpson's modified method of discs (SMOD) and the area-length method; LA diameter in short-axis and long-axis to aortic in short-axis ratio, effective regurgitant orifice area indexed to body surface area measured in RT3DE en face view and calculated using four-chamber (4Ch) and two-chamber views alone or in combination; percentage increase in left ventricular end-diastolic and systolic internal diameters; fractional shortening; E wave velocity; regurgitant jet area/LA area.ResultsAll 14 variables were significantly predictive of cardiac-related mortality, and 11 were predictive of all-cause mortality. The prognosis was best predicted by LA volume/BW estimated by SMOD or RT3DE, consistently showing the highest predictive value in all analyses.ConclusionsLeft atrial volume calculated by SMOD showed a similar predictive value compared to RT3DE. Performing SMOD from apical 4Ch images should be considered an alternative to RT3DE for echocardiographic examinations where prognostication of disease outcome is sought. |
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| Keywords: | Simpson's modified method of discs Area-length method Mitral regurgitation Effective regurgitant orifice area |
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