Open AccessPrevalence and Prognostic Importance of Pulmonary Hypertension in Dogs with Myxomatous Mitral Valve Disease
Author(s) -
Borgarelli M.,
Abbott J.,
BrazRuivo L.,
Chiavegato D.,
Crosara S.,
Lamb K.,
Ljungvall I.,
Poggi M.,
Santilli R.A.,
Haggstrom J.
Publication year - 2015
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.12564
Subject(s) - medicine , pulmonary hypertension , cardiology , mitral regurgitation , medical record , regurgitation (circulation) , heart failure , univariate analysis , mitral valve , population , multivariate analysis , environmental health
Background Pulmonary hypertension ( PH ) is common in dogs with myxomatous mitral valve disease ( MMVD ) but its effect on clinical outcome has not been investigated. Hypothesis/objectives The presence of PH worsens the outcome in dogs with MMVD . To compare survival times of dogs with MMVD and PH to those without PH . Animals Two hundred and twelve client‐owned dogs. Methods Case review study. Medical records of dogs diagnosed with ACVIM stage B 2 and C MMVD between J anuary 2010 and D ecember 2011 were retrospectively reviewed. Long‐term outcome was determined by telephone interview or from the medical record. End of the observation period was M arch 2013. PH was identified if tricuspid regurgitation peak velocity was >3 m/s. Results Two hundred and twelve were identified. Eighty‐three dogs (39%) had PH . PH was more commonly identified in stage C compared to B 2 ( P < .0001). One hundred and five (49.5%) dogs died during the observation period. Median survival time for the entire study population was 567 days (95% CI 512–743). Stage C ( P = .003), the presence of PH ( P = .009), left atrial to aortic root ratio ( LA / A o) >1.7 ( P = .0002), normalized left‐ventricular end‐diastolic diameter ( LVED n) >1.73 ( P = .048), and tricuspid regurgitation pressure gradient ( TRPG ) >55 mmHg ( P = .009) were associated with worse outcomes in the univariate analyses. The presence of TRPG >55 mmHg ( HR 1.8 95% CI 1–2.9; P = .05) and LA / A o > 1.7 ( HR 2 95% CI 1.2–3.4; P = .01) remained significant predictors of worse outcome in the multivariate analysis. Conclusions and Clinical Importance In dogs with MMVD , moderate to severe PH worsens outcome.