The prevalence of pulmonary hypertension in Cavalier King Charles spaniels compared with other breeds with myxomatous mitral valve disease

Sudunagunta, Siddharth; Green, D.; Christley, Robert M.; Dukes‐McEwan, J.

doi:10.1016/j.jvc.2019.01.002

Cited by 5 publications

(8 citation statements)

References 35 publications

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“…PH is a common finding in dogs with MMVD, and its prevalence has been shown to increase with disease stage and to be associated with worse outcome. [32][33][34][35] Nineteen dogs (19%) in our study had PH, which is comparable to proportions found in other studies. 32,35 PH associated with MMVD can contribute to low output failure and systemic hypotension, if right ventricular systolic function is unable to compensate for the increased afterload, potentially affecting SI.…”

Section: Discussionsupporting

confidence: 90%

Retrospective evaluation of the utility of shock index to determine the presence of congestive heart failure in dogs with myxomatous mitral valve disease (2019–2021): 98 cases

Matson,

Llewellyn

2024

J Vet Emergen Crit Care

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ObjectivesTo calculate the shock index (SI) in dogs with myxomatous mitral valve disease (MMVD) and to evaluate its use to predict the presence of congestive heart failure (CHF).DesignRetrospective study.SettingSmall animal university veterinary teaching hospital.AnimalsNinety‐eight dogs with MMVD and 20 healthy dogs as part of a control group.InterventionsHeart rate (HR) and systolic blood pressure (SBP) were recorded, and SI was calculated by dividing HR by SBP for each dog.Measurements and Main ResultsThe mean (SD) HR, SBP, and SI were 123/min (32.6), 147 mm Hg (21.5), and 0.86 (0.3), respectively, for dogs with MMVD and 98/min (20.9), 145 mm Hg (18.7), and 0.68 (0.13), respectively, for control dogs. Dogs with MMVD had a significantly higher HR compared with control dogs (P < 0.01), and an elevation in HR was seen as the severity of MMVD increased. Dogs in stage B2 and C/D MMVD had a significantly higher SI value compared with control dogs (P = 0.04 and P < 0.01, respectively). SI was significantly higher in dogs in stage C/D MMVD compared with dogs in stage B2 MMVD (P < 0.01). Ten of 98 (10%) dogs had an arrhythmia. HR, SBP, and SI were not significantly different between dogs with and without arrhythmias (P = 0.13, P = 0.57, and P = 0.07, respectively), but significantly more dogs with CHF had an arrhythmia (P = 0.01). SI (area under the curve [AUC]: 0.98) and HR (AUC: 0.95) were excellent indicators for the presence of CHF. An optimal SI cutoff value ≥1.1 had 92% sensitivity and 95% specificity for predicting the presence of CHF, and an optimal HR cutoff value of ≥157/min had 92% sensitivity and 93% specificity for the prediction of CHF.ConclusionsWhen there are compatible clinical signs, SI values ≥1.1 may suggest the presence of CHF in dogs with MMVD.

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Section: Discussionsupporting

confidence: 90%

Retrospective evaluation of the utility of shock index to determine the presence of congestive heart failure in dogs with myxomatous mitral valve disease (2019–2021): 98 cases

Matson,

Llewellyn

2024

J Vet Emergen Crit Care

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“…Considering the TR velocity cut-off of 2.8 m/s, the prevalence of PH in our population of CKCSs affected by MMVD was 17.6%, and age significantly affected the presence of PH; indeed, for each year of age, the likelihood of having PH increased by about 50%. The prevalence of PH in our CKCS population was significantly lower compared to that obtained in a previous study conducted on CKCSs of 9.72 ± 2.26 years old (75.5%), in which the authors considered the same TR cut-off value of 2.8 m/s [27]. This different result could be due to the different inclusion criteria used in this study by Sudunagunta et al, in which only dogs with ACVIM stage B2 or higher MMVD were included.…”

Section: Discussioncontrasting

confidence: 86%

“…Pulmonary arterial pressure was estimated solely by measuring the TR velocity. Pulmonary hypertension was assessed using three different cut-offs: ≥2.8 m/s [26,27], >3 m/s [10,28], and >3.4 m/s [29].…”

Section: Methodsmentioning

confidence: 99%

Clinical and Echocardiographic Findings in an Aged Population of Cavalier King Charles Spaniels

Ramos¹,

Corda

Swift

et al. 2021

Animals

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Myxomatous mitral valve disease (MMVD) is the most common cardiac disease in dogs. It varies from dogs without clinical signs to those developing left-sided congestive heart failure, leading to death. Cavalier King Charles Spaniels (CKCSs) are particularly susceptible to MMVD. We hypothesised that within the elderly CKCS population, there is a sub-cohort of MMVD-affected dogs that do not have cardiac remodelling. The objectives of the present study were (i) to determine the prevalence and the degree of cardiac remodelling associated with MMVD; and (ii) assess the effect of age, gender, and body weight on echocardiographic status in a population of aged CKCSs. A total of 126 CKCSs ≥ 8 years old were prospectively included. They all had a physical and echocardiographic examination. A systolic murmur was detected in 89% of dogs; the presence of clinical signs was reported in 19% of them; and echocardiographic evidence of MMVD was described in 100%. Despite the high prevalence, 44.4% of the dogs were clear of echocardiographic signs of cardiac remodelling. Age was significantly associated with the presence and severity of cardiac remodelling and mitral valve prolapse. Our results showed that a proportion of elderly CKCS with confirmed MMVD did not undergo advanced stages of this pathology.

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“…The remodeling process involves the left ventricle in parallel, followed by the right ventricle and the right atrium. Typical of the course of congestive heart failure (CHF) due to MMVD are multiple recurrences of pulmonary edema of varying degrees of severity [11], and pulmonary hypertension (PH) [12,13]. Right heart enlargement develops in more severe and/or chronic cases of PH [11].…”

Section: Introductionmentioning

confidence: 99%

“…Other symptoms commonly associated with PH are syncope and restlessness. Exercise intolerance, weakness, weight loss, and depression are considered non-specific but associated with PH [1,12,13,[16][17][18][19]. In symptomatic heart failure (stage C according to the American College of Veterinary Internal Medicine, ACVIM), patients with a high probability of PH have a significantly worse prognosis, with a survival time about 2 months shorter compared to patients with a lower probability of PH [16,17,20].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease in Dogs: Current Insights into the Histological Manifestation and Its Determining Factors

Grzeczka,

Pasławska,

Graczyk

et al. 2024

Applied Sciences

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Pulmonary venous hypertension (PVH) is caused by deteriorating left ventricular function. The most common cause of PVH in dogs is myxomatous mitral valve degeneration (MMVD). It causes left ventricular volume overload and an increase in left atrial and pulmonary venous pressure (PVH), which leads to pulmonary vascular wall remodeling and contributes to the perpetuation and worsening of PVH. Pulmonary vascular wall remodeling is also characteristic of pulmonary arterial hypertension (PAH). However, the changes in PVH arise secondary to heart failure and vascular remodeling progresses as the disease progresses. On the other hand, PAH is a primary disease that can be triggered, for example, by the use of certain drugs. Similar structural changes may suggest the influence of similar pathophysiological mechanisms or the intermediation of similar mediators. Therefore, this article discusses recent and hitherto uncommented findings elucidating the pathophysiology of the processes and influences on the pattern of histological changes observed in pulmonary hypertension secondary to degenerative mitral valve disease. In particular, we focus on the activity of factors such as endothelin, serotonin, and nitric oxide, which are involved in pulmonary vascular wall remodeling in both PVH and PAH.

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The prevalence of pulmonary hypertension in Cavalier King Charles spaniels compared with other breeds with myxomatous mitral valve disease

Cited by 5 publications

References 35 publications

Retrospective evaluation of the utility of shock index to determine the presence of congestive heart failure in dogs with myxomatous mitral valve disease (2019–2021): 98 cases

Retrospective evaluation of the utility of shock index to determine the presence of congestive heart failure in dogs with myxomatous mitral valve disease (2019–2021): 98 cases

Clinical and Echocardiographic Findings in an Aged Population of Cavalier King Charles Spaniels

Pulmonary Hypertension Secondary to Myxomatous Mitral Valve Disease in Dogs: Current Insights into the Histological Manifestation and Its Determining Factors

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