Retrospective review of carvedilol administration in 38 dogs with preclinical chronic valvular heart disease

Gordon, Sonya G.; Saunders, Ashley B.; Hariu, Crystal D.; Boggess, May; Miller, Matthew W.

doi:10.1016/j.jvc.2012.01.007

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Advancing age was associated with an increased hazard of death due to all‐cause mortality in dogs with DMVD, consistent with previous reports . In contrast to previous studies, sex was an independent risk factor for all‐cause mortality, with males having a lower hazard of death than females. This association might reflect sex differences in the risk of death due to non‐cardiac disorders or type I error.…”

Section: Discussionsupporting

confidence: 90%

“…Higher heart rates were associated with increased hazards of an adverse outcome in agreement with a number of studies . Decreased cardiac output and arterial hypotension as a result of DMVD elicit a decrease in vagal tone and increase the activity of the sympathetic nervous system (SNS) and renin‐angiotensin‐aldosterone system (RAAS) .…”

Section: Discussionsupporting

confidence: 85%

“…Echocardiographic and radiographic indices of cardiac enlargement and mitral regurgitation severity have prognostic value in dogs with DMVD . However, the equipment and expertise required to perform these procedures and interpret the findings might not be readily available in primary care practice .…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors in dogs with presumed degenerative mitral valve disease attending primary‐care veterinary practices in the United Kingdom

Mattin

Boswood

Church

et al. 2018

Veterinary Internal Medicne

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Background Prognostic risk factors were identified for dogs with degenerative mitral valve disease (DMVD) monitored by veterinary cardiologists. The value of these measurements has not been determined in the wider primary care setting. Objectives To evaluate whether plasma cardiac biomarkers and data obtained from routine history‐taking and physical examination are predictive of survival in dogs with DMVD attending primary care practice. Animals Eight‐hundred and ninety‐three dogs with a presumptive diagnosis of DMVD recruited from 79 primary care veterinary practices in the United Kingdom. Methods Prospective cohort study. Primary care veterinary practitioners recorded clinical data. Plasma N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and cardiac troponin I (cTnI) were measured at presentation. Cox regression models evaluated associations between risk factor variables and hazard of death (all‐cause mortality and cardiac‐related death). Flexible parametric models generated predicted survival probabilities for dogs with different combinations of prognostic risk factor variable values. Results Dogs with higher NT‐proBNP and cTnI concentrations, higher heart rates, older dogs, females, and those reported to be exercise intolerant, dyspneic, and diagnosed with selected comorbidities had an increased hazard of death due to any cause. Dogs with higher concentrations of plasma biomarkers, higher heart rates, and heart murmur intensities, those with exercise intolerance and those receiving potent diuretics had a higher hazard of cardiac‐related death. Conclusions and Clinical Importance Cardiac biomarkers and key clinical findings identified in this study can help primary care veterinary practitioners identify dogs with DMVD that are at highest risk of death.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 85%

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Prognostic factors in dogs with presumed degenerative mitral valve disease attending primary‐care veterinary practices in the United Kingdom

Mattin

Boswood

Church

et al. 2018

Veterinary Internal Medicne

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“…Previous observational studies and randomized controlled trials have evaluated factors associated with disease progression in dogs with stage B DMVD . Natriuretic peptides, radiographic and echocardiographic measurements, presenting signs and physical examination findings, age, systolic arterial blood pressure, and pimobendan treatment have been reported to be associated with outcome in dogs with preclinical DMVD. However, the samples of dogs included in these studies were restricted to those attending teaching or referral hospitals or a single breed.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with disease progression in dogs with presumed preclinical degenerative mitral valve disease attending primary care veterinary practices in the United Kingdom

Mattin

Brodbelt

Church

et al. 2018

Veterinary Internal Medicne

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Background Factors associated with disease progression in dogs with preclinical (stage B) degenerative mitral valve disease (DMVD) have not been evaluated previously in primary care veterinary practice. Objectives To evaluate whether plasma cardiac biomarkers, clinical signs, and physical examination findings are associated with clinical progression (reaching the composite endpoint of initiation of treatment with a potent diuretic or cardiac death) in dogs presumed to have stage B DMVD. Animals Six‐hundred and eighty‐four dogs diagnosed with DMVD recruited from 73 primary care practices in the United Kingdom. Dogs were not receiving potent diuretics at recruitment. Methods Prospective cohort study design. Primary care veterinarians recorded the presence or absence of clinical signs and physical examination findings. Baseline plasma N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and cardiac troponin I were measured. Cox regression models measured associations between risk factor variables and clinical progression. Flexible parametric models generated predicted probabilities of reaching the composite endpoint for dogs with different combinations of prognostic risk factor variables. Results Plasma NT‐proBNP, heart rate, heart murmur intensity, presence of a cough, being a Cavalier King Charles Spaniel, and being prescribed pimobendan were associated with clinical progression to initiation of treatment with a potent diuretic or cardiac‐related death. Conclusions and Clinical Importance Dogs with stage B DMVD identified as having a high risk of disease progression might benefit from more frequent monitoring or further diagnostic evaluation. The prognostic factors identified could facilitate risk stratification of dogs presenting with preclinical DMVD.

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“…[1] This condition is known as myxomatous valve degeneration (mvd), a heart disease commonly acquired by small dog breeds during adulthood. [2] The disease does not have a defined etiology, and for this reason several hypotheses have arisen about the ways in which genetics and hemodynamic and endogenous factors may affect the disease. [3][4][5] mvd is the most common cause of heart failure in dogs and is considered to comprise 70-80% of heart-related diseases affecting this species.…”

Section: Introductionmentioning

confidence: 99%

Myxomatous valve degeneration

et al. 2013

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Abstract. This review article is an analysis of the most recent published scientific articles about myxomatous valve degeneration (mvd) and was conducted over a five month period. The aim of this review is to consolidate information about the most recent medical developments in regards to myxomatous degeneration in the mitral valve. The authors of this article reached a consensus on both the development of the disease and the most effective type of diagnosis and treatment that is available today. Myxomatous valve degeneration is the most common heart disease in the canine population. It is identified by a loss of mechanical integrity in the heart due to structural changes in the valvular components. Degenerative changes occur due to an accumulation of mucopolysaccharides in the leaflets and chordae which affect the proper operation of the valve apparatus. This is caused by faulty coaptation of the leaflets, resulting in mitral or tricuspid regurgitation, dilated ventricles and annuli, which are lesions that eventually cause the rupture of the chordae tendineae, leading to complications or possibly death. Due to the gradual progression of the disease and the presence or absence of clinical signs, it is very important that veterinarians accurately diagnose and follow-up on these patients in order to achieve stabilization and provide a suitable prognosis and treatment plan. The current ideal treatment of the disease is a low-sodium diet, administration of the ace inhibitor (angiotensin-converting-enzyme inhibitor) spironolactone and a diuretic in order to reduce the presence of pulmonary edema and avoid the progression of the disease to congestive heart failure.Keywords: av valves, canine, heart, Myxomatous degeneration, treatment. Degeneração valvar mixomatosa. Um olhar nos últimos avanços em todos os aspectos da doençaResumo. Este artigo de revisão se realizou durante um período de cinco meses. Incluíram-se, neste, os últimos avanços publicados em artigos científicos. Conseguiu-se realizar um consenso quanto ao desenvolvimento da doença, ao tipo de diagnóstico mais adequado e ao tratamento que melhores resultados está mostrando na atualidade. O objetivo desta revisão foi conhecer as últimas atualizações sobre a degeneração valvular mixomatosa. A degeneração valvar mixomatosa é a doença cardíaca mais comum na população canina, na qual há uma perda da integridade mecânica devido a mudanças estruturais nos componentes valvulares. As mudanças se devem a uma acumulação de mucopolisacáridos nas cordas tendíneas e nas valvas as quais iniciam com falhas na coaptação das valvas gerando uma regurgitação mitral ou tricuspidiana, dilatação dos ventrículos e do anel valvular, levando a complicações ou morte do paciente. Devido ao progresso gradual das lesões na doença e à manifestação ou não de signos clínicos, o diagnóstico exato e seguimento apropriado desses pacientes é de grande importância para os médicos veterinários com o objetivo de prognosticar e instaurar o tratamento adequado. O melhor tratamento na atualidade para...

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Retrospective review of carvedilol administration in 38 dogs with preclinical chronic valvular heart disease

Cited by 8 publications

References 31 publications

Prognostic factors in dogs with presumed degenerative mitral valve disease attending primary‐care veterinary practices in the United Kingdom

Prognostic factors in dogs with presumed degenerative mitral valve disease attending primary‐care veterinary practices in the United Kingdom

Factors associated with disease progression in dogs with presumed preclinical degenerative mitral valve disease attending primary care veterinary practices in the United Kingdom

Myxomatous valve degeneration

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