Reimann M J, Møller J E, Häggström J, Martinussen T, Zatrazemi S S C, Svanholm L, Nielsen L B M, Pedersen H D, Olsen L H
Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
J Vet Intern Med. 2017 Jul;31(4):1008-1016. doi: 10.1111/jvim.14759. Epub 2017 Jun 1.
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).
1125 privately owned CKCS.
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.
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 all-cause (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 (LVIDS ).
Moderate to severe MR, even if intermittent, and increased LVIDS in dogs <3 years of age were associated with cardiac death later in life in CKCS.
犬黏液瘤性二尖瓣疾病（MMVD）的发展和进展难以预测。在幼年时识别出未来有不良预后高风险的犬是很有必要的。
假设/目标：研究幼年时获得的与MMVD相关的特定临床和超声心动图特征对预测骑士查理王小猎犬（CKCS）长期心脏和全因死亡率的预测价值。
1125只私人饲养的CKCS。
一项回顾性研究，纳入1 - 3岁接受检查的CKCS。通过与主人电话访谈评估长期结局。通过Cox比例风险分析和Kaplan - Meier分析研究预测死亡率的变量值。
彩色多普勒超声心动图显示存在中度至重度二尖瓣反流（MR）（风险比（HR）= 3.03，95%置信区间（95%CI）= 1.48 - 6.23，P = 0.0025），即使是间歇性中度至重度MR（HR = 2.23，95%CI = 1.48 - 6.23，P = 0.039）也与心脏死亡风险增加显著相关。MR与性别之间的相互作用对全因死亡率有显著影响（P = 0.035），表明中度至重度MR的雄性犬与无MR的雄性犬相比全因死亡率更高（HR = 2.38，95%CI = 1.27 - 4.49，P = 0.0071），而雌性MR组之间未发现差异。心脏（HR = 1.37，95%CI = 1.14 - 1.63，P < 0.001）和全因（HR = 1.13，95%CI = 1.02 - 1.24，P = 0.016）死亡率风险随着体重标准化的左心室收缩末期内径（LVIDS）增加而升高。
3岁以下犬的中度至重度MR，即使是间歇性的，以及LVIDS增加与CKCS后期的心脏死亡相关。
