Kurogochi Kentaro, Furusato Shimon, Takahashi Emi, Tabata Miho, Mizuno Masashi, Nii Yasuyuki, Uechi Masami
JASMINE Veterinary Cardiovascular Medical Center, Yokohama, Kanagawa, Japan.
Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina, USA.
J Vet Intern Med. 2025 Jul-Aug;39(4):e70171. doi: 10.1111/jvim.70171.
Myxomatous mitral valve disease (MMVD) in dogs commonly progresses to congestive heart failure, which carries a poor prognosis. Mitral valve repair (MVR) is a recognized treatment for advanced-stage MMVD.
HYPOTHESIS/OBJECTIVES: Identify the risk factors and prognosis in dogs undergoing MVR.
We enrolled 1019 dogs with MMVD (ACVIM stages B2, C, and D) that underwent MVR between January 2017 and December 2020.
Medical records from a single institution were retrospectively reviewed. Early and late postoperative periods were defined as < 100 days and 100-1400 days after surgery, respectively. The outcome was time to a composite of all-cause mortality, onset of postoperative congestive heart failure, or undergoing a second MVR (surgical revision).
In the early postoperative period, 61 dogs experienced the composite outcome; in the late period, 211 dogs did. No dogs underwent a second MVR. The incidence rate was 19.6 and 7.1 events per 1000 dog-months in the early and late periods, respectively. Compared with stage B2 dogs, stage D dogs had 2.2 times the daily hazard of experiencing an early postoperative event. In the late period, increasing age (per year; hazard ratio [HR], 1.3), higher body weight (per kilogram; HR, 1.1), Cavalier King Charles Spaniels compared with Chihuahuas (HR, 2.2), and preoperative tricuspid valve regurgitant velocity > 3.7 m/s (HR, 2.5) were associated with the events.
A higher incidence of the event was observed in the early postoperative period rather than later, with the outcome varying according to MMVD condition and patient-specific factors.
犬黏液瘤性二尖瓣疾病（MMVD）通常会发展为充血性心力衰竭，预后较差。二尖瓣修复术（MVR）是晚期MMVD的一种公认治疗方法。
假设/目标：确定接受MVR的犬的风险因素和预后。
我们纳入了2017年1月至2020年12月期间接受MVR的1019只患有MMVD（ACVIM分期为B2、C和D期）的犬。
对来自单一机构的病历进行回顾性分析。术后早期和晚期分别定义为术后<100天和100 - 1400天。结局指标为全因死亡率、术后充血性心力衰竭发作或接受二次MVR（手术翻修）的复合时间。
术后早期，61只犬出现复合结局；晚期，211只犬出现该结局。没有犬接受二次MVR。早期和晚期的发病率分别为每1000犬月19.6次和7.1次事件。与B2期犬相比，D期犬术后早期发生事件的每日风险是其2.2倍。在晚期，年龄增加（每年；风险比[HR]，1.3）、体重增加（每千克；HR，1.1）、与吉娃娃犬相比的骑士查理王小猎犬（HR，2.2）以及术前三尖瓣反流速度>3.7 m/s（HR，2.5）与这些事件相关。
术后早期观察到的事件发生率高于晚期，结局因MMVD病情和患者特异性因素而异。
