PREDICTING FIRST ONSET OF CONGESTIVE HEART FAILURE IN DOGS WITH MITRAL VALVE DISEASE

摘要

Degenerative mitral valve disease (DMVD) is a common disease of adult dogs. Approximately 3/4 of dogs with heart disease will have mitral valve disease, and evaluating severity of heart disease and risk for congestive heart failure is an important feature of this condition. This presentation will review current and emerging methods used to diagnosis and assess risk for heart failure, with the goal of predicting the first onset of heart failure in dogs with asymptomatic mitral valve disease.Methods involve the physical examination, ECG, thoracic radiographs, biomarker testing, and echocardiography. The goal of these methods is to identify the subset of dogs with progressive mitral valve disease, volume overload, and impending congestive heart failure. Once identified, these dogs might benefit from medical therapy or increased vigilance that would potentially prevent an unexpected and catastrophic episode of heart failure.The diagnosis of mitral valve disease can be presumptively made on the basis of the classic murmur in an adult small breed dog. As mitral regurgitation worsens, the intensity of the left basilar heart murmur increases; however there is a great deal of individual variation, particularly in dogs with mild disease. Due to the orientation of the mitral regurgitant jet, it is not uncommon for dogs with mild mitral valve disease to have relatively loud murmurs. On echocardiographic examination disease of theanterior mitral valve leaflet can be seen to typically produce a mitral regurgitant jet orientated towards the lateral atrial wall, thus creating a relatively loud focal murmur. While it can be said that dogs with a grade 4 or 5 murmur will typically have more disease than dogs with a murmur of lesser intensity, it is difficult to base individualized treatment plans on the absolute intensity of the heart murmur.