Peer-reviewed veterinary case report
Predicting heart failure risk in dogs with mitral valve disease
By Vereb, Michelle et al.·Published in Journal of veterinary internal medicine·2024·Department of Veterinary Clinical Sciences, United States·View original on PubMed →
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Original publication title: Efficacy of a mitral regurgitation severity index to predict long-term outcome in dogs with myxomatous mitral valve disease.
- Species:
- dog
Plain-English summary
A study involving 869 dogs with myxomatous mitral valve disease (MMVD) found that a specific scoring system called the mitral regurgitation severity index (MRSI) can help predict how long a dog might live before developing congestive heart failure (CHF) or passing away. For dogs in the early stages of the disease (Stage B2), a higher MRSI score indicated a shorter time to CHF and a higher risk of death. This means that if your dog has MMVD, your vet can use this index to better understand their condition and plan for their care. The MRSI proved to be more effective than looking at heart rate, age, or other individual factors alone.
People also search for: dog heart disease prognosis · mitral valve disease in dogs · how to manage congestive heart failure in dogs
Abstract
BACKGROUND: Predicting progression of myxomatous mitral valve disease (MMVD) in dogs can be challenging. HYPOTHESIS/OBJECTIVES: The mitral regurgitation severity index (MRSI) will predict time to congestive heart failure (CHF) and all-cause death in dogs with MMVD. ANIMALS: Eight hundred sixty-nine client-owned dogs. METHODS: Retrospective study pooling data from 4 previous samples including dogs with MMVD stage B2 or C. MRSI was calculated as: (heart rate [HR]/120) × left atrium-to-aorta ratio (LA:Ao) × (age in years/10) × 100. Alternative MRSI formulas substituting radiographic measures of left atrial size were also calculated. Cox proportional hazard modeling and time-dependent receiver-operator characteristic curves quantified prognostic performance. RESULTS: For Stage B2 pooled samples, MRSI > 156 was predictive of time to CHF (median 407 vs 1404 days; area under the curve [AUC] 0.68; hazard ratio 3.02 [95% CI 1.9-4.9]; P < .001). MRSI > 173 was predictive of all-cause death (median survival 868 vs 1843 days; AUC 0.64; hazard ratio 4.26 [95% CI 2.4-7.5]; P < .001). MRSI showed superior predictive value compared to the individual variables of HR, LA:Ao, and age. Variations of the MRSI equation substituting radiographic vertebral left atrial size for LA:Ao were also significantly predictive of outcome in stage B2. MRSI was not consistently predictive of outcome in Stage C. CONCLUSIONS AND CLINICAL IMPORTANCE: MRSI was predictive of outcome (onset of CHF and all-cause death) in MMVD Stage B2, demonstrating utility as a useful prognostic tool. Echocardiographic LA:Ao can be effectively replaced by radiographically determined LA size in the MRSI formula.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37909399/