Prevalence and prognostic role of L wave and selected clinical and echocardiographic variables in dogs with atrial fibrillation.

Abstract

BACKGROUND: Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. HYPOTHESIS/OBJECTIVES: To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. ANIMALS: Fifty-five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. METHODS: Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all-cause mortality using Cox proportional hazards regression models. RESULTS: L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI]&#xa0;=&#xa0;47%-72%) but their presence did not influence outcome. Increased left ventricular end-systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR]&#xa0;=&#xa0;4.41, 95% CI&#xa0;=&#xa0;1.18-16.54; P&#xa0;=&#xa0;.03) and all-cause mortality (HR&#xa0;=&#xa0;9.39, 95% CI&#xa0;=&#xa0;2.49-35.32; P&#x2009;<&#x2009;.001). Heart rate assessed during echocardiography (Echo-HR) represented an additional significant predictor of cardiac death (HR&#xa0;=&#xa0;1.01, 95% CI&#xa0;=&#xa0;1.00-1.01; P&#xa0;=&#xa0;.04) and all-cause mortality (HR&#xa0;=&#xa0;1.01, 95% CI&#xa0;=&#xa0;1.00-1.01; P&#xa0;=&#xa0;.04). CONCLUSIONS AND CLINICAL IMPORTANCE: L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo-HR represented independent predictors of negative outcome in these animals.