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      ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs

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          Abstract

          This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.

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          Left atrial to aortic root indices using two-dimensional and M-mode echocardiography in cavalier King Charles spaniels with and without left atrial enlargement.

          Kerstin Hansson, Jens Häggström, Clarence Kvart … (2015)
          Two-dimensional (2-D) echocardiographic measurement of the left atrium (LA) has the potential to be more accurate than the standard M-mode method, because the LA body can be measured. We evaluated a 2-D method for measuring LA and aorta (AO) in a right parasternal short-axis view and compared it to the M-mode method. An index for LA size (LA/AO) was calculated in 166 cavalier King Charles spaniels, 56 normal and 110 dogs with mitral regurgitation (MR) of varying degrees secondary to chronic valvular disease. In normal dogs, the AO-2-D and LA/AO-2-D did not correlate to body weight (BW) or BW2; whereas, all M-mode values and the LA-2-D were significantly (p < .05) related to both BW parameters. In normal dogs, there was no difference between M-mode and 2-D indices. For all dogs (normal and dogs with MR) there was an 11% bias between the M-mode and 2-D index with the LA/AO-2-D being higher than the LA/AO-M. The association between the mean and the difference of the indices demonstrated a quadratic relationship. Dogs with a mean LA/AO of 2.0-2.5 showed the largest difference between the two indices. Small values for the 2-D coefficients of variation for respiration and stage of diastole were found; 3.4 and 3.1%, respectively. The 2-D index is more sensitive to LA enlargement than the M-mode index.
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            Historical review, epidemiology and natural history of degenerative mitral valve disease.

            Michele Borgarelli, James W Buchanan (2012)
            Chronic mitral valve disease due to myxomatous degeneration (MMVD) is the most common cardiovascular disease in dogs and has been known to cause congestive heart failure for more than 100 years. This article presents an historical perspective of the disease and reviews the most updated data on epidemiology and natural history of MMVD in dogs.
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              Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy.

              Michele Borgarelli, Jens Häggström (2010)
              Myxomatous mitral valve disease is a common condition in geriatric dogs. Most dogs affected are clinically asymptomatic for a long time. However, about 30% of these animals present a progression to heart failure and eventually die as a consequence of the disease. Left atrial enlargement, and particularly a change in left atrial size, seems to be the most reliable predictor of progression in some studies, however further studies are needed to clarify how to recognize asymptomatic patients at higher risk of developing heart failure. According to the published data on the natural history of the disease and the results of published studies evaluating the effect of early therapy on delaying the progression of the disease, it seems that no currently available treatment delays the onset of clinical signs of congestive heart failure (CHF). Although the ideal treatment of more severely affected dogs is probably surgical mitral valve repair or mitral valve replacement, this is not a currently available option. The results of several clinical trials together with clinical experience suggest that dogs with overt CHF can be managed with acceptable quality of life for a relatively long time period with medical treatment including furosemide, an angiotensin-converting enzyme inhibitor, pimobendan, and spironolactone.
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                Author and article information

                Contributors
                Bruce W. Keene:
                ORCID: https://orcid.org/0000-0002-4758-5654
                bruce_keene@ncsu.edu
                Journal
                Journal ID (nlm-ta): J Vet Intern Med
                Journal ID (iso-abbrev): J. Vet. Intern. Med
                Journal ID (doi): 10.1111/(ISSN)1939-1676
                Journal ID (publisher-id): JVIM
                Title: Journal of Veterinary Internal Medicine
                Publisher: John Wiley & Sons, Inc. (Hoboken, USA )
                ISSN (Print): 0891-6640
                ISSN (Electronic): 1939-1676
                Publication date (Electronic): 11 April 2019
                Publication date (Print): May-Jun 2019
                Volume: 33
                Issue: 3 ( doiID: 10.1111/jvim.2019.33.issue-3 )
                Pages: 1127-1140
                Affiliations
                [ 1 ] Department of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina
                [ 2 ] Department of Veterinary Clinical Sciences The Ohio State University Columbus Ohio
                [ 3 ] The Elmer and Mamdouha Bobst Hospital, The Animal Medical Center New York New York
                [ 4 ] Department of Clinical Sciences Swedish University of Agricultural Sciences Uppsala Sweden
                [ 5 ] Department of Clinical Science and Services Royal Veterinary College London United Kingdom
                [ 6 ] Department of Clinical Sciences and Advanced Medicine University of Pennsylvania Philadelphia Pennsylvania
                [ 7 ] Department of Clinical Sciences, Cummings School of Veterinary Medicine Tufts University North Grafton Massachusetts
                [ 8 ] Department of Medical Sciences University of Wisconsin Madison Wisconsin
                [ 9 ] Jasmine Veterinary Cardiovascular Medical Center Yokohama Japan
                Author notes
                [*] [* ] Correspondence

                Bruce W. Keene, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC 27607.

                Email: bruce_keene@ 123456ncsu.edu

                Author information
                https://orcid.org/0000-0002-4758-5654
                https://orcid.org/0000-0003-4089-0573
                https://orcid.org/0000-0003-3402-023X
                https://orcid.org/0000-0002-8277-8996
                Article
                Publisher ID: JVIM15488
                DOI: 10.1111/jvim.15488
                PMC ID: 6524084
                PubMed ID: 30974015
                SO-VID: 273874a0-cddd-482a-bc74-c78fee28ef0f
                Copyright © © 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                Date received : 06 March 2019
                Date accepted : 13 March 2019
                Page count
                Figures: 1, Tables: 1, Pages: 14, Words: 12828
                Categories
                Subject: Consensus Statement
                Subject: Consensus Statements
                Custom metadata
                source-schema-version-number 2.0
                component-id jvim15488
                cover-date May/June 2019
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.3 mode:remove_FC converted:17.05.2019

                ScienceOpen disciplines: Veterinary medicine
                Keywords: canine,congestive heart failure,evidence‐based treatment,mitral
                Data availability:
                ScienceOpen disciplines: Veterinary medicine
                Keywords: canine, congestive heart failure, evidence‐based treatment, mitral

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