Prediction of first onset of congestive heart failure in dogs with degenerative mitral valve disease: the PREDICT cohort study.
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OBJECTIVE: To identify risk factors for first-onset congestive heart failure (CHF) in dogs with degenerative mitral valve disease (DMVD). ANIMALS: Eighty-two dogs with and without CHF secondary to DMVD were retrospectively assigned to a derivation cohort. Sixty-five dogs with asymptomatic DMVD were recruited into a prospective validation cohort. METHODS: Variables associated with risk of CHF in dogs were identified in a derivation cohort and used to construct a predictive model, which was then prospectively tested through longitudinal examination of a validation cohort. RESULTS: Logistic regression analysis of the derivation cohort yielded a predictive model that included the left atrial to aortic root dimension ratio (LA:Ao) and plasma concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP). When this model was prospectively applied to the validation cohort, it correctly predicted first-onset of CHF in 69.2% of cases. Analysis of the validation cohort revealed that plasma NT-proBNP concentration and indexed left ventricular end-diastolic diameter (LVIDd:Ao) were independent risk factors for development of first-onset CHF in dogs with DMVD (NT-proBNP 1500 pmol/L, odds ratio (OR), 5.76, 95% confidence interval (CI), 1.37-24.28, P = 0.017; LVIDd:Ao 3, OR, 6.11, 95% CI, 1.09-34.05, P = 0.039). CONCLUSIONS: Measures of left heart size and plasma NT-proBNP concentration independently estimate risk of first-onset of CHF in dogs with DMVD. These parameters can contribute to the management of dogs with DMVD.
Reynolds, C. A., Brown, D. C., Rush, J. E., Fox, P. R., Nguyenba, T. P., Lehmkuhl, L. B., ... Oyama, M. A.
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Reynolds, Caryn A||Brown, Dorothy Cimino||Rush, John E||Fox, Philip R||Nguyenba, Thaibihn P||Lehmkuhl, Linda B||Gordon, Sonya G||Kellihan, Heidi B||Stepien, Rebecca L||Lefbom, Bonnie K||Meier, C Kate||Oyama, Mark A