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Prognostic value of left ventricular-arterial coupling estimated using echocardiography in dogs with myxomatous mitral valve disease

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Title: Prognostic value of left ventricular-arterial coupling estimated using echocardiography in dogs with myxomatous mitral valve disease
Authors: Osuga, Tatsuyuki Browse this author
Morita, Tomoya Browse this author
Sasaki, Noboru Browse this author →KAKEN DB
Morishita, Keitaro Browse this author →KAKEN DB
Ohta, Hiroshi Browse this author →KAKEN DB
Takiguchi, Mitsuyoshi Browse this author →KAKEN DB
Keywords: canine
Ea
Ees
elastance
mitral regurgitation
survival time
Issue Date: 6-Nov-2021
Publisher: John Wiley & Sons
Journal Title: Journal of Veterinary Internal Medicine
Start Page: 16290
Publisher DOI: 10.1111/jvim.16290
Abstract: Background The interaction between the left ventricle (LV) and systemic arterial systems, known as left ventricular-arterial coupling (VAC), has been evaluated based on the effective arterial elastance (Ea) to LV end-systolic elastance (Ees) ratio (Ea/Ees). The Ea reflects the total arterial load of LV, whereas Ees reflects the LV systolic function. A recent study found that inappropriate VAC based on increased Ea/Ees estimated by echocardiography is associated with advanced disease severity in dogs with myxomatous mitral valve disease (MMVD). Hypothesis Inappropriate VAC assessed by echocardiographic estimation of Ea/Ees is associated with a worse prognosis in dogs with MMVD. Animals Eighty-nine dogs with MMVD. Methods Prospective cohort study. Dogs underwent echocardiographic examinations at enrollment. The Ea was estimated using the formula: mean blood pressure/(forward stroke volume/body weight). The Ees was estimated using the formula: mean blood pressure/(LV end-systolic volume/body weight). The Ea/Ees was calculated. Results By end of study, 22 dogs died of cardiac-related causes with 67 dogs censored. Dogs with increased Ea/Ees (Ea/Ees >0.34; median survival time, 527 days; 95% confidence interval [CI], 322 days-not determinable) had a shorter survival time (P < .0001) than those without increased Ea/Ees (Ea/Ees <= 0.34; median survival time, >1112 days; 95% CI, not determinable). Multivariate Cox proportional hazard analysis showed that Ea/Ees, body weight, peak systolic mitral annular velocity, and the peak early diastolic transmitral velocity-to-peak early diastolic mitral annular velocity ratio were independent predictors of cardiac-related death among echocardiographic indices. Conclusions and Clinical Importance Inappropriate VAC assessed based on echocardiographically-estimated Ea/Ees is associated with a worse prognosis in dogs with MMVD.
Type: article
URI: http://hdl.handle.net/2115/83491
Appears in Collections:獣医学院・獣医学研究院 (Graduate School of Veterinary Medicine / Faculty of Veterinary Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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