Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease

Background: Myxomatous mitral valve degeneration (MMVD) is the most common heart disease affecting small dogs, it reduces cardiac output resulting in compensatory adaptation of the autonomic nervous system. Chronically it leads to reduced heart rate variability (HRV) which is an accurate marker for...

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Autores principales:	Julio P. dos Santos, Stephany B. Lucina, Bruna N. da Costa, Karla L. C. Olaguivel, Giovana L. R. Tuleski, Marlos G. Sousa
Formato:	article
Lenguaje:	EN
Publicado:	Tripoli University 2021
Materias:	baroreflex autonomic balance heart rate variability turbulence slope turbulence onset Zoology QL1-991
Acceso en línea:	https://doaj.org/article/903382a1a29b49909e2f84dabfb8c868
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spelling	oai:doaj.org-article:903382a1a29b49909e2f84dabfb8c8682021-11-20T21:22:47ZAssessment of heart rate turbulence in dogs with myxomatous mitral valve disease10.5455/OVJ.2021.v11.i4.132226-44852218-6050https://doaj.org/article/903382a1a29b49909e2f84dabfb8c8682021-11-01T00:00:00Zhttps://www.openveterinaryjournal.com/OVJ-2021-03-053%20J.P.%20dos%20Santos%20et%20al.pdfhttps://doaj.org/toc/2226-4485https://doaj.org/toc/2218-6050Background: Myxomatous mitral valve degeneration (MMVD) is the most common heart disease affecting small dogs, it reduces cardiac output resulting in compensatory adaptation of the autonomic nervous system. Chronically it leads to reduced heart rate variability (HRV) which is an accurate marker for autonomic balance. More than two decades ago in human medicine an indicator of autonomic balance that happens after a premature ventricular beat, it was described as heart rate turbulence (HRT). In humans with ischaemic heart disease the absence of HRT has proven to be a more accurate and an independent indicator of mortality than known HRV parameters. Currently there are very few studies of HRT in dogs and it is still not tested in small dogs within different stages of myxomatous mitral valve disease. Aim: The aim of this study was to assess the HRT indicators, onset and slope, in small dogs with myxomatous mitral valve disease and to statistically test it. Methods: Dogs under 25 kg had electrocardiogram and echocardiography performed and, in some patients, holter monitoring was carried out. Data was divided into groups B1, B2, C and D for mean comparison with ANOVA and Tukey test. In addition, Receiver Operating Characteristic (ROC) curve for differentiating among symptomatic and asymptomatic dogs and for differentiating between remodeled and non-remodeled hearts. The Pearson was executed after correlations of TO and TS with commonly used echocardiographic parameters. Results: Variance analyses held significant differences in TO and TS between stages B1 from stages C and D, while B2 held similarity to the other groups. In the Receiver Operating Curve(ROC) was found a very good AUC for differentiating among symptomatic and asymptomatic dogs and remodeled and non-remodeled dogs. Few echocardiography parameters held weak correlation with TO while others held weak to moderate correlation with TS. Conclusion: In dogs with MMVD and without other diseases, heart rate turbulence is a feasible indicator for autonomic balance. Our result suggests HRT changes as the MMVD progresses and CHF is present. More studies with HRT are needed. The number of VPCs may be the strongest limitation for the technique.Julio P. dos SantosStephany B. LucinaBruna N. da CostaKarla L. C. OlaguivelGiovana L. R. TuleskiMarlos G. SousaTripoli Universityarticlebaroreflexautonomic balanceheart rate variabilityturbulence slopeturbulence onsetZoologyQL1-991ENOpen Veterinary Journal, Vol 11, Iss 4, Pp 635-644 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	baroreflex autonomic balance heart rate variability turbulence slope turbulence onset Zoology QL1-991
spellingShingle	baroreflex autonomic balance heart rate variability turbulence slope turbulence onset Zoology QL1-991 Julio P. dos Santos Stephany B. Lucina Bruna N. da Costa Karla L. C. Olaguivel Giovana L. R. Tuleski Marlos G. Sousa Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
description	Background: Myxomatous mitral valve degeneration (MMVD) is the most common heart disease affecting small dogs, it reduces cardiac output resulting in compensatory adaptation of the autonomic nervous system. Chronically it leads to reduced heart rate variability (HRV) which is an accurate marker for autonomic balance. More than two decades ago in human medicine an indicator of autonomic balance that happens after a premature ventricular beat, it was described as heart rate turbulence (HRT). In humans with ischaemic heart disease the absence of HRT has proven to be a more accurate and an independent indicator of mortality than known HRV parameters. Currently there are very few studies of HRT in dogs and it is still not tested in small dogs within different stages of myxomatous mitral valve disease. Aim: The aim of this study was to assess the HRT indicators, onset and slope, in small dogs with myxomatous mitral valve disease and to statistically test it. Methods: Dogs under 25 kg had electrocardiogram and echocardiography performed and, in some patients, holter monitoring was carried out. Data was divided into groups B1, B2, C and D for mean comparison with ANOVA and Tukey test. In addition, Receiver Operating Characteristic (ROC) curve for differentiating among symptomatic and asymptomatic dogs and for differentiating between remodeled and non-remodeled hearts. The Pearson was executed after correlations of TO and TS with commonly used echocardiographic parameters. Results: Variance analyses held significant differences in TO and TS between stages B1 from stages C and D, while B2 held similarity to the other groups. In the Receiver Operating Curve(ROC) was found a very good AUC for differentiating among symptomatic and asymptomatic dogs and remodeled and non-remodeled dogs. Few echocardiography parameters held weak correlation with TO while others held weak to moderate correlation with TS. Conclusion: In dogs with MMVD and without other diseases, heart rate turbulence is a feasible indicator for autonomic balance. Our result suggests HRT changes as the MMVD progresses and CHF is present. More studies with HRT are needed. The number of VPCs may be the strongest limitation for the technique.
format	article
author	Julio P. dos Santos Stephany B. Lucina Bruna N. da Costa Karla L. C. Olaguivel Giovana L. R. Tuleski Marlos G. Sousa
author_facet	Julio P. dos Santos Stephany B. Lucina Bruna N. da Costa Karla L. C. Olaguivel Giovana L. R. Tuleski Marlos G. Sousa
author_sort	Julio P. dos Santos
title	Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
title_short	Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
title_full	Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
title_fullStr	Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
title_full_unstemmed	Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
title_sort	assessment of heart rate turbulence in dogs with myxomatous mitral valve disease
publisher	Tripoli University
publishDate	2021
url	https://doaj.org/article/903382a1a29b49909e2f84dabfb8c868
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Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease

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