Atrial Fibrillation as a Prognostic Indicator in Medium to Large-Sized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure

S. W. Jung, W. Sun, Leigh Griffiths, M. D. Kittleson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The prevalence and prognostic importance of atrial fibrillation (AF) on survival in nonsmall breed dogs with myxomatous mitral valvular disease (MMVD) and congestive heart failure (CHF) remain unknown. Aim: To identify the prevalence of AF in nonsmall breed dogs with CHF because of MMVD and to characterize the impact of AF on survival outcome. Animal: Sixty-four client-owned dogs (>15 kg) with MMVD and CHF. Methods: Retrospective review of medical records for dogs weighing >15 kg with MMVD treated for CHF. Results: Thirty-three dogs presented with AF or developed AF during follow-up examinations, and 31 dogs were free of AF until cardiac-related death. For dogs with AF, median survival time (MST) was 142 days (range: 9-478) while dogs without AF lived 234 days (range: 13-879 days). AF increased risk of cardiac-related death (HR = 2.544; 95% CI = 1.41-4.59; P =.0019) when compared to dogs without AF. MST was significantly prolonged for dogs with AF whose rates were adequately controlled (<160 bpm; 171 days; n = 13) when compared to dogs that failed to respond to negative chronotropic agents (61 days; n = 20; P =.032). The administration of combination treatment (diltiazem and digoxin) significantly decreased median HR to 144 bpm (range: 84-218 bpm) in dogs with AF and significantly prolonged MST (diltiazem+digoxin: 130 days versus diltiazem: 35 days, P =.0241) when compared to diltiazem alone. Conclusions and Clinical Importance: Inadequately controlled AF is associated with a higher rate of mortality. Optimization of therapeutic strategies for the rate control of AF remains determined.

Original languageEnglish (US)
Pages (from-to)51-57
Number of pages7
JournalJournal of Veterinary Internal Medicine
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

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heart failure
Atrial Fibrillation
Heart Failure
Dogs
dogs
Diltiazem
digoxin
Digoxin
dog breeds
atrial fibrillation
death
Medical Records

Keywords

  • Atrial fibrillation
  • Congestive heart failure
  • Myxomatous valvular disease
  • Prognosis

ASJC Scopus subject areas

  • veterinary(all)

Cite this

@article{292e332f18d0445c997e35e0b8ffec05,
title = "Atrial Fibrillation as a Prognostic Indicator in Medium to Large-Sized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure",
abstract = "Background: The prevalence and prognostic importance of atrial fibrillation (AF) on survival in nonsmall breed dogs with myxomatous mitral valvular disease (MMVD) and congestive heart failure (CHF) remain unknown. Aim: To identify the prevalence of AF in nonsmall breed dogs with CHF because of MMVD and to characterize the impact of AF on survival outcome. Animal: Sixty-four client-owned dogs (>15 kg) with MMVD and CHF. Methods: Retrospective review of medical records for dogs weighing >15 kg with MMVD treated for CHF. Results: Thirty-three dogs presented with AF or developed AF during follow-up examinations, and 31 dogs were free of AF until cardiac-related death. For dogs with AF, median survival time (MST) was 142 days (range: 9-478) while dogs without AF lived 234 days (range: 13-879 days). AF increased risk of cardiac-related death (HR = 2.544; 95{\%} CI = 1.41-4.59; P =.0019) when compared to dogs without AF. MST was significantly prolonged for dogs with AF whose rates were adequately controlled (<160 bpm; 171 days; n = 13) when compared to dogs that failed to respond to negative chronotropic agents (61 days; n = 20; P =.032). The administration of combination treatment (diltiazem and digoxin) significantly decreased median HR to 144 bpm (range: 84-218 bpm) in dogs with AF and significantly prolonged MST (diltiazem+digoxin: 130 days versus diltiazem: 35 days, P =.0241) when compared to diltiazem alone. Conclusions and Clinical Importance: Inadequately controlled AF is associated with a higher rate of mortality. Optimization of therapeutic strategies for the rate control of AF remains determined.",
keywords = "Atrial fibrillation, Congestive heart failure, Myxomatous valvular disease, Prognosis",
author = "Jung, {S. W.} and W. Sun and Leigh Griffiths and Kittleson, {M. D.}",
year = "2016",
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language = "English (US)",
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pages = "51--57",
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T1 - Atrial Fibrillation as a Prognostic Indicator in Medium to Large-Sized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure

AU - Jung, S. W.

AU - Sun, W.

AU - Griffiths, Leigh

AU - Kittleson, M. D.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: The prevalence and prognostic importance of atrial fibrillation (AF) on survival in nonsmall breed dogs with myxomatous mitral valvular disease (MMVD) and congestive heart failure (CHF) remain unknown. Aim: To identify the prevalence of AF in nonsmall breed dogs with CHF because of MMVD and to characterize the impact of AF on survival outcome. Animal: Sixty-four client-owned dogs (>15 kg) with MMVD and CHF. Methods: Retrospective review of medical records for dogs weighing >15 kg with MMVD treated for CHF. Results: Thirty-three dogs presented with AF or developed AF during follow-up examinations, and 31 dogs were free of AF until cardiac-related death. For dogs with AF, median survival time (MST) was 142 days (range: 9-478) while dogs without AF lived 234 days (range: 13-879 days). AF increased risk of cardiac-related death (HR = 2.544; 95% CI = 1.41-4.59; P =.0019) when compared to dogs without AF. MST was significantly prolonged for dogs with AF whose rates were adequately controlled (<160 bpm; 171 days; n = 13) when compared to dogs that failed to respond to negative chronotropic agents (61 days; n = 20; P =.032). The administration of combination treatment (diltiazem and digoxin) significantly decreased median HR to 144 bpm (range: 84-218 bpm) in dogs with AF and significantly prolonged MST (diltiazem+digoxin: 130 days versus diltiazem: 35 days, P =.0241) when compared to diltiazem alone. Conclusions and Clinical Importance: Inadequately controlled AF is associated with a higher rate of mortality. Optimization of therapeutic strategies for the rate control of AF remains determined.

AB - Background: The prevalence and prognostic importance of atrial fibrillation (AF) on survival in nonsmall breed dogs with myxomatous mitral valvular disease (MMVD) and congestive heart failure (CHF) remain unknown. Aim: To identify the prevalence of AF in nonsmall breed dogs with CHF because of MMVD and to characterize the impact of AF on survival outcome. Animal: Sixty-four client-owned dogs (>15 kg) with MMVD and CHF. Methods: Retrospective review of medical records for dogs weighing >15 kg with MMVD treated for CHF. Results: Thirty-three dogs presented with AF or developed AF during follow-up examinations, and 31 dogs were free of AF until cardiac-related death. For dogs with AF, median survival time (MST) was 142 days (range: 9-478) while dogs without AF lived 234 days (range: 13-879 days). AF increased risk of cardiac-related death (HR = 2.544; 95% CI = 1.41-4.59; P =.0019) when compared to dogs without AF. MST was significantly prolonged for dogs with AF whose rates were adequately controlled (<160 bpm; 171 days; n = 13) when compared to dogs that failed to respond to negative chronotropic agents (61 days; n = 20; P =.032). The administration of combination treatment (diltiazem and digoxin) significantly decreased median HR to 144 bpm (range: 84-218 bpm) in dogs with AF and significantly prolonged MST (diltiazem+digoxin: 130 days versus diltiazem: 35 days, P =.0241) when compared to diltiazem alone. Conclusions and Clinical Importance: Inadequately controlled AF is associated with a higher rate of mortality. Optimization of therapeutic strategies for the rate control of AF remains determined.

KW - Atrial fibrillation

KW - Congestive heart failure

KW - Myxomatous valvular disease

KW - Prognosis

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