Key result
In dogs with myxomatous mitral valve disease, reduced peak atrial longitudinal strain was an independent predictor of future atrial fibrillation (RR 0.96), with a value ≤28% yielding a sensitivity of 0.80 and specificity of 0.65.
Why the study?
Atrial fibrillation occurs in dogs with myxomatous mitral valve disease secondary to left atrial dilatation and impacts survival and quality of life, but the utility of echocardiography for predicting its first occurrence required evaluation.
Do echocardiographic variables predict the first occurrence of atrial fibrillation in dogs with myxomatous mitral valve disease?
Case-Control (n=44)
Yes
Do echocardiographic variables predict the first occurrence of atrial fibrillation in dogs with myxomatous mitral valve disease?
Absolute cardiac diameters and left atrial speckle tracking echocardiography (specifically PALS) are useful predictors for the development of atrial fibrillation in dogs with myxomatous mitral valve disease.
BACKGROUND: Atrial fibrillation (AF) occurs in dogs with myxomatous mitral valve disease (MMVD) as a consequence of left atrial (LA) dilatation, and it affects survival and quality of life. OBJECTIVES: To evaluate the usefulness of echocardiography in predicting the first occurrence of AF in dogs with MMVD. ANIMALS: Forty-four client-owned dogs with MMVD, 22 dogs that developed AF, and 22 dogs that maintained sinus rhythm. METHODS: Retrospective observational study. Medical databases were reviewed for dogs that developed AF during the year after diagnosis of MMVD (AF group). The last echocardiographic examination obtained while still in sinus rhythm was used to derive selected variables. For each dog with AF, a control dog matched for body weight, class of heart failure, and LA dimension was selected. Echocardiographic results including LA volumes and LA speckle tracking echocardiography (STE)-derived variables were measured. RESULTS: Among the tested echocardiographic variables, only LA diameter (P = .03) and left ventricular internal diameter in diastole (P = .03) differed significantly between groups, whereas body weight-indexed variables of cardiac dimension as well as LA volumes and volume-derived functional variables were not different. Among the STE-derived variables, peak atrial longitudinal strain (PALS) results differed significantly between the AF group (23.8% ± 8.6%) and the control group (30.5% ± 9.6%; P = .03). A value of PALS ≤28% predicted AF occurrence with sensitivity and specificity of 0.80 and 0.65, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Absolute cardiac diameters and LA STE (in particular, PALS) are useful echocardiographic predictors for the development of AF in dogs with MMVD.
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Toaldo et al. (2020) conducted a case-control in Myxomatous mitral valve disease (n=44). Peak atrial longitudinal strain (PALS) vs. Normal sinus rhythm (Control group) was evaluated on First occurrence of atrial fibrillation (RR 0.96, 95% CI 0.93-0.99, p=0.03). In dogs with myxomatous mitral valve disease, reduced peak atrial longitudinal strain was an independent predictor of future atrial fibrillation (RR 0.96), with a value ≤28% yielding a sensitivity of 0.80 and specificity of 0.65.
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