Why the study?
Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation was limited.
Does the presence of L waves and other echocardiographic variables predict mortality in dogs with atrial fibrillation?
Observational (n=55)
Yes
Does the presence of L waves and other echocardiographic variables predict mortality in dogs with atrial fibrillation?
In dogs with atrial fibrillation secondary to structural heart disease, L waves are common but not prognostic, whereas increased normalized left ventricular end-systolic diameter and higher heart rate during echocardiography independently predict mortality.
LVSDn increase was associated with higher mortality in canine AF; supports its prognostic value but leaves open prospective validation.
BACKGROUND: Information regarding the frequency of L waves and their prognostic relevance in dogs with secondary atrial fibrillation (AF) is limited. HYPOTHESIS/OBJECTIVES: To determine whether L waves occur and ascertain their prognostic role, as well as the role of other clinical and echocardiographic variables in dogs with AF. ANIMALS: Fifty-five dogs with AF associated with myxomatous mitral valve disease or dilated cardiomyopathy. METHODS: Retrospective, multicenter observational study. In addition to L waves analysis, other clinical and echocardiographic variables, including type of antiarrhythmic treatment, were evaluated. A survival analysis was performed to test for predictors of cardiac death and all-cause mortality using Cox proportional hazards regression models. RESULTS: L waves were evident in 33/55 dogs (60%, 95% confidence interval [CI] = 47%-72%) but their presence did not influence outcome. Increased left ventricular end-systolic diameter normalized for body weight (LVSDn) was a significant predictor of both cardiac death (hazard ratio [HR] = 4.41, 95% CI = 1.18-16.54; P = .03) and all-cause mortality (HR = 9.39, 95% CI = 2.49-35.32; P < .001). Heart rate assessed during echocardiography (Echo-HR) represented an additional significant predictor of cardiac death (HR = 1.01, 95% CI = 1.00-1.01; P = .04) and all-cause mortality (HR = 1.01, 95% CI = 1.00-1.01; P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE: L waves occurred frequently in dogs with AF, but held no prognostic relevance. Conversely, LVSDn and Echo-HR represented independent predictors of negative outcome in these animals.
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Romito et al. (2022) conducted an observational in Atrial fibrillation secondary to myxomatous mitral valve disease or dilated cardiomyopathy (n=55). 1-unit increase in left ventricular end-systolic diameter normalized for body weight (LVSDn) vs. Baseline LVSDn was evaluated on All-cause mortality (HR 9.39, 95% CI 2.49-35.32, p=<0.001).
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