Prediction of first onset of congestive heart failure in dogs with degenerative mitral valve disease: the PREDICT cohort study.

OBJECTIVE: To identify risk factors for first-onset congestive heart failure (CHF) in dogs with degenerative mitral valve disease (DMVD). ANIMALS: Eighty-two dogs with and without CHF secondary to DMVD were retrospectively assigned to a derivation cohort. Sixty-five dogs with asymptomatic DMVD were recruited into a prospective validation cohort. METHODS: Variables associated with risk of CHF in dogs were identified in a derivation cohort and used to construct a predictive model, which was then prospectively tested through longitudinal examination of a validation cohort. RESULTS: Logistic regression analysis of the derivation cohort yielded a predictive model that included the left atrial to aortic root dimension ratio (LA:Ao) and plasma concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP). When this model was prospectively applied to the validation cohort, it correctly predicted first-onset of CHF in 69.2% of cases. Analysis of the validation cohort revealed that plasma NT-proBNP concentration and indexed left ventricular end-diastolic diameter (LVIDd:Ao) were independent risk factors for development of first-onset CHF in dogs with DMVD (NT-proBNP ≥ 1500 pmol/L, odds ratio (OR), 5.76, 95% confidence interval (CI), 1.37-24.28, P = 0.017; LVIDd:Ao ≥ 3, OR, 6.11, 95% CI, 1.09-34.05, P = 0.039). CONCLUSIONS: Measures of left heart size and plasma NT-proBNP concentration independently estimate risk of first-onset of CHF in dogs with DMVD. These parameters can contribute to the management of dogs with DMVD.

Pericardial effusion in cats: a retrospective study of clinical findings and outcome in 146 cats.

BACKGROUND: Pericardial effusion (PE) in dogs most often is associated with neoplasia or idiopathic pericarditis, and frequently causes cardiac tamponade. Studies of PE in the cat are limited. HYPOTHESIS: Congestive heart failure (CHF) is the most common cause of PE in the cat. ANIMALS: All cats diagnosed with PE on echocardiographic examination at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania (MJR-VHUP) from 2000 to 2005. METHODS: The clinical and pathologic findings in 146 cats with PE were reviewed. Records were examined retrospectively to identify additional underlying conditions. Follow-up status and cause of death were determined by review of the medical records or phone interviews with the owners. RESULTS: The most common cause of PE in this study was CHF (75%). Biochemical abnormalities were uncommon, but aspartate aminotransferase (AST) activity frequently was increased (85%). Follow-up information was available on 108 cats (74%). Median survival time (MST) was 144 days for cats that were not euthanized within 24 hours (n = 85). The MST of cats with heart failure was 41 days, whereas the MST of cats without heart failure was 361 days, when those euthanized within 24 hours were excluded. CONCLUSIONS: Survival time of cats with heart failure in this study was significantly shorter than previously reported, and significantly shorter than in cats without heart failure as a cause of PE.