PMID- 35070858 OWN - NLM STAT- MEDLINE DCOM- 20220418 LR - 20220430 IS - 2218-6050 (Electronic) IS - 2226-4485 (Print) IS - 2218-6050 (Linking) VI - 11 IP - 4 DP - 2021 Oct-Dec TI - Assessment of heart rate turbulence in dogs with myxomatous mitral valve disease. PG - 635-644 LID - 10.5455/OVJ.2021.v11.i4.13 [doi] AB - 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 ischemic 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 were divided into groups B1, B2, C, and D for mean comparison with analysis of variance 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 turbulence onset (TO) and turbulence slope (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 was found a very good area under the curve 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, HRT is a feasible indicator for autonomic balance. Our result suggests HRT changes as the MMVD progresses and congestive heart failure is present. More studies with HRT are needed. The number of ventricular premature contractions (VPCs) may be the strongest limitation for the technique. FAU - Dos Santos, Julio P AU - Dos Santos JP AD - Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Parana (UFPR), Curitiba, Brazil. FAU - Lucina, Stephany B AU - Lucina SB AD - Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Parana (UFPR), Curitiba, Brazil. FAU - da Costa, Bruna N AU - da Costa BN AD - Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Parana (UFPR), Curitiba, Brazil. FAU - Olaguivel, Karla L C AU - Olaguivel KLC AD - Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Parana (UFPR), Curitiba, Brazil. FAU - Tuleski, Giovana L R AU - Tuleski GLR AD - Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Parana (UFPR), Curitiba, Brazil. FAU - Sousa, Marlos G AU - Sousa MG AD - Laboratory of Comparative Cardiology, Department of Veterinary Medicine, Federal University of Parana (UFPR), Curitiba, Brazil. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20211113 PL - Libya TA - Open Vet J JT - Open veterinary journal JID - 101653182 SB - IM MH - Animals MH - *Dog Diseases MH - Dogs MH - Electrocardiography, Ambulatory/veterinary MH - Heart Rate MH - *Heart Valve Diseases/veterinary MH - Humans MH - Mitral Valve MH - *Ventricular Premature Complexes/veterinary PMC - PMC8770193 OTO - NOTNLM OT - *Autonomic balance OT - *Baroreflex OT - *Heart rate variability OT - *Turbulence onset OT - *Turbulence slope COIS- The authors declare that there is no conflict of interest. EDAT- 2022/01/25 06:00 MHDA- 2022/04/19 06:00 PMCR- 2021/10/01 CRDT- 2022/01/24 08:54 PHST- 2021/04/05 00:00 [received] PHST- 2021/10/21 00:00 [accepted] PHST- 2022/01/24 08:54 [entrez] PHST- 2022/01/25 06:00 [pubmed] PHST- 2022/04/19 06:00 [medline] PHST- 2021/10/01 00:00 [pmc-release] AID - OVJ-11-635 [pii] AID - 10.5455/OVJ.2021.v11.i4.13 [doi] PST - ppublish SO - Open Vet J. 2021 Oct-Dec;11(4):635-644. doi: 10.5455/OVJ.2021.v11.i4.13. Epub 2021 Nov 13.