Chordae tendineae rupture in dogs with degenerative mitral valve disease: prevalence, survival, and prognostic factors (114 cases, 2001-2006).
BACKGROUND
Degenerative mitral valve disease (MVD) is the most common heart disease in small breed dogs, and chordae tendineae rupture (CTR) is a potential complication of this disease. The survival time and prognostic factors predictive of survival in dogs with CTR remain unknown.


OBJECTIVE
The prevalence and prognosis of CTR in dogs with MVD increases and decreases, respectively, with heart failure class.


METHODS
This study used 706 dogs with MVD.


METHODS
The diagnosis of CTR was based on a flail mitral leaflet with the tip pointing into the left atrium during systole, which was confirmed in several 2-dimension imaging planes using the left and right parasternal 4-chamber views.


RESULTS
CTR was diagnosed in 114 of the 706 dogs with MVD (16.1%) and most of these (106/114, 93%) had severe mitral valve regurgitation as assessed by color Doppler mode. CTR prevalence increased with International Small Animal Cardiac Health Council (ISACHC) clinical class (i.e., 1.9, 20.8, 35.5, and 69.6% for ISACHC classes Ia, Ib, II, and III, respectively [P < .05]). Long-term follow-up was available for 57 treated dogs (angiotensin-converting enzyme inhibitors and diuretics) and 58% of these (33/57) survived > 1 year after initial CTR diagnosis (median survival time, 425 days). Clinical class, the presence of ascites or acute dyspnea at the time of diagnosis, heart rate, plasma urea concentration, and left atrial size were predictors of survival.


CONCLUSIONS
CTR is associated with a higher overall survival time than previously supposed. Its prognosis mostly depends on a combination of clinical and biochemical factors.
Serres
François
F
Unité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort , France.
Chetboul
Valérie
V
Tissier
Renaud
R
Sampedrano
Carolina Carlos
CC
Gouni
Vassiliki
V
Nicolle
Audrey P
AP
Pouchelon
Jean-Louis
JL
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D002815:Chordae Tendineae / Q000473:pathology*; D004232:Diuretics / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D004285:Dogs; D005260:Female; D008297:Male; D008944:Mitral Valve Insufficiency / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000662:veterinary*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000453:epidemiology / Q000662:veterinary; D015996:Survival Rate
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics