title: Prediction of first onset of congestive heart failure in dogs with degenerative mitral valve disease: the PREDICT cohort study.
abstract: OBJECTIVE
  To identify risk factors for first-onset congestive heart failure (CHF) in dogs with degenerative mitral valve disease (DMVD).
  
  
  METHODS
  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.
authors.affiliation: Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Caryn A
authors.initials: CA
authors.lastname: Reynolds
authors.forename: Dorothy Cimino
authors.initials: DC
authors.lastname: Brown
authors.forename: John E
authors.initials: JE
authors.lastname: Rush
authors.forename: Philip R
authors.initials: PR
authors.lastname: Fox
authors.forename: Thaibihn P
authors.initials: TP
authors.lastname: Nguyenba
authors.forename: Linda B
authors.initials: LB
authors.lastname: Lehmkuhl
authors.forename: Sonya G
authors.initials: SG
authors.lastname: Gordon
authors.forename: Heidi B
authors.initials: HB
authors.lastname: Kellihan
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Stepien
authors.forename: Bonnie K
authors.initials: BK
authors.lastname: Lefbom
authors.forename: C Kate
authors.initials: CK
authors.lastname: Meier
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oyama
mesh_terms: D000818:Animals; D015331:Cohort Studies; D004283:Dog Diseases / Q000209:etiology* / Q000473:pathology; D004285:Dogs; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000662:veterinary*; D016015:Logistic Models; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000662:veterinary*; D012189:Retrospective Studies; D012307:Risk Factors