title: Auscultatory, echocardiographic, biochemical, nutritional, and environmental characteristics of mitral valve disease in Norfolk terriers.
abstract: OBJECTIVE
  In order to more fully understand degenerative mitral valve disease (DMVD) in the Norfolk terrier, we sought to characterize findings from the physical and echocardiographic examination; biochemical, biomarker, and nutritional profiles; and select environmental variables from a cohort of apparently healthy Norfolk terriers.
  
  
  METHODS
  Overtly healthy Norfolk terriers ≥ 6 yrs old were recruited by 3 different veterinary hospitals and underwent historical, physical, electrocardiographic (ECG), and 2D/color-flow Doppler echocardiographic examinations. Anterior mitral valve leaflet length, maximal thickness, area, and degree of prolapse were measured or calculated from two-dimensional images. Blood samples were obtained for serum biochemistry, serum serotonin, plasma NT-proBNP, amino acid profile, C-reactive protein, and cardiac troponin I.
  
  
  RESULTS
  Of the 48 dogs entered into the study, 23 (48%) had murmurs, 2 (4%) had mid-systolic clicks, 11 (23%) had ECG P pulmonale, and 41 (85%) were deemed to have echocardiographic evidence of DMVD, including 18 Norfolk terriers without a murmur. Seven (15%), 28 (58%), and 13 (27%) dogs were classified as normal (stage 0), International Small Animal Cardiac Health Council (ISACHC) stage 1a, and 1b, respectively. Mean indexed echocardiographic mitral leaflet thickness (P = 0.017), area (P = 0.0002), prolapse (P = 0.0004), and left atrial to aortic diameter (P = 0.01) were significantly different between ISACHC 0, 1a, and 1b.
  
  
  CONCLUSIONS
  DMVD is relatively common in Norfolk terriers and echocardiographic changes consistent with mild DMVD can be seen in dogs without a heart murmur.
authors.affiliation: Department of Clinical Studies-Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Trafny
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Freeman
authors.forename: Barret J
authors.initials: BJ
authors.lastname: Bulmer
authors.forename: John M
authors.initials: JM
authors.lastname: MacGregor
authors.forename: John E
authors.initials: JE
authors.lastname: Rush
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Meurs
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oyama
mesh_terms: D000818:Animals; D015415:Biomarkers; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D004452:Echocardiography / Q000662:veterinary*; D005260:Female; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D008944:Mitral Valve Insufficiency / Q000662:veterinary*; D012307:Risk Factors
chemical_list: D015415:Biomarkers