HEART RATE AND HEART RATE VARIABILITY IN DOGS WITH DIFFERENT DEGREES OF MYXOMATOUS MITRAL VALVE DISEASE. CE Rasmussen1, T Falk1, NE Zois1, SG Moesgaard1, HD Pedersen2, J Häggström3 and LH Olsen1. 1. Department of Basic Animal and Veterinary Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark. 2. Novo Nordic A/S, Maaloev, Denmark. 3. Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden.
Heart rate variability (HRV) is an indirect measurement of the autonomic modulation of heart rate (HR). Reduced HRV measured from short-time electrocardiography is seen in dogs with heart failure (HF) secondary to myxomatous mitral valve disease (MMVD). However, HRV is suggested to increase with disease severity at early stages of MMVD. The aims of this study were 1) to associate HR and HRV with severity of MMVD in Cavalier King Charles Spaniels (CKCS) and 2) to compare HR and HRV between CKCS and other dog breeds in a group of dogs in HF secondary to MMVD.
One-hundred dogs were examined by echocardiography and 24-hour electrocardiography. The dogs were divided into five groups: 1) CKCS with no/minimal mitral regurgitation (MR) (MR jet=15% of the left atrial area using color Doppler mapping) and no murmur, 2) CKCS with mild MR (20%<jet=50%), 3) CKCS with moderate/severe MR (jet>50%) and no clinical signs of HF, 4) CKCS in HF (HF defined as left atrium to aortic root ratio (LA/Ao) >1.5, clinical signs of HF and furosemide responsiveness) and 5) non-CKCS in HF. Dogs in HF were allowed HF therapy. Both HR and HRV were analysed over a 24-hour period, while HRV were also analysed over a 6-hour nightly period. Analyses of variance were performed with HR or HRV as response variables and the explanatory variables dog group and echocardiographic indices of MMVD were included separately. All P-values were Bonferroni corrected.
Minimum- and mean HR were significantly higher in CKCS with moderate/severe MR and in HF compared to CKCS with no/minimal and mild MR (all P<0.001). Seven out of 26 HRV variables were significantly decreased in CKCS with moderate/severe MR and in HF compared to CKCS with no/minimal and mild MR (all P<0.02). Another 10 HRV variables showed the same groupwise differences (all P<0.02), except that the difference between CKCS with mild MR and CKCS with moderate/severe MR did not reach statistical significance. Minimum HR, mean HR and the HRV variables (7 and 10) differing between dog groups, also consistently decreased with increasing MR, LA/Ao and the proximal isovelocity surface area in CKCS. Non-CKCS in HF had a lower minimum HR compared to CKCS in HF (P=0.03) and a higher triangular index measured in both periods (all P<0.04).
In conclusion, HR increased and most HRV variables decreased with increasing severity of MMVD in CKCS, even prior to the development of HF. Other breeds in HF secondary to MMVD had lower minimum HR, but higher triangular index compared to CKCS in HF.