Canine dilated cardiomyopathy: a retrospective study of prognostic findings in 367 clinical cases.

OBJECTIVE To review the association between clinical signs and diagnostic findings and the survival time of dogs with dilated cardiomyopathy (DCM), and any influence of treatment prescribed. METHODS A retrospective observational study of 367 dogs with DCM. Survival times until death or euthanasia for cardiac reasons were analysed using the Kaplan-Meier method plus univariate and multivariate Cox proportional hazards models. Two-tailed P values less than 0.05 were considered statistically significant. RESULTS In the multivariate model, left ventricular diameter (LVDs)-index (P=0.0067), presence of pulmonary oedema on radiography (P=0.043), presence of ventricular premature complexes (VPCs) (P=0.0012), higher plasma creatinine (P=0.0002), lower plasma protein (P=0.029) and great Dane breed (P=0.0003) were negatively associated with survival. Most dogs were treated with angiotensin-converting enzyme inhibitors (93%) or furosemide (86%), and many received digoxin (50%) and/or pimobendan (30%). Thirteen dogs were lost to follow-up. No conclusions could be made in this study on the association between use of drugs and survival. CLINICAL SIGNIFICANCE The LVDs-index was the single best variable for assessing the prognosis in this group of dogs with DCM. Other variables that were negatively associated with survival were presence of pulmonary oedema on radiography, presence of VPCs, higher plasma creatinine, lower plasma protein and great Dane breed.

[1]  P. Armstrong,et al.  Renal Insufficiency and Heart Failure: Prognostic and Therapeutic Implications From a Prospective Cohort Study , 2004, Circulation.

[2]  G. Kingsley,et al.  Non‐steroidal anti‐inflammatory drugs and cardiac failure: meta‐analyses of observational studies and randomised controlled trials , 2008, European journal of heart failure.

[3]  A J Tajik,et al.  Two-Dimensional and Doppler Echocardiography Alone Can Adequately Define Preoperative Anatomy and Hemodynamic Status before Repair of Complete Atrioventricular Septal Defect in Infants <1 Year Old , 1994, Circulation.

[4]  J W Buchanan,et al.  Vertebral scale system to measure canine heart size in radiographs. , 1995, Journal of the American Veterinary Medical Association.

[5]  J. Häggström,et al.  Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. , 2008, Journal of veterinary internal medicine.

[6]  M. Salman,et al.  Idiopathic dilated cardiomyopathy in dogs: survival and prognostic indicators. , 1995, Journal of veterinary internal medicine.

[7]  J. Pouchelon The effect of benazepril on survival times and clinical signs of dogs with congestive heart failure: Results of a multicenter, prospective, randomized, double-blinded, placebo-controlled, long-term clinical trial. , 1999, Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.

[8]  K. Loboz,et al.  Drug combinations and impaired renal function -- the 'triple whammy'. , 2005, British journal of clinical pharmacology.

[9]  H. Pedersen,et al.  Heart rate variability in young, clinically healthy Dachshunds: influence of sex, mitral valve prolapse status, sampling period and time of day. , 1999, Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.

[10]  Salim Yusuf,et al.  Predictors of mortality and morbidity in patients with chronic heart failure. , 2006, European heart journal.

[11]  M. Borgarelli,et al.  Prognostic Indicators for Dogs with Dilated Cardiomyopathy , 2006 .

[12]  R. Horne,et al.  Effect of pimobendan on case fatality rate in Doberman Pinschers with congestive heart failure caused by dilated cardiomyopathy. , 2008, Journal of veterinary internal medicine.

[13]  M. Lauer,et al.  Predictors of mortality in patients with heart failure and preserved systolic function in the Digitalis Investigation Group trial. , 2003, Journal of the American College of Cardiology.

[14]  Jens Häggström,et al.  Proposed guidelines for the diagnosis of canine idiopathic dilated cardiomyopathy. , 2003, Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.

[15]  J. Woodfield Controlled clinical evaluation of enalapril in dogs with heart failure: results of the Cooperative Veterinary Enalapril Study Group. The COVE Study Group. , 1995, Journal of veterinary internal medicine.

[16]  B. Corcoran,et al.  A double-blind, randomized, placebo-controlled study of pimobendan in dogs with dilated cardiomyopathy. , 2002, Journal of veterinary internal medicine.

[17]  A. Tidholm Survival in dogs with dilated cardiomyopathy and congestive heart failure treated with digoxin, furosemide and propranolol: A retrospective study of 62 dogs. , 2006, Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.

[18]  M W S Martin,et al.  Canine dilated cardiomyopathy: a retrospective study of signalment, presentation and clinical findings in 369 cases. , 2009, The Journal of small animal practice.

[19]  J. Concato,et al.  Importance of events per independent variable in proportional hazards regression analysis. II. Accuracy and precision of regression estimates. , 1995, Journal of clinical epidemiology.

[20]  Allometric scaling of M-mode cardiac measurements in normal adult dogs. , 2004 .

[21]  C. Sylvén,et al.  Survival and prognostic factors in 189 dogs with dilated cardiomyopathy. , 1997, Journal of the American Animal Hospital Association.

[22]  J. Brown,et al.  Signalment, survival, and prognostic factors in Doberman pinschers with end-stage cardiomyopathy. , 1997, Journal of veterinary internal medicine.

[23]  R. Prescott,et al.  Predicting death due to progressive heart failure in patients with mild-to-moderate chronic heart failure. , 2002, Journal of the American College of Cardiology.

[24]  Salim Yusuf,et al.  A multivariate model for predicting mortality in patients with heart failure and systolic dysfunction. , 2004, The American journal of medicine.