Tuesday, April 23, 2013

Prognóstico da instalação da insuficiência cardíaca congestiva em cães com degeneração de valva mitral: O estudo PREDICT / Prediction of first onset of congestive heart failure in dogs with degenerative mitral valve disease: The PREDICT cohort study



Volume 14, Issue 1, March 2012, Pages 193–202
The Mitral Valve

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).

Animals

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.

Keywords

  • Natriuretic peptide
  • Mitral regurgitation
  • BNP
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