Retrospective evaluation of the utility of shock index to determine the presence of congestive heart failure in dogs with myxomatous mitral valve disease (2019–2021): 98 cases

Hannah Matson, Efa Llewellyn

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objectives: To calculate the shock index (SI) in dogs with myxomatous mitral valve disease (MMVD) and to evaluate its use to predict the presence of congestive heart failure (CHF). Design: Retrospective study. Setting: Small animal university veterinary teaching hospital. Animals: Ninety-eight dogs with MMVD and 20 healthy dogs as part of a control group. Interventions: Heart rate (HR) and systolic blood pressure (SBP) were recorded, and SI was calculated by dividing HR by SBP for each dog. Measurements and Main Results: The mean (SD) HR, SBP, and SI were 123/min (32.6), 147 mm Hg (21.5), and 0.86 (0.3), respectively, for dogs with MMVD and 98/min (20.9), 145 mm Hg (18.7), and 0.68 (0.13), respectively, for control dogs. Dogs with MMVD had a significantly higher HR compared with control dogs (P < 0.01), and an elevation in HR was seen as the severity of MMVD increased. Dogs in stage B2 and C/D MMVD had a significantly higher SI value compared with control dogs (P = 0.04 and P < 0.01, respectively). SI was significantly higher in dogs in stage C/D MMVD compared with dogs in stage B2 MMVD (P < 0.01). Ten of 98 (10%) dogs had an arrhythmia. HR, SBP, and SI were not significantly different between dogs with and without arrhythmias (P = 0.13, P = 0.57, and P = 0.07, respectively), but significantly more dogs with CHF had an arrhythmia (P = 0.01). SI (area under the curve [AUC]: 0.98) and HR (AUC: 0.95) were excellent indicators for the presence of CHF. An optimal SI cutoff value ≥1.1 had 92% sensitivity and 95% specificity for predicting the presence of CHF, and an optimal HR cutoff value of ≥157/min had 92% sensitivity and 93% specificity for the prediction of CHF. Conclusions: When there are compatible clinical signs, SI values ≥1.1 may suggest the presence of CHF in dogs with MMVD.

Original languageEnglish
Pages (from-to)231-237
JournalJournal of Veterinary Emergency and Critical Care
Volume34
Issue number3
Early online date29 May 2024
DOIs
Publication statusE-pub ahead of print - 29 May 2024

Keywords / Materials (for Non-textual outputs)

  • canine
  • heart rate
  • pulmonary hypertension
  • shock
  • valve disease

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