Insights on the canine mitral valve in the course of myxomatous mitral valve disease

Sonia C Orozco, Martha Olivera-Angel, Pedro Vargas-Pinto

Resumen


Myxomatous mitral valve disease (MMVD) is the most common heart alteration in dogs. A vast extent of research has been focused on echocardiographic tissue Doppler and strain indices and the medical treatment of this condition, which are beyond the scope of this article. This review intends to include less known information of the mitral valve, acknowledge the American College of Veterinary Internal Medicine (ACVIM) consensus on MMVD and state different surgical approaches and devices, all valuable information for small animal clinicians and cardiologists. Also, during the last decade studies have been oriented towards to understand valve’s mechanical structure and function, genes involved in the etiology and molecular signaling pathways. Advances have been made in understanding the mitral valve, but more assessment and efforts are needed in this specific area.

Información sobre la válvula mitral canina en el curso de la degeneración mixomatosa valvular mitral

La degeneración mixomatosa valvular mitral (MMVD) es la alteración cardíaca más común en perros. Una gran parte de la investigación se ha centrado en índices ecocardiográficos de doppler tisular y strain y la terapéutica médica de esta afección, aspectos que están más allá del alcance de este artículo. Esta revisión pretende incluir información menos difundida de la válvula mitral, señalar el consenso del Colegio Americano de Medicina Interna Veterinaria (ACVIM) sobre el MMVD y conocer diferentes métodos y dispositivos quirúrgicos, toda información valiosa para clínicos de caninos y felinos y cardiólogos. Adicionalmente, durante la última década, los estudios se han orientado a comprender la biomecánica y la función de las válvulas, los genes involucrados en la etiología y las vías de señalización molecular. Se ha avanzado en el entendimiento de la válvula mitral, pero más revisiones y esfuerzos son necesarios en esta área específica.


Palabras clave: cardiología, corazón, perro, válvula atrioventricular.

 

Percepções sobre a válvula mitral canina no curso da doença mitral mixomatosa

A doença valvar mitral mixomatosa (DMVM) é a alteração cardíaca mais comum em cães. Uma vasta extensão da pesquisa tem sido focada nos índices de Doppler tecidual e de strain ecocardiográfico e no tratamento médico dessa condição, que estão além do escopo deste artigo. Esta revisão pretende incluir informações menos conhecidas sobre a válvula mitral, reconhecer o Consenso do Colégio Americano de Medicina Interna Veterinária (ACVIM) sobre MMVD e indicar diferentes abordagens e dispositivos cirúrgicos, todas informações valiosas para clínicos e cardiologistas de pequenos animais. Além disso, durante a última década, os estudos foram orientados para entender a estrutura mecânica e a função da válvula, genes envolvidos nas vias de etiologia e sinalização molecular. Avanços foram feitos no entendimento da valva
mitral, mas mais avaliações e esforços são necessários nessa área específica.

Palavras-chave: cão, cardiología, coração, válvula atrioventricular.


Palabras clave


atrioventricular valve, cardiology, dog, heart.

Texto completo:

PDF

Referencias


Atkins, C., Bonagura, J., Ettinger, S., Fox, P., Gordon, S., Haggstrom, S., … Stepien,

R. (2009). Guidelines for the Diagnosis and Treatment of Canine Chronic Valvular

Heart Disease, 23, 1142–1150. https://doi.org/10.1111/jvim.13834

Atkins, C. E., & Häggström, J. (2012). Pharmacologic management of myxomatous

mitral valve disease in dogs. Journal of Veterinary Cardiology, 14(1), 165–184.

https://doi.org/10.1016/j.jvc.2012.02.002

Aupperle, H., & Disatian, S. (2012). Pathology, protein expression and signaling in

myxomatous mitral valve degeneration: Comparison of dogs and humans. Journal

of Veterinary Cardiology, 14(1), 59–71. https://doi.org/10.1016/j.jvc.2012.01.005

Birkegård, A. C., Reimann, M. J., Martinussen, T., Häggström, J., Pedersen, H. D., &

Olsen, L. H. (2016). Breeding Restrictions Decrease the Prevalence of Myxomatous

Mitral Valve Disease in Cavalier King Charles Spaniels over an 8- to 10-Year

Period. Journal of Veterinary Internal Medicine, 30(1). https://doi.org/10.1111/

jvim.13663

Borgarelli, M., Abbott, J., Braz-Ruivo, L., Chiavegato, D., Crosara, S., Lamb, K.,

… Haggstrom, J. (2015). Prevalence and Prognostic Importance of Pulmonary

Hypertension in Dogs with Myxomatous Mitral Valve Disease. Journal of Veterinary

Internal Medicine, 29(2), 569–574. https://doi.org/10.1111/jvim.12564

Borgarelli, M., & Buchanan, J. W. (2012). Historical review, epidemiology and natural

history of degenerative mitral valve disease. Journal of Veterinary Cardiology,

(1), 93–101. https://doi.org/10.1016/j.jvc.2012.01.011

Borgarelli, M., Crosara, S., Lamb, K., Savarino, P., La Rosa, G., Tarducci, A., & Haggstrom,

J. (2012). Survival characteristics and prognostic variables of dogs with

preclinical chronic degenerative mitral valve disease attributable to myxomatous

degeneration. Journal of Veterinary Internal Medicine, 26(1), 69–75. https://

doi.org/10.1111/j.1939-1676.2011.00860.

Boswood, A., Häggström, J., Gordon, S. G., Wess, G., Stepien, R. L., Oyama, M. A.,

… Watson, P. (2016). Effect of Pimobendan in Dogs with Preclinical Myxomatous

Mitral Valve Disease and Cardiomegaly: The EPIC Study. A Randomized Clinical Trial.

Journal of Veterinary Internal Medicine, 30(6), 1765–1779. https://doi.org/10.1111/

jvim.14586

Chompoosan, C., Buranakarl, C., Chaiyabutr, N., & Chansaisakorn, W. (2014). Decreased

sympathetic tone after short-term treatment with enalapril in dogs with

mild chronic mitral valve disease. Research in Veterinary Science, 96(2), 347–354.

https://doi.org/10.1016/j.rvsc.2014.01.006

Connell, P. S., Han, R. I., & Grande-Allen, K. J. (2012). Differentiating the aging of

the mitral valve from human and canine myxomatous degeneration. Journal of

Veterinary Cardiology, 14(1), 31–45. https://doi.org/10.1016/j.jvc.2011.11.003

Cremer, S. E., Moesgaard, S. G., Rasmussen, C. E., Zois, N. E., Falk, T., Reimann,

M. J., … Olsen, L. H. (2015). Alpha-smooth muscle actin and serotonin receptors

A and 2B in dogs with myxomatous mitral valve disease. Research in Veterinary

Science, 100, 197–206. https://doi.org/10.1016/j.rvsc.2015.03.020

Cremer, S. E., Singletary, G. E., Olsen, L. H., Wallace, K., Häggström, J., Ljungvall,

I., … Oyama, M. A. (2014). Serotonin Concentrations in Platelets, Plasma, Mitral

Valve Leaflet, and Left Ventricular Myocardial Tissue in Dogs with Myxomatous

Mitral Valve Disease. Journal of Veterinary Internal Medicine, 28(5). https://doi.

org/10.1111/jvim.12420

Eriksson, A. S., Häggström, J., Pedersen, H. D., Hansson, K., Järvinen, A. K.,

Haukka, J., & Kvart, C. (2014). Increased NT-pro ANP predicts risk of congestive

heart failure in Cavalier King Charles spaniels with mitral regurgitation caused

by myxomatous valve disease. Journal of Veterinary Cardiology, 16(3). https://doi.

org/10.1016/j.jvc.2014.05.001

Fox, P. R. (2012). Pathology of myxomatous mitral valve disease in the dog.

Journal of Veterinary Cardiology, 14(1), 103–126. https://doi.org/10.1016/j.

jvc.2012.02.001

French, A. T., Ogden, R., Eland, C., Hemani, G., Pong-Wong, R., Corcoran, B., & Summers,

K. M. (2012). Genome-wide analysis of mitral valve disease in Cavalier King

Charles Spaniels. Veterinary Journal, 193(1), 283–286. https://doi.org/10.1016/j.

tvjl.2011.09.011

Häggström, J., Boswood, A., O’Grady, M., Jöns, O., Smith, S., Swift, S., … Difruscia,

R. (2013). Longitudinal analysis of quality of life, clinical, radiographic, echocardiographic,

and laboratory variables in dogs with myxomatous mitral valve disease

receiving pimobendan or benazepril: The QUEST study. Journal of Veterinary

Internal Medicine, 27(6). https://doi.org/10.1111/jvim.12181

Han, R. I., Black, A., Culshaw, G., French, A. T., & Corcoran, B. M. (2010a). Structural and

cellular changes in canine myxomatous mitral valve disease: an image analysis

study. The Journal of Heart Valve Disease.

Han, R. I., Black, A., Culshaw, G., French, A. T., & Corcoran, B. M. (2010b). Structural and

cellular changes in canine myxomatous mitral valve disease: an image analysis

study. The Journal of Heart Valve Disease, 19(1), 60–70.

Han, R. I., Clark, C. H., Black, A., French, A., Culshaw, G. J., Kempson, S. A., & Corcoran,

B. M. (2013). Morphological changes to endothelial and interstitial cells

and to the extra-cellular matrix in canine myxomatous mitral valve disease

(endocardiosis). Veterinary Journal, 197(2), 388–394. https://doi.org/10.1016/j.

tvjl.2013.01.027

Lacerda, C. M. R., MacLea, H. B., Kisiday, J. D., & Orton, E. C. (2012). Static and

cyclic tensile strain induce myxomatous effector proteins and serotonin in canine

mitral valves. Journal of Veterinary Cardiology, 14(1), 223–230. https://doi.

org/10.1016/j.jvc.2011.12.002

Lake-Bakaar, G. A., Singh, M. K., Kass, P. H., & Griffiths, L. G. (2015). Effect of pimobendan

on the incidence of arrhythmias in small breed dogs with myxomatous

mitral valve degeneration. Journal of Veterinary Cardiology, 17(2), 120–128.

https://doi.org/10.1016/j.jvc.2015.01.005

Liu, M. M., Flanagan, T. C., Lu, C. C., French, A. T., Argyle, D. J., & Corcoran, B.

M. (2015). Culture and characterisation of canine mitral valve interstitial and

endothelial cells. Veterinary Journal, 204(1), 32–39. https://doi.org/10.1016/j.

tvjl.2015.01.011

Ljungvall, I., Höglund, K., Lilliehöök, I., Oyama, M. A., Tidholm, A., Tvedten, H., & Häggström,

J. (2013). Serum serotonin concentration is associated with severity of

myxomatous mitral valve disease in dogs. Journal of Veterinary Internal Medicine,

(5). https://doi.org/10.1111/jvim.12137

Ljungvall, I., Rishniw, M., Porciello, F., Ferasin, L., & Ohad, D. G. (2014). Murmur

intensity in small-breed dogs with myxomatous mitral valve disease reflects disease

severity. Journal of Small Animal Practice, 55(November), 545–550. https://

doi.org/10.1111/jsap.12265

Lu, C. C., Liu, M. M., Clinton, M., Culshaw, G., Argyle, D. J., & Corcoran, B. M. (2015).

Developmental pathways and endothelial to mesenchymal transition in canine

myxomatous mitral valve disease. Veterinary Journal, 206(3), 377–384. https://

doi.org/10.1016/j.tvjl.2015.08.011

Lu, C. C., Liu, M. M., Culshaw, G., Clinton, M., Argyle, D. J., & Corcoran, B. M. (2015).

Gene network and canonical pathway analysis in canine myxomatous mitral valve

disease: A microarray study. Veterinary Journal, 204(1), 23–31. https://doi.org/

1016/j.tvjl.2015.02.021

Mangklabruks, T., & Surachetpong, S. D. (2014). Plasma and platelet serotonin

concentrations in healthy dogs and dogs with myxomatous mitral valve disease.

Journal of Veterinary Cardiology, 16(3), 155–162. https://doi.org/10.1016/j.

jvc.2014.05.003

Markby, G., Summers, K. M., MacRae, V. E., Del-Pozo, J., & Corcoran, B. M. (2017).

Myxomatous Degeneration of the Canine Mitral Valve: From Gross Changes to

Molecular Events. Journal of Comparative Pathology, 156(4), 371–383. https://doi.

org/10.1016/j.jcpa.2017.01.009

Mattin, M. J., Boswood, A., Church, D. B., López-Alvarez, J., McGreevy, P. D., O’Neill,

D. G., … Brodbelt, D. C. (2015). Prevalence of and Risk Factors for Degenerative Mitral

Valve Disease in Dogs Attending Primary-care Veterinary Practices in England.

Journal of Veterinary Internal Medicine, 29(3), 847–854. https://doi.org/10.1111/

jvim.12591

Mattin, M. J., Boswood, A., Church, D. B., McGreevy, P. D., O’Neill, D. G., Thomson,

P. C., & Brodbelt, D. C. (2015). Degenerative mitral valve disease: Survival of dogs

attending primary-care practice in England. Preventive Veterinary Medicine, 122(4),

–442. https://doi.org/10.1016/j.prevetmed.2015.05.007

Mavropoulou, A., Guazzetti, S., Borghetti, P., De Angelis, E., & Quintavalla, C. (2016).

Cytokine expression in peripheral blood mononuclear cells of dogs with mitral

valve disease. Veterinary Journal (London, England : 1997), 211, 45–51. https://doi.

org/10.1016/j.tvjl.2016.03.002

Meurs, K. M., Friedenberg, S. G., Williams, B., Keene, B. W., Atkins, C. E., Adin, D., …

Mackay, T. (2018). Evaluation of genes associated with human myxomatous mitral

valve disease in dogs with familial myxomatous mitral valve degeneration.

Veterinary Journal, 232, 16–19. https://doi.org/10.1016/j.tvjl.2017.12.002

Nishida, M., Kagawa, Y., Mizukoshi, T., Mizuno, M., Mizuno, T., Harada, K., & Uechi,

M. (2012). Post-mortem evaluation of expanded polytetrafluoroethylene (ePTFE)

used in mitral valve repair in dogs. Journal of Veterinary Cardiology, 14(1), 307–312.

https://doi.org/10.1016/j.jvc.2011.11.004

Orton, E. C. (2012). Mitral valve degeneration: Still more questions than

answers. Journal of Veterinary Cardiology, 14(1), 3–5. https://doi.org/10.1016/j.

jvc.2012.02.003

Orton, E. C. (2015). Transcatheter Mitral Valve Therapies, 547–555.

Orton, E. C., Lacerda, C. M. R., & MacLea, H. B. (2012). Signaling pathways in mitral

valve degeneration. Journal of Veterinary Cardiology, 14(1), 7–17. https://doi.org/

1016/j.jvc.2011.12.001

Parker, H. G., & Kilroy-Glynn, P. (2012). Myxomatous mitral valve disease in dogs:

Does size matter? Journal of Veterinary Cardiology, 14(1), 19–29. https://doi.org/

1016/j.jvc.2012.01.006

Petit, A. M., Gouni, V., Tissier, R., Trehiou-Sechi, E., Misbach, C., Pouchelon, J. L.,

… Chetboul, V. (2013). Systolic arterial blood pressure in small-breed dogs with

degenerative mitral valve disease: A prospective study of 103 cases (2007-2012).

Veterinary Journal, 197(3), 830–835. https://doi.org/10.1016/j.tvjl.2013.05.040

Rasmussen, C. E., Falk, T., Domanjko Petrič, A., Schaldemose, M., Zois, N. E., Moesgaard,

S. G., … Olsen, L. H. (2014). Holter monitoring of small breed dogs with advanced

myxomatous mitral valve disease with and without a history of syncope.

Journal of Veterinary Internal Medicine, 28(2). https://doi.org/10.1111/jvim.12290

Reimann, M. J., Ljungvall, I., Hillström, A., Møller, J. E., Hagman, R., Falk, T., …

Olsen, L. H. (2016). Increased serum C-reactive protein concentrations in dogs

with congestive heart failure due to myxomatous mitral valve disease. Veterinary

Journal (London, England : 1997), 209, 113–118. https://doi.org/10.1016/j.

tvjl.2015.12.006

Reimann, M. J., Møller, J. E., Häggström, J., Markussen, B., Holen, A. E. W., Falk, T.,

& Olsen, L. H. (2014). R-R interval variations influence the degree of mitral regurgitation

in dogs with myxomatous mitral valve disease. Veterinary Journal, 199(3),

–354. https://doi.org/10.1016/j.tvjl.2014.01.001

Richards, J. M., Farrar, E. J., Kornreich, B. G., Mose, N. S., & Butcher, J. T. (2012).

The mechanobiology of mitral valve function, degeneration, and repair. Journal

of Veterinary Cardiology, 14(1), 47–58. https://doi.org/10.1016/j.jvc.2012.01.002

Sakarin, S., Rungsipipat, A., & Surachetpong, S. D. (2016). Galectin-3 in cardiac

muscle and circulation of dogs with degenerative mitral valve disease. Journal

of Veterinary Cardiology, 18(1), 34–46. https://doi.org/10.1016/j.jvc.2015.10.007

Sleeper, M. M., Maczuzak, M. E., & Bender, S. J. (2015). Myocardial infarct associated

with a partial thickness left atrial tear in a dog with mitral insufficiency. Journal

of Veterinary Cardiology, 17(3), 229–236. https://doi.org/10.1016/j.jvc.2015.04.003

Uechi, M. (2012). Mitral valve repair in dogs. Journal of Veterinary Cardiology, 14(1),

–192. https://doi.org/10.1016/j.jvc.2012.01.004

Uechi, M., Mizukoshi, T., Mizuno, T., Mizuno, M., Harada, K., Ebisawa, T., … Nakamura,

T. (2012). Mitral valve repair under cardiopulmonary bypass in small-breed dogs:

cases (2006-2009). Journal of the American Veterinary Medical Association,

(10), 1194–1201. https://doi.org/10.2460/javma.240.10.1194

Yokoyama, S., Kanemoto, I., Mihara, K., Ando, T., Kawase, K., Sahashi, Y., & Iguchi,

K. (2017). Treatment of severe mitral regurgitation caused by lesions in both leaflets

using multiple mitral valve plasty techniques in a small dog. Open Veterinary

Journal, 7(4), 328. https://doi.org/10.4314/ovj.v7i4.7

Zois, N. E., Moesgaard, S. G., Kjelgaard-Hansen, M., Rasmussen, C. E., Falk, T.,

Fossing, C., … Olsen, L. H. (2012). Circulating cytokine concentrations in dogs with

different degrees of myxomatous mitral valve disease. Veterinary Journal, 192(1),

–111. https://doi.org/10.1016/j.tvjl.2011.05.009




Licencia de Creative Commons

Este obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.