Mitral regurgitation, MR. valvular disease, CDVD Myxomatous mitral valve disease, MMVD IE IE CDVD CDVD. e.g. CDVD CDVD

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1 Mitral regurgitation, MR MR MR MR Chronic Degenerative valvular disease, CDVD Myxomatous mitral valve disease, MMVD CDVD CDVD CDVD CDVD MR MR IE IE e.g. DCM DCM MR CDVD MR CDVD TEL FAX takano-in-loanhead@hotmail.com

2 CDVD Systolic anterior motion, SAM MR Endocardial cushion defect, ECD MR ECD cleft MR MR RR CDVD CDVD MR Left-sided congestive heart failure, L-CHF CDVD CDVD CKCS CDVD MR L-CHF CDVD CDVD Pulmonary hypertension, PHT CDVD PHT CDVD PHT PHT Tricuspid regurgitation, TR

3 International Small Animal Cardiac Health Council ISACHC ACVIM CDVD ISACHC CDVD Stage A Stage C L-CHF CDVD CDVD Musical murmur CDVD MR MR CDVD crackle TR CDVD ACVIM NT-proBNP ANP stage B

4 Target Organ Damege, TOD CDVD ACVIM CDVD CDVD Ca β CDVD P R CDVD CDVD CDVD Vertebral Heart Size, VHSVHS VHS v mass VD DV CDVD CDVD MR MR CDVD CDVD B

5 S CDVD CDVD CDVD TR TR CDVD IE CDVD M B LA Ao M LA Ao B M E Regurgitant Fraction, RF LA Ao CDVD L-CHF VHS L-CHF CDVD ACVIM B Stage A B B ACEi

6 β ACVIM Stage C1 C2 C1 C2 QOL Stage C RAA Stage C1 ACE Stage C2 ACEi Stage C D1 D2D1 Stage C1 HgHg D2 CDVD Stage C CDVD CDVD CDVD Stage B Stage B A Borgarelli M, Haggstrom J. Canine degenerative myxomatous mitral valve disease : natural history,

7 clinical presentation and therapy. The Veterinary clinics of North America Small animal practice 2010 ; 40 : Atkins C, Bonagura J, Ettinger S, et al. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. Journal of veterinary internal Medicine 2009 ; 23 : Bonagura JD, Schober KE. Can ventricular function be assessed by echocardiography in chronic canine mitral valve disease? The Journal of small animal practice 2009 ; 50 Suppl 1 : John D. Bonagura DCT. KIRK S Current Vetrinary Therapy Ray S. The echocardiographic assessment of functional mitral regurgitation. European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 2010 ; 11 : i Saponaro V, Staffieri F, Franchini D, et al. Complete atrioventricular canal in a dog. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2010 ; 12 : Yamano S, Uechi M,Tanaka K, et al. Surgical repair of a complete endocardial cushion defect in a dog. Veterinary surgery : VS 2011 ; 40 : Han RI, Black A, Culshaw GJ,etal.Distribution of myofibroblasts, smooth muscle-like cells, macrophages, and mast cells in mitral valve leaflets of dogs with myxomatous mitral valve disease. American journal of veterinary research 2008 ; 69 : Chetboul V, Tissier R, Villaret F, et al. [Epidemiological, clinical, echo-doppler characteristics of mitral valve endocardiosis in Cavalier King Charles in France : a retrospective study of 451 cases (1995 to 2003)]. The Canadian veterinary journal La revue veterinaire canadienne 2004 ; 45 : Serfass P, Chetboul V, Sampedrano CC, et al. Retrospective study of 942 small-sized dogs : Prevalence of left apical systolic heart murmur and leftsided heart failure, critical effects of breed and sex. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2006 ; 8 : Haggstrom J, Boswood A, O Grady M, 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. Journal of veterinary internal medicine / American College of Veterinary Internal Medicine 2008 ; 22 : Kvart C, Haggstrom J, Pedersen HD, et al. Efficacy of enalapril for prevention of congestive heart failure in dogs with myxomatous valve disease and asymptomatic mitral regurgitation. Journal of veterinary internal medicine / American College of Veterinary Internal Medicine 2002 ; 16 : Borgarelli M, Savarino P, Crosara S, et al. Survival characteristics and prognostic variables of dogs with mitral regurgitation attributable to myxomatous valve disease. Journal of veterinary internal Medicine 2008 ; 22 : Atkins CE, Haggstrom J. Pharmacologic management of myxomatous mitral valve disease in dogs. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2012 ; 14 : Stepien RL. Pulmonary arterial hypertension secondary to chronic left-sided cardiac dysfunction in dogs. The Journal of small animal practice 2009 ; 50 Suppl 1 : International small animal cardiac health council. Recommendations for the diagnosis and treatment of heart failure in small animalswoodbridge, NJ ; 1994 ; 5. Ljungvall I, Ahlstrom C, Hoglund K, et al. Use of signal analysis of heart sounds and murmurs to assess severity of mitral valve regurgitation attributable to myxomatous mitral valve disease in dogs. American journal of veterinary research 2009 ; 70 : Oyama MA, Singletary GE. The use of NTproBNP assay in the management of canine patients with heart disease. The Veterinary clinics of North America Small animal practice 2010 ; 40 : 545

8 -558. Chetboul V, Serres F, Tissier R, et al. Association of plasma N-terminal pro-b-type natriuretic peptide concentration with mitral regurgitation severity and outcome in dogs with asymptomatic degenerative mitral valve disease. Journal of veterinary internal Medicine 2009 ; 23 : Moonarmart W, Boswood A, Luis Fuentes V, et al. N-terminal pro B-type natriuretic peptide and left ventricular diameter independently predict mortality in dogs with mitral valve disease. The Journal of small animal practice 2010 ; 51 : Oyama MA, Rush JE, Rozanski EA, et al. Assessment of serum N-terminal pro-b-type natriuretic peptide concentration for differentiation of congestive heart failure from primary respiratory tract disease as the cause of respiratory signs in dogs. Journal of the American Veterinary Medical Association 2009 ; 235 : Brown S, Atkins C, Bagley R, et al. Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. Journal of veterinary internal medicine / American College of Veterinary Internal Medicine 2007 ; 21 : Buchanan JW, Bucheler J. Vertebral scale system to measure canine heart size in radiographs. Journal of the American Veterinary Medical Association 1995 ; 206 : Lamb CR, Wikeley H, Boswood A, et al. Use of breed-specific ranges for the vertebral heart scale as an aid to the radiographic diagnosis of cardiac disease in dogs. The Veterinary record 2001 ; 148 : Diana A, Guglielmini C, Pivetta M, et al. Radiographic features of cardiogenic pulmonary edema in dogs with mitral regurgitation : 61 cases ( ). Journal of the American Veterinary Medical Association 2009 ; 235 : TerzoE,DiMarcello M, McAllister H, et al. Echocardiographic assessment of537 dogs with mitral valve prolapse and leaflet involvement. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association 2009 ; 50 : Nakayama T, Wakao Y, Nemoto H, et al. Mitral valve protrusion assessed by use of B-mode echocardiography in dogs with mitral regurgitation. American journal of veterinary research 1996 ; 57 : Serres FJ, Chetboul V, Tissier R, et al. Doppler echocardiography-derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease : 86 cases ( ). Journal of the American Veterinary Medical Association 2006 ; 229 : Cornell CC, Kittleson MD, Della Torre P, et al. Allometric scaling of M-mode cardiac measurements in normal adult dogs. Journal ofveterinary internal Medicine 2004 ; 18 : Rishniw M, Erb HN. Evaluation of four 2- dimensional echocardiographic methods of assessing left atrial size in dogs. Journal of veterinary internal Medicine 2000 ; 14 : Hansson K, Haggstrom J, Kvart C, et al. Left atrial to aortic root indices using two-dimensional and M-mode echocardiography in cavalier King Charles spaniels with and without left atrial enlargement. Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association 2002 ; 43 : Lord P, Hansson K, Kvart C, et al. Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation. The Journal of small animal practice 2010 ; 51 : Uechi M. Mitral valve repair in dogs. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2012 ; 14 : Uechi M, Mizukoshi T, Mizuno T, et al. Mitral valve repair under cardiopulmonary bypass in small -breed dogs : 48 cases ( ). Journal of the American Veterinary Medical Association 2012 ; 240 :

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