Chronic mitral valvular insufficiency (CMVI) in dogs is very common and may cause clinical signs of congestion and poor tissue perfusion. Poor tissue perfusion from CMVI causes pancreatitis in dogs, as indicated by serum pancreatic lipase concentrations. Spec® cPLTM is an assay for canine pancreas-specific lipase measuring pancreatic lipase immunoreactivity (PLI) originating from exocrine pancreas and is widely used for detecting pancreatitis in dogs. Because pancreatitis can be ischemic injuries such as congestive heart failure (CHF), we investigated the concentration of serum PLI in dogs with different stage of congestive heart failure caused by CMVI. To achieve the goal of study, the study was divided into two sections. In the first part of study, the conventional echocardiographic indices for assessing the severity and progression of CMVI were assessed in our study population. In the second part of study, the serum PLI concentration was evaluated in our study population. The 62 client-owned dogs consisting of 40 dogs with different stages of heart failure from CMVI and 22 age-matched healthy dogs were enrolled in this study.
In the comparison of conventional echocardiography indices in dogs with different stage of heart failure (CMVI), significant differences found in LA dimension (P < .05), LA/Ao ratio (P < .001), LVIDd dimension (P < .001), LVIDd/Ao ratio (P < .001), EDV (P < .001), EDVI (P < .05), LVIDs dimension (P < .001), LVIDs/Ao ratio (P < .05), E-peak velocity (P < .001), E/A ratio (P < .05) and MR velocity (P < .05).
Serum canine pancreatic lipase immunoreactivity (cPLI) concentrations were determined by quantitative cPLI test in healthy and CMVI groups. Serum cPLI concentrations were 54.0 μg/L (IQR: 38.0-78.8 μg/L) in control, 55.0 μg/L (IQR: 38.3-88.8 μg/L) in ISACHC I, 115.0 μg/L (IQR: 45.0-179.0 μg/L) in ISACHC II and 223.0 μg/L (IQR: 119.5-817.5 μg/L) in ISACHC III. Also, Close correlation to serum cPLI concentration was found in the left atrial to aorta (LA/Ao) ratio (r = 0.597; P = .000) and the severity of heart failure (r = 0.530; P = .000).
To conclude our study, this study found that known conventional echocardiographic indices, including LA dimension, LA/Ao ratio, LVIDd dimension, LVIDd/Ao ratio, EDV, EDVI, E-velocity and E/A ratio were well-correlated with the severity of CMVI. In addition, this study also found the CMVI is associated with pancreatic injury in congestive heart failure due to CMVI. Periodic monitoring on the status of progression using echocardiography is important for successful management of CMVI in dogs. The cPLI test is also useful for monitoring to early detection of complication such as pancreatitis in dogs with heart failure from CMVI.