López-Alvarez, J.Boswood, A.W. MoonarmartHezzell, M.J.Lotter, N.Elliott, J.Mahidol University. Faculty of Veterinary Science. Department of Clinical Sciences and Public Health.2015-02-122017-04-072015-02-122017-04-072015-01-122014Journal of Veterinary Internal Medicine. Vol.28, No.2 (Mar-Apr 2014), 393-4001939-1676https://repository.li.mahidol.ac.th/handle/123456789/1648Background: Increased heart rate (HR) and decreased heart rate variability (HRV) are evident in some dogs with degenerative mitral valve disease (DMVD). Objectives: Evaluation of the factors influencing HR and HRV (assessed by the vasovagal tonus index; VVTI) and their change over time in dogs with DMVD. Animals: Client-owned dogs (n = 257) with DMVD recruited from first opinion practice. Methods: Prospective longitudinal follow-up at six-monthly intervals of dogs with DMVD. Dogs followed up for at least 18 months (n = 102) were grouped according to their outcome as dogs dying/euthanized because of cardiac disease (n = 28; Group 1), noncardiac disease (n = 40; Group 2) and dogs alive (n = 34; Group 3). HR and VVTI were measured on 1-minute ECG recordings. Repeated measures linear models were constructed to investigate the factors that influence HR and VVTI and their changes over time. Results: Heart rate and VVTI were affected by disease severity and were different in Cavaliers compared to other breeds. Group 1 and Group 2 dogs underwent an increase in HR and decrease in VVTI, evident at least 18 months before death. Group 1 had a further decrease in VVTI followed by an increase in HR approximately 1 year and 6 months before death, respectively. Conclusions and Clinical Importance: Dogs with DMVD have an increase in HR and decrease in HRV over a year before death, with greater changes in those dogs dying/euthanized because of cardiac disease. Both HR and VVTI can potentially be regarded as biomarkers for all-cause mortality.engMahidol UniversityAutonomic nervous systemHeart rate variabilityVasovagal tonus indexOpen Access articleArticleAmerican College of Veterinary Internal Medicine10.1111/jvim.12311