Veterinary Research Communications

, Volume 42, Issue 2, pp 153–160 | Cite as

Polymorphism, coupling interval and prematurity index in dogs with degenerative mitral valve disease and ventricular arrhythmias

  • Elizabeth Regina CarvalhoEmail author
  • Roberto Andrés Navarrete Ampuero
  • Giovana Laís Ruviaro Tuleski
  • Aparecido Antonio Camacho
  • Marlos Gonçalves Sousa
Original Article


Ventricular arrhythmias (VA) are a recognized concern in dogs with degenerative mitral valve disease (DMVD). The coupling interval (CI) and the prematurity index (PI) have been shown to accurately differentiate between benign and malignant VA in people, where ventricular arrhythmias are known to be associated with an increased risk of development of signs of heart failure or sudden death. In this study, we characterized ventricular arrhythmias in dogs with symptomatic and asymptomatic DMVD. Seventy dogs with naturally-occurring DMVD and ventricular arrhythmias were retrospectively studied. A cross-sectional investigation including dogs with either symptomatic (stages C/D; n = 41) or asymptomatic (stages B1/B2; n = 29) DMVD was performed. Electrocardiographic tracings were reviewed to calculate both the CI and PI. In eight dogs these indices were compared with those obtained from both a Holter recording and a standard ECG tracing and no statistical differences were found (CI, p = 0.97; PI, p = 0.17). Even though CI and PI were determined in all animals enrolled in the study, VPC characteristics were only compared between symptomatic and asymptomatic dogs when a 24-h Holter recording was available (n = 49). The PI was different (p = 0.01) between symptomatic (0.65 ± 0.17) and asymptomatic (0.56 ± 0.18) dogs, but CI was considered similar (p = 0.91). Also, the symptomatic dogs had more polymorphic VPC (p = 0.002) and supraventricular arrhythmias (p = 0.0002) than the asymptomatic animals. Polymorphism, and repeating patterns of ventricular premature complexes, were characteristics frequently present in overtly symptomatic animals affected by mitral endocardiosis.


Electrocardiography Endocardiosis Ventricular premature complexes Polymorphic Supraventricular arrhythmia 



Atrial fibrillation


Coupling interval


Degenerative mitral valve disease


Ventricular premature complex


Prematurity index


Paroxysmal ventricular tachycardia


Sinus cycle length


Supraventricular arrhythmias


Supraventricular tachycardia


Tricuspid insufficiency


Ventricular arrhythmias


Ventricular tachycardia


Compliance with ethical standards

Conflict of interest

The authors do not have any conflicts of interest to disclose.


  1. Atkins C, Bonagura J, Ettinger S et al (2009) Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 23:1142–1150. CrossRefPubMedGoogle Scholar
  2. Barlow MB, Bosman MB (1965) Aneurysmal protrusion of the posterior leaflet of the mitral valve. Am Heart J 71:166–178CrossRefGoogle Scholar
  3. Basso C, Perazzolo Marra M, Rizzo S et al (2015) Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death. Circulation 132:556–566. CrossRefPubMedGoogle Scholar
  4. Borgarelli M, Savarino P, Crosara S et al (2008) Survival characteristics and prognostic variables of dogs with mitral regurgitation attributable to myxomatous valve disease. J Vet Intern Med 22:120–128. CrossRefPubMedGoogle Scholar
  5. Chetboul V, Tissier R (2012) Echocardiographic assessment of canine degenerative mitral valve disease. J Vet Cardiol 14:127–148. CrossRefPubMedGoogle Scholar
  6. Crosara S, Borgarelli M, Perego M et al (2010) Holter monitoring in 36 dogs with myxomatous mitral valve disease. Aust Vet J 88:386–392. CrossRefPubMedGoogle Scholar
  7. Del Carpio Munoz F, Syed FF, Noheria A et al (2011) Characteristics of premature ventricular complexes as correlates of reduced left ventricular systolic function: study of the burden, duration, coupling interval, morphology and site of origin of PVCs. J Cardiovasc Electrophysiol 22:791–798. CrossRefPubMedGoogle Scholar
  8. Duffee DF, Shen WK, Smith HC (1998) Suppression of frequent premature ventricular contractions and improvement of left ventricular function in patients with presumed idiopathic dilated cardiomyopathy. Mayo Clin Proc 73:430–433. CrossRefPubMedGoogle Scholar
  9. Haissaguerre M, Shoda M, Jais P (2002) Mapping and ablation of idiopathic ventricular fibrillation. Circulation 106:962–967. CrossRefPubMedGoogle Scholar
  10. Hansen DE, Craig CS, Hondeghem LM (1990) Stretch-induced arrhythmias in the isolated canine ventricle. Evidence for the importance of mechanoelectrical feedback. Circulation 81:1094–1105. CrossRefPubMedGoogle Scholar
  11. Igarashi M, Tada H, Kurosaki K et al (2012) Electrocardiographic determinants of the polymorphic QRS morphology in idiopathic right ventricular outflow tract tachycardia. J Cardiovasc Electrophysiol 23:521–526. CrossRefPubMedGoogle Scholar
  12. Kanei Y, Friedman M, Ogawa N et al (2008) Frequent premature ventricular complexes originating from the right ventricular outflow tract are associated with left ventricular dysfunction. Ann Noninvasive Electrocardiol 13:81–85. CrossRefPubMedGoogle Scholar
  13. Kim YR, Nam GB, Kwon CH et al (2014) Second coupling interval of nonsustained ventricular tachycardia to distinguish malignant from benign outflow tract ventricular tachycardias. Hear Rhythm 11:2222–2230. CrossRefGoogle Scholar
  14. Knecht S, Sacher F, Wright M et al (2011) Long-Term Follow-Up of Idiopathic Ventricular Fibrillation Ablation A Multicenter Study. J Am Coll Cardiol 54:522–528. CrossRefGoogle Scholar
  15. Kurosaki K, Nogami A, Shirai Y, Kowase S (2013) Positive QRS complex in lead i as a malignant sign in right ventricular outflow tract tachycardia. Circ J 77:968–974. CrossRefPubMedGoogle Scholar
  16. Lee YH, Zhong L, Roger VL et al (2014) Frequency, origin, and outcome of ventricular premature complexes in patients with or without heart diseases. Am J Cardiol 114:1373–1378. CrossRefPubMedGoogle Scholar
  17. Mason JW, Koch FH, Billingham ME, Winkle RA (1978) Cardiac biopsy evidence for a cardiomyopathy associated with symptomatic mitral valve prolapse. Am J Cardiol 42:557–562. CrossRefPubMedGoogle Scholar
  18. Oliveira MS, Muzzi R, Araújo LRB, et al (2012) Heart rate variability parameters of myxomatous mitral valve disease in dogs with and without heart failure obtained using 24-hour Holter electrocardiography. Vet Rec 170:622. CrossRefPubMedGoogle Scholar
  19. Piccirillo G, Ogawa M, Song J et al (2009) Power spectral analysis of heart rate variability and autonomic nervous system activity measured directly in healthy dogs and dogs with tachycardia-induced heart failure. Heart Rhythm 6:546–552. CrossRefPubMedPubMedCentralGoogle Scholar
  20. Rhee KH, Jung JY, Rhee KS et al (2006) Tachycardiomyopathy induced by ventricular premature complexes: complete recovery after radiofrequency catheter ablation. Korean J Intern Med 21:213–217CrossRefPubMedPubMedCentralGoogle Scholar
  21. Savage DD, Levy D, Garrison RJ et al (1983) Mitral valve prolapse in the general population. 3. Dysrhythmias: the framingham study. Am Heart J 106:582–586. CrossRefPubMedGoogle Scholar
  22. Sheldon SH, Gard JJ, Asirvatham SJ (2010) Premature ventricular contractions and non-sustained ventricular tachycardia: association with sudden cardiac death, risk stratification, and management strategies. Indian Pacing Electrophysiol J 10:357–371PubMedPubMedCentralGoogle Scholar
  23. Shepard JW, Garrison MW, Grither DA, Dolan GF (1985) Relationship of ventricular ectopy to oxyhemoglobin desaturation in patients with obstructive sleep apnea. Chest 88:335–340. CrossRefPubMedGoogle Scholar
  24. Shiraishi H, Ishibashi K, Urao N et al (2002) A case of cardiomyopathy induced by premature ventricular complexes. Circ J 66:1065–1067. CrossRefPubMedGoogle Scholar
  25. Sun Y, Blom NA, Yu Y et al (2003) The influence of premature ventricular contractions on left ventricular function in asymptomatic children without structural heart disease: an echocardiographic evaluation. Int J Cardiovasc Imaging 19:295–299CrossRefPubMedGoogle Scholar
  26. Takemoto M, Yoshimura H, Ohba Y et al (2005) Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease. J Am Coll Cardiol 45:1259–1265. CrossRefPubMedGoogle Scholar
  27. Viskin S, Rosso R, Rogowski O, Belhassen B (2005) The “short-coupled” variant of right ventricular outflow ventricular tachycardia: a not-so-benign form of benign ventricular tachycardia? J Cardiovasc Electrophysiol 16:912–916. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Elizabeth Regina Carvalho
    • 1
    Email author
  • Roberto Andrés Navarrete Ampuero
    • 1
  • Giovana Laís Ruviaro Tuleski
    • 2
  • Aparecido Antonio Camacho
    • 1
  • Marlos Gonçalves Sousa
    • 2
  1. 1.College of Veterinary Medicine and Agricultural SciencesSão Paulo State University (UNESP) JaboticabalJaboticabalBrazil
  2. 2.Department of Veterinary MedicineFederal University of Paraná (UFPR)CuritibaBrazil

Personalised recommendations