Retrospective evaluation of the utility of shock index to determine the presence of congestive heart failure in dogs with myxomatous mitral valve disease (2019–2021): 98 cases

Abstract

Objectives

To calculate the shock index (SI) in dogs with myxomatous mitral valve disease (MMVD) and to evaluate its use to predict the presence of congestive heart failure (CHF).

Design

Retrospective study.

Setting

Small animal university veterinary teaching hospital.

Animals

Ninety-eight dogs with MMVD and 20 healthy dogs as part of a control group.

Interventions

Heart rate (HR) and systolic blood pressure (SBP) were recorded, and SI was calculated by dividing HR by SBP for each dog.

Measurements and Main Results

The mean (SD) HR, SBP, and SI were 123/min (32.6), 147 mm Hg (21.5), and 0.86 (0.3), respectively, for dogs with MMVD and 98/min (20.9), 145 mm Hg (18.7), and 0.68 (0.13), respectively, for control dogs. Dogs with MMVD had a significantly higher HR compared with control dogs (P < 0.01), and an elevation in HR was seen as the severity of MMVD increased. Dogs in stage B2 and C/D MMVD had a significantly higher SI value compared with control dogs (P = 0.04 and P < 0.01, respectively). SI was significantly higher in dogs in stage C/D MMVD compared with dogs in stage B2 MMVD (P < 0.01). Ten of 98 (10%) dogs had an arrhythmia. HR, SBP, and SI were not significantly different between dogs with and without arrhythmias (P = 0.13, P = 0.57, and P = 0.07, respectively), but significantly more dogs with CHF had an arrhythmia (P = 0.01). SI (area under the curve [AUC]: 0.98) and HR (AUC: 0.95) were excellent indicators for the presence of CHF. An optimal SI cutoff value ≥1.1 had 92% sensitivity and 95% specificity for predicting the presence of CHF, and an optimal HR cutoff value of ≥157/min had 92% sensitivity and 93% specificity for the prediction of CHF.

Conclusions

When there are compatible clinical signs, SI values ≥1.1 may suggest the presence of CHF in dogs with MMVD.