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- Title
Avaliação da variabilidade da frequencia cardíaca (VFC) em cão da raça Boxer com cardiomiopatia arritmogênica do ventrículo direito (CAVD).
- Authors
Correia Costa, Paula Priscila; Martins Gomes, Victor; Galvão Rocha, Danilo; Lustosa Martins, Patricia; Amorim Bezerra, Windleyanne Gonçalves; Patricia Aragão, Carla; Maciel Medeiros Maia, Emanuel Luis; Correia Ribeiro, Wesley Lyeverton
- Abstract
Background: Boxer dog cardiomyopathy was initially described by Neil Harpster in 1983 and has received different names. However, several recent studies demonstrated a similarity to the human arrhythmogenic right ventricular cardiomyopathy (ARVC), which led to the name Boxer ARVC. This hereditary disease seems to be linked to a mutation in the gene that codifies the cardiac ryanodine receptor. This mutation leads to an alteration of the calcium cycle in the heart. The analysis of the heart rate variability is an important predictive factor for diagnosing this disease. Therefore, this study aims to report a case of a Boxer ARVC providing electrocardiographic data and heart rate variability. Case: A 11 year-old male Boxer dog, weighting 29.65 kg, was submitted to a heart check-up due to sudden occurrence of fatigue and syncope. At the clinical examination, heart auscultation did not revealed sounds or arrhythmias. The electrocardiogram results presented tachycardia and a regular rhythm with ventricular premature complexes (VPC's). Ecodopplercargiogram was performed and values were within normal standards. Thus, a dynamic monitoring of 24 h was performed using a Holter monitor. This analysis demonstrated tachycardia in the sinus rhythm, type I second degree sinoatrial block, normal PR interval and normal length of QRS complexes. In addition, severe ventricular ectopy was identified in the following forms: isolated, paired, and nonsustained ventricular tachycardia. The heart rate variability analysis resulted in mean values of 213 ms (SNDD), 132 ms (SDANN), 211ms (rMSSD) and 33.46% (pNN50). Based on these data, Boxer ARVC is the probable diagnosis. However, a ventricular myocardial biopsy necessary to confirm the disease was not performed due to the inherent risk of the procedure. Treatment was performed with sotalol and a commercial feed specially designed for dogs with for cardiac diseases. Discussion: Dogs with arrhythmogenic right ventricular cardiomyopathy frequently demonstrate some clinical signs, such as exercise intolerance and/or syncope, as did the boxer in this report. Less frequently, congestive cardiac insufficiency may be present, which was not identified in this case. Diagnosis of this disease is performed with patient and family history, ventricular arrhythmias results in electrocardiogram and alterations in the heart morpho-physiological aspects, which can be observed in echocardiography. Ventricular premature complexes (VPC's) associated with ventricular extra systoles were suggested as a tool to diagnose ARVC. Concerning the heart rate variability, elevated values of SDNN, rMSSD and pNN50 were observed. These results indicate an increase in the heart frequency itself (SDNN) and in the parasympathetic modulation (rMSSD and pNN50). However, these measurements are not adequate for the prognosis of Boxer ARVC according to some studies. Sotalol is a class III antiarrhythmic drug used for the treatment of ventricular tachycardia in Boxers that present normal or mildly altered myocardium. Regular heart examinations are important for all adult Boxer dogs if an early diagnosis of ARVC is expected. In these cases, appropriate medication may be used to prevent sudden death and affected individuals may be discarded from reproduction programs to decrease the mutation frequency in the population.
- Publication
Acta Scientiae Veterinariae, 2018, Vol 46, Issue Suppl, p1
- ISSN
1678-0345
- Publication type
Article