P-Wave Terminal Force in Dogs With Myxomatous Mitral Valve Disease

P-wave terminal force (PTF) is accepted as an electrocardiographic criteria to assess left atrial abnormalities in humans. In this study, the applicability of PTF in dogs with myxomatous mitral valve disease (MMVD) was evaluated, and compared its ability to identify left atrial dilatation with 4 oth...

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Bibliographic Details
Published in:Topics in companion animal medicine 2021-08, Vol.44, p.100531-100531, Article 100531
Main Authors: Calderón-Olaguivel, Karla L., Wolf, Marcela, Brüler, Bruna C., Silva, Vinícius B.C., Sousa, Marlos G.
Format: Article
Language:English
Subjects:
Abnormalities
Atria
Cardiac arrhythmia
Cardiology
Disease
Dogs
Electrocardiography
Enlargement
Heart
Heart valves
Investigations
Laboratory animals
mitral insufficiency
Mitral valve
Morphology
Morris index
P waves
Parameter identification
Polarity
precordial lead
Rheumatic heart disease
Veterinary medicine
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Summary:P-wave terminal force (PTF) is accepted as an electrocardiographic criteria to assess left atrial abnormalities in humans. In this study, the applicability of PTF in dogs with myxomatous mitral valve disease (MMVD) was evaluated, and compared its ability to identify left atrial dilatation with 4 other P-wave derived parameters. Seventy-four dogs with echocardiographically diagnosed MMVD were recruited for this prospective cross-sectional study. Also, 47 healthy dogs were included to serve as controls. All dogs underwent physical, electrocardiographic and standard echocardiographic examinations prior to enrollment. Electrocardiographic measurements were obtained from simultaneous recordings at three different locations for precordial lead V1. PTF was defined as the deflection following the second half of the P-wave, and was best documented at the first and third right intercostal spaces. In those locations, the P-wave was negative and P-wave terminal force was recognized as a positive undulation in baseline following P-wave. P-wave terminal force and P-wave duration measured from recordings obtained at either the first or third right intercostal spaces had poor to weak correlations (P < .05) with echocardiographic surrogates of cardiac remodeling and congestion. In dogs with MMVD, only P-wave duration and P-wave area distinguished normal and dilated left atria (P < .05). In conclusion, PTF had positive polarity and was best recorded when precordial lead V1 electrode was placed at the most cranial right intercostal locations. PTF failed to reliably identify left atrial enlargement in dogs with MMVD.
ISSN:1938-9736
1946-9837
1876-7613
DOI:10.1016/j.tcam.2021.100531