Three-dimensional echocardiographic determinants of the early onset of myxomatous mitral valve disease within two years in young Cavalier King Charles spaniel dogs.

A wider mitral valve non-planar angle on 3DTTE predicts earlier MMVD onset in young CKCSs.

This prospective cohort study investigated whether three-dimensional transthoracic echocardiography (3DTTE) morphological variables could predict early onset of myxomatous mitral valve disease (MMVD) in young Cavalier King Charles Spaniels (CKCSs). Seventy-five healthy CKCSs (median age 2 years, range 1–3 years) without echocardiographic evidence of MMVD were enrolled and evaluated every four months for up to 24 months or until MMVD development. Standard 2D echocardiography and 3DTTE were performed at enrollment, with dedicated software used to quantify mitral valve morphological variables. Cox proportional hazard modeling identified non-planar angle (NPA) and tenting area as significant univariable predictors of MMVD onset. In the multivariable backward stepwise model, NPA remained the sole independent predictor, with a wider NPA associated with earlier MMVD onset (HR: 1.03, 95% CI: 1.004–1.061, P=0.027). These findings suggest that 3DTTE-derived mitral valve geometry, particularly NPA, may serve as a non-invasive tool to stratify MMVD risk in predisposed young CKCSs before clinical signs emerge. Limitations include the single-center design, small sample size, and results being specific to the echocardiographic machine and 3D software utilized, potentially limiting generalizability. Despite these constraints, this study provides valuable preliminary evidence supporting 3DTTE as a predictive modality for MMVD onset, which could guide monitoring frequency and future breeding program decisions in this high-risk breed.

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