Changes in renin-angiotensin-aldosterone system during cardiac remodeling after mitral valvuloplasty in dogs
Chieh‐Jen Cheng, Ahmed S. Mandour, Tomohiko Yoshida, Toshihiro WATARI, Ryou Tanaka, Katsuhiro Matsuura
Abstract
BACKGROUND: Information regarding changes in renin-angiotensin-aldosterone system (RAAS) during cardiac remodeling after mitral valvuloplasty (MVP) in dogs remains lacking. HYPOTHESIS/OBJECTIVES: To assess the longitudinal effects of MVP on circulating RAAS activity. ANIMALS: Eight client-owned dogs receiving MVP for myxomatous mitral valve disease (MMVD). METHODS: This is a cohort study. Plasma renin activity (PRA), angiotensin II (AT2), aldosterone (PAC), blood urea nitrogen (BUN), and creatinine concentrations, were measured in these dogs before (baseline) and at 3 consecutive monthly follow-ups (Post-1M, Post-2M, Post-3M). Echocardiography was concomitantly used to assess the process of cardiac recovery after MVP. RESULTS: The echocardiography revealed a significant decrease in LVIDDN, LA/Ao, FS, E velocity, E/A, E' sep, S' lat, E' lat, and A' lat after MVP compared with baseline (P < .05). There was a significant reduction in the PRA (2.45, 3.05, 2.74 vs 8.8 ng/mL/h; P = .002), AT2 (466, 315, 235 vs 1200 pg/mL; P = .009), and PAC (39.88, 47, 54.62 vs 179.5 pg/mL; P = .01), respectively at Post-1M, Post-2M, Post-3M compared to the baseline. Additionally, BUN and creatinine concentrations decreased from Post-1M. The RAAS variables showed significant, weak to moderate, relationship with selected echocardiographic variables. CONCLUSIONS AND CLINICAL IMPORTANCE: Mitral valvuloplasty contributes to decreased RAAS activity in MMVD dogs, which paralleled the process of cardiac reverse remodeling up to Post-3M. This information facilitates formulating strategies to optimize clinical outcomes for dogs after MVP.