Changes in renin-angiotensin-aldosterone system during cardiac remodeling after mitral valvuloplasty in dogs

J Vet Intern Med. 2022 Mar;36(2):397-405. doi: 10.1111/jvim.16346. Epub 2022 Jan 7.

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.

Keywords: angiotensin II; biomarker; cardiac recovery; cardiac reverse remodeling; mitral valve repair; plasma renin activity.

MeSH terms

  • Aldosterone
  • Animals
  • Cohort Studies
  • Dog Diseases* / diagnostic imaging
  • Dog Diseases* / therapy
  • Dogs
  • Humans
  • Mitral Valve
  • Renin-Angiotensin System*
  • Ventricular Remodeling

Substances

  • Aldosterone