Arrhythmogenic right ventricular cardiomyopathy in Boxer dogs: the diagnosis as a link to the human disease

Acta Myol. 2017 Sep 1;36(3):135-150. eCollection 2017 Sep.

Abstract

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a myocardial disease with an increased risk for ventricular arrhythmias. The condition, which occurs in Boxer dogs, shares phenotypic features with the human disease arrhythmogenic cardiomyopathy (ACM) suggesting its potential as a natural animal model. However, there are currently no universally accepted clinical criteria to diagnose ARVC in Boxer dogs. We aimed to identify diagnostic criteria for ARVC in Boxer dogs defining a more uniform and consistent phenotype.

Methods and results: Clinical records from 264 Boxer dogs from a referral veterinary hospital were retrospectively analysed. ARVC was initially diagnosed according to the number of ventricular premature complexes (VPCs) in the 24-hour-Holter-ECG in the absence of another obvious cause. Dogs diagnosed this way had more VPCs, polymorphic VPCs, couplets, triplets, VTs and R-on-T-phenomenon and syncope, decreased right ventricular function and dilatation in comparison to a control group of all other Boxer dogs seen by the Cardiology Service over the same period. Presence of couplets and R-on-T-phenomenon on a 24h-ECG were identified as independent predictors of the diagnosis. A diagnosis based on ≥100 VPCs in 24 hours, presence of couplets and R-on-T phenomenon on a 24h-ECG was able to select Boxer dogs with a phenotype most similar to human ACM.

Conclusion: We suggest the diagnosis of ARVC in Boxer dogs requires two out of the three following criteria: presence of ≥ 100 VPCs, presence of couplets or R-on-T-phenomenon on a 24 h-ECG. This results in a uniform phenotype similar to that described in human ACM and may result in the adoption of the term ACM for this analogous condition in Boxer dogs.

Keywords: Holter electrocardiography; arrhythmogenic right ventricular dysplasia/cardiomyopathy; ventricular tachycardia.

MeSH terms

  • Animals
  • Arrhythmogenic Right Ventricular Dysplasia / complications
  • Arrhythmogenic Right Ventricular Dysplasia / diagnosis*
  • Arrhythmogenic Right Ventricular Dysplasia / physiopathology
  • Arrhythmogenic Right Ventricular Dysplasia / veterinary*
  • Dog Diseases / genetics
  • Dog Diseases / physiopathology
  • Dogs
  • Electrocardiography, Ambulatory*
  • Female
  • Humans
  • Male
  • Phenotype
  • ROC Curve
  • Retrospective Studies
  • Syncope / etiology
  • Syncope / veterinary
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / veterinary
  • Ventricular Dysfunction, Right / etiology
  • Ventricular Dysfunction, Right / veterinary
  • Ventricular Premature Complexes / etiology*
  • Ventricular Premature Complexes / veterinary*