책임운영기관 농촌진흥청 국립축산과학원 (로고)

Background: Hypomagnesemia is associated with a poor prognosis in humans with congestive heart failure (CHF), but studies in veterinary medicine are limited. Hypothesis: Serum ionized magnesium concentration [iMg2+] would decrease as CHF progresses compared with the initial diagnostic levels and that lower [iMg2+] would be negatively associated with prognosis in dogs with CHF. Animals: A total of 181 client-owned dogs with myxomatous mitral valve disease (MMVD) were included. They were classified into the preclinical stage (NO-CHF, n = 108), stage C (n = 42), and stage D (n = 31) based on the American College of Veterinary Internal Medicine MMVD classification. Methods: This is aretrospective study from 2 referral centers. The [iMg2+] was compared among the NO-CHF, stage C, and stage D groups. Kaplan-Meier curves and the log-rank test were used to compare the incidence of death between groups. Multivariable Cox regression analysis was used to estimate the association of hypomagnesemia with the death. Results: In the stage D group, the [iMg2+] was lower than that in the NO-CHF(P < .0001) and stage C groups (P < .003). In the Kaplan-Meier survival analysis, the 1-year cumulative survival rate in hypomagnesemic dogs was 53% compared with 91.5% in normomagnesemic dogs (log-rank test, P < .0001). In the multivariable Cox analysis, lower concentration of [K+] and [iMg2+], along with higher Evel, were associated with negative prognoses. Specifically, hypomagnesemia was associated with an approximately 4-fold increased risk of death (hazard ratio = 4.015; 95% confidence interval, 1.537-10.488; P < .005). Conclusions and Clinical Importance: Assessing the [iMg2+] might serve as a potential marker for estimating the severity and prognosis indirectly in dogs with MMVD. Combining [iMg2+] measurement with other diagnostic methods, such as echocardiography, could improve the prognostic evaluation of MMVD in dogs.