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Prognostic Value of Intrarenal Venous Flow Analysis Using Pulsed-Wave Doppler.

Tomoya Morita1, Hiroki Terukina1, Masahiro Yamasaki1

  • 1Laboratory of Veterinary Small Animal Internal Medicine, Cooperative Department of Veterinary Medicine, Faculty of Veterinary Medicine, Iwate University, Morioka, Japan.

Journal of Veterinary Internal Medicine
|October 3, 2025
PubMed
Summary

Intrarenal venous impedance index (VII) and waveform patterns can predict survival in dogs with myxomatous mitral valve disease (MMVD). A high VII or discontinuous venous flow indicates a higher risk of cardiac- and renal-related death.

Keywords:
canineintrarenal Dopplermitral regurgitationpulmonary hypertensionvenous impedance index

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Area of Science:

  • Veterinary Cardiology
  • Renal Physiology in Animals
  • Diagnostic Imaging in Canine Medicine

Background:

  • Myxomatous mitral valve disease (MMVD) is a common cardiac condition in dogs.
  • The prognostic value of intrarenal Doppler ultrasonography (IRD) in dogs with MMVD is not well-established.
  • Early identification of dogs at risk for poor outcomes is crucial for effective management.

Purpose of the Study:

  • To investigate the predictive value of IRD indices for survival in dogs diagnosed with MMVD.
  • To determine if specific IRD parameters, such as venous impedance index (VII) and intrarenal venous flow patterns, correlate with cardiac- and renal-related mortality.

Main Methods:

  • A prospective cohort study involving 71 client-owned dogs with various stages of MMVD.
  • Echocardiography and IRD analysis were performed, measuring resistance index and VII from renal interlobar arteries and veins.
  • Intrarenal venous flow waveforms were classified as continuous or discontinuous, with discontinuous defined by a minimum velocity of 0.

Main Results:

  • A high venous impedance index (VII > 0.37) was an independent predictor of cardiac- and renal-related death (HR ≥ 4.62).
  • A discontinuous intrarenal venous flow pattern also independently predicted adverse outcomes (HR ≥ 3.62).
  • No significant association was found between the resistance index and survival outcomes in the multivariable analysis.

Conclusions:

  • Intrarenal venous flow analysis, specifically VII and waveform patterns, can predict worse outcomes in dogs with MMVD.
  • These IRD parameters offer valuable prognostic information for dogs suffering from this common cardiac disease.
  • This non-invasive technique may aid in risk stratification and guide clinical decision-making for canine MMVD patients.