The mitral valve in horses is a component of the heart's left atrioventricular valve system, situated between the left atrium and left ventricle. It functions to regulate blood flow from the atrium to the ventricle and prevents backflow during ventricular contraction. The mitral valve consists of two cusps, or leaflets, that open and close in response to pressure changes within the heart chambers. Abnormalities or dysfunctions of the mitral valve, such as mitral valve regurgitation or prolapse, can affect cardiac efficiency and are subjects of veterinary cardiology. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, and pathophysiology of the mitral valve in horses, as well as diagnostic and therapeutic approaches to mitral valve disorders.
Piotrowski IL, Junge HK, Schwarzwald CC.Mitral and aortic valve insufficiencies have been commonly reported in horses. The objective of this study was to establish the use of acoustic cardiography (Audicor®) in horses with aortic (AI) or mitral valve insufficiency (MI). A total of 17 healthy horses, 18 horses with AI, and 28 horses with MI were prospectively included. None of the horses was in heart failure. Echocardiography and Audicor® analyses were conducted. Electromechanical activating time (EMAT), rate-corrected EMATc, left ventricular systolic time (LVST), rate-corrected LVSTc, and intensity and persistence of the third and...
Huesler IM, Mitchell KJ, Schwarzwald CC.Echocardiographic assessment of left atrial (LA) size and function in horses is not standardized. Objective: The aim of this study was to establish reference intervals for echocardiographic indices of LA size and function in Warmblood horses and to provide proof of concept for allometric scaling of variables and for the clinical use of area-based indices. Methods: Thirty-one healthy Warmblood horses and 91 Warmblood horses with a primary diagnosis of mitral regurgitation (MR) or aortic regurgitation (AR). Methods: Retrospective study. Echocardiographic indices of LA size and function were meas...
Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB, van Loon G.Although atrial fibrillation (AF) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence. Objective: To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for AF recurrence in horses. Methods: 117 horses treated for AF at 4 referral centers. Methods: Retrospective study. Inclusion criteria were successful cardioversion, echocardiography at 24 hours after cardioversion and ≥4 months follow-up. To determine factors associated with A...
Walders W, Gehlen H.This study evaluated a device for blood pressure measurement using high definition oscillometry (HDO) for its acceptability and practicability in the horse. Furthermore, we evaluated whether this device can determine differences in blood pressure between healthy horses and horses with heart diseases and between different measurement times. Methods: The study population consisted of 60 horses (aged 4-31 years). All horses underwent clinical examination, conventional echocardiography (including cardiac output measurement at the pulmonary artery), repeated noninvasive blood pressure measurement a...
Decloedt A, Verheyen T, Sys S, De Clercq D, Bijnens B, van Loon G.The influence of atrioventricular (AV) interaction on mitral valve closure (MVC) and left ventricular (LV) isovolumic contraction is not fully clarified. We investigated the relationship among AV delay, MVC, and LV isovolumic contraction using a horse model because of the low heart rate and physiologically long AV delay. Results: Six horses were evaluated during sinus rhythm, right ventricular pacing without preceding atrial contraction, and dual-chamber pacing at AV delays of 150 to 350 ms, programmed at a constant rate. Right parasternal 4-chamber views were recorded for simultaneous measure...
Imhasly A, Tschudi PR, Lombard CW, Gerber V.The clinical and echocardiographic characteristics of 108 horses with echocardiographically confirmed mild mitral valve regurgitation (MR) were investigated along with its clinical progression. Follow-up consisted of a re-examination of 28 horses and questionnaires were used to obtain information on a further 43 cases. Thirty-seven horses with mild MR were lost to follow-up. Horses with mild MR were re-examined between 2 and 9 years (3.8+/-1.8 years) following first presentation, with mild MR still present and a small, but statistically significant (P=0.049) increase of left ventricular diamet...
Gehlen H, Bubeck K, Stadler P.In 12 healthy warmblood horses and 10 horses with mitral valve insufficiencies (MVI) of various degrees heart rate and pulmonary artery wedge pressure (PWP) was measured at rest and during standardised exercise on a high speed treadmill. There was a significant increase in PWP with each change in speed of the treadmill (p < 0.01). The PWP of horses with mild mitral valve regurgitation under working conditions was not significantly different compared to the healthy horses. The horses with moderate mitral valve regurgitation showed a significant higher pulmonary artery wedge pressure at rest and...
Gehlen H, Vieht JC, Stadler P.Twenty horses with mitral valve insufficiency, but without signs of congestive heart failure, and five horses without signs of heart disease were examined before and after medication with an angiotensin-converting enzyme (ACE) inhibitor. The examination included echocardiography assessment as well as heart catheterization. The echocardiographic examination included B-mode, M-mode, conventional and colour Doppler techniques. For 8 weeks, all horses were treated with Accupro 20 (active substance: Quinapril) at an oral dose rate of 120 mg/horse/day. A follow-up of the horses with mitral valve ins...
Young LE, Wood JL.Cardiac auscultation was carried out on 111 Thoroughbred horses age 2-5 years to test the hypothesis that athletic training might influence the development of atrioventricular (AV) valve regurgitation in young Thoroughbreds. Murmurs of valvular regurgitation were identified and graded on a 1-6 scale. There were 2 sources of auscultation data: 1) 55 2-year-old horses that were examined by auscultation before training commenced and 9 months later when at race fitness; 2) 56 horses age 2-5 years that were examined on one occasion only (25 2-year-olds, 23 3-year-olds, five 4-year-olds and five 5-y...
Reef VB, Bain FT, Spencer PA.Forty-three horses with mitral regurgitation (MR) and congestive heart failure were examined, using M-mode, 2-dimensional real-time and Doppler echocardiography. There was no breed or sex predisposition when compared to the general hospital population. The mean +/- s.d. age of affected horses was 7.6 +/- 8.1 years. Horses with MR and congestive heart failure had significant increases in mean values for left ventricular chamber size, left atrial size and heart rate and significant decreases in interventricular septal and left ventricular free wall thickness. Significant increases in pulmonary a...
Stadler P, Weinberger T, Kinkel N, Deegen E.B- and M-mode echocardiography was performed on 38 horses. 34 patients had systolic heart murmur with the point of maximal intensity over mitral valve. Additionally, 17 of these patients were examined with the pulsed wave doppler echocardiography (Vingmed 200). In 26 patients with cardiac murmur and in 4 patients without cardiac murmur a mitral valve insufficiency was diagnosed by echocardiography. In 8 horses with a systolic murmur over mitral valve M- and B-mode evaluation could not reveal a haemodynamic importance of the murmur. The diagnosis of MVI was based on a dilation of left atrium wi...
Dedrick P, Reef VB, Sweeney RW, Morris DD.Using echocardiography, mitral valve bacterial endocarditis was diagnosed in a yearling Thoroughbred filly with a history of periodic fever and intermittent hind limb lameness. Streptococcus sp were isolated from blood, and the filly was treated with penicillin, resulting in a bacteriologic cure. Severe mitral regurgitation developed secondary to scarring of the valve, which resulted in the filly's death. A poor prognosis usually is indicated in horses with bacterial endocarditis, as bacteriologic cures are infrequent and severe valvular insufficiency often develops.
Wingfield WE, Miller CW, Voss JL, Bennett DG, Breukels J.Echocardiography is a non-invasive, safe means of assessing intracardiac structures and their motion. In the normal motion of the mitral valve there is anterior motion noted during atrial systole. In 3 horses with atrial fibrillation the mitral valve motion had no anterior motion to correspond with atrial contractions. Quinidine returned the electrocardiogram of one horse to a sinus rhythm after which echocardiography demonstrated the reappearance of the anterior motion of the mitral valve.
Young LE, Wood JL.Cardiac auscultation was carried out on 111 Thoroughbred horses age 2-5 years to test the hypothesis that athletic training might influence the development of atrioventricular (AV) valve regurgitation in young Thoroughbreds. Murmurs of valvular regurgitation were identified and graded on a 1-6 scale. There were 2 sources of auscultation data: 1) 55 2-year-old horses that were examined by auscultation before training commenced and 9 months later when at race fitness; 2) 56 horses age 2-5 years that were examined on one occasion only (25 2-year-olds, 23 3-year-olds, five 4-year-olds and five 5-y...
Imhasly A, Tschudi PR, Lombard CW, Gerber V.The clinical and echocardiographic characteristics of 108 horses with echocardiographically confirmed mild mitral valve regurgitation (MR) were investigated along with its clinical progression. Follow-up consisted of a re-examination of 28 horses and questionnaires were used to obtain information on a further 43 cases. Thirty-seven horses with mild MR were lost to follow-up. Horses with mild MR were re-examined between 2 and 9 years (3.8+/-1.8 years) following first presentation, with mild MR still present and a small, but statistically significant (P=0.049) increase of left ventricular diamet...
Decloedt A, Verheyen T, Sys S, De Clercq D, Bijnens B, van Loon G.The influence of atrioventricular (AV) interaction on mitral valve closure (MVC) and left ventricular (LV) isovolumic contraction is not fully clarified. We investigated the relationship among AV delay, MVC, and LV isovolumic contraction using a horse model because of the low heart rate and physiologically long AV delay. Results: Six horses were evaluated during sinus rhythm, right ventricular pacing without preceding atrial contraction, and dual-chamber pacing at AV delays of 150 to 350 ms, programmed at a constant rate. Right parasternal 4-chamber views were recorded for simultaneous measure...
Gehlen H, Bubeck K, Stadler P.In 12 healthy warmblood horses and 10 horses with mitral valve insufficiencies (MVI) of various degrees heart rate and pulmonary artery wedge pressure (PWP) was measured at rest and during standardised exercise on a high speed treadmill. There was a significant increase in PWP with each change in speed of the treadmill (p < 0.01). The PWP of horses with mild mitral valve regurgitation under working conditions was not significantly different compared to the healthy horses. The horses with moderate mitral valve regurgitation showed a significant higher pulmonary artery wedge pressure at rest and...
Walders W, Gehlen H.This study evaluated a device for blood pressure measurement using high definition oscillometry (HDO) for its acceptability and practicability in the horse. Furthermore, we evaluated whether this device can determine differences in blood pressure between healthy horses and horses with heart diseases and between different measurement times. Methods: The study population consisted of 60 horses (aged 4-31 years). All horses underwent clinical examination, conventional echocardiography (including cardiac output measurement at the pulmonary artery), repeated noninvasive blood pressure measurement a...
Wingfield WE, Miller CW, Voss JL, Bennett DG, Breukels J.Echocardiography is a non-invasive, safe means of assessing intracardiac structures and their motion. In the normal motion of the mitral valve there is anterior motion noted during atrial systole. In 3 horses with atrial fibrillation the mitral valve motion had no anterior motion to correspond with atrial contractions. Quinidine returned the electrocardiogram of one horse to a sinus rhythm after which echocardiography demonstrated the reappearance of the anterior motion of the mitral valve.
Dedrick P, Reef VB, Sweeney RW, Morris DD.Using echocardiography, mitral valve bacterial endocarditis was diagnosed in a yearling Thoroughbred filly with a history of periodic fever and intermittent hind limb lameness. Streptococcus sp were isolated from blood, and the filly was treated with penicillin, resulting in a bacteriologic cure. Severe mitral regurgitation developed secondary to scarring of the valve, which resulted in the filly's death. A poor prognosis usually is indicated in horses with bacterial endocarditis, as bacteriologic cures are infrequent and severe valvular insufficiency often develops.
Stadler P, Weinberger T, Kinkel N, Deegen E.B- and M-mode echocardiography was performed on 38 horses. 34 patients had systolic heart murmur with the point of maximal intensity over mitral valve. Additionally, 17 of these patients were examined with the pulsed wave doppler echocardiography (Vingmed 200). In 26 patients with cardiac murmur and in 4 patients without cardiac murmur a mitral valve insufficiency was diagnosed by echocardiography. In 8 horses with a systolic murmur over mitral valve M- and B-mode evaluation could not reveal a haemodynamic importance of the murmur. The diagnosis of MVI was based on a dilation of left atrium wi...
Reef VB, Bain FT, Spencer PA.Forty-three horses with mitral regurgitation (MR) and congestive heart failure were examined, using M-mode, 2-dimensional real-time and Doppler echocardiography. There was no breed or sex predisposition when compared to the general hospital population. The mean +/- s.d. age of affected horses was 7.6 +/- 8.1 years. Horses with MR and congestive heart failure had significant increases in mean values for left ventricular chamber size, left atrial size and heart rate and significant decreases in interventricular septal and left ventricular free wall thickness. Significant increases in pulmonary a...
Decloedt A, Schwarzwald CC, De Clercq D, Van Der Vekens N, Pardon B, Reef VB, van Loon G.Although atrial fibrillation (AF) can be successfully treated in horses, recurrence occurs frequently. In humans, atrial function after cardioversion can predict recurrence. Objective: To examine the prognostic value of atrial mechanical function at 24 hours after cardioversion and other potential predictor variables for AF recurrence in horses. Methods: 117 horses treated for AF at 4 referral centers. Methods: Retrospective study. Inclusion criteria were successful cardioversion, echocardiography at 24 hours after cardioversion and ≥4 months follow-up. To determine factors associated with A...
Gehlen H, Vieht JC, Stadler P.Twenty horses with mitral valve insufficiency, but without signs of congestive heart failure, and five horses without signs of heart disease were examined before and after medication with an angiotensin-converting enzyme (ACE) inhibitor. The examination included echocardiography assessment as well as heart catheterization. The echocardiographic examination included B-mode, M-mode, conventional and colour Doppler techniques. For 8 weeks, all horses were treated with Accupro 20 (active substance: Quinapril) at an oral dose rate of 120 mg/horse/day. A follow-up of the horses with mitral valve ins...
Huesler IM, Mitchell KJ, Schwarzwald CC.Echocardiographic assessment of left atrial (LA) size and function in horses is not standardized. Objective: The aim of this study was to establish reference intervals for echocardiographic indices of LA size and function in Warmblood horses and to provide proof of concept for allometric scaling of variables and for the clinical use of area-based indices. Methods: Thirty-one healthy Warmblood horses and 91 Warmblood horses with a primary diagnosis of mitral regurgitation (MR) or aortic regurgitation (AR). Methods: Retrospective study. Echocardiographic indices of LA size and function were meas...
Piotrowski IL, Junge HK, Schwarzwald CC.Mitral and aortic valve insufficiencies have been commonly reported in horses. The objective of this study was to establish the use of acoustic cardiography (Audicor®) in horses with aortic (AI) or mitral valve insufficiency (MI). A total of 17 healthy horses, 18 horses with AI, and 28 horses with MI were prospectively included. None of the horses was in heart failure. Echocardiography and Audicor® analyses were conducted. Electromechanical activating time (EMAT), rate-corrected EMATc, left ventricular systolic time (LVST), rate-corrected LVSTc, and intensity and persistence of the third and...
