Effect of left-sided valvular regurgitation on mortality and causes of death among a population of middle-aged and older horses.
Authors: Stevens K B, Marr C M, Horn J N R, Pfeiffer D U, Perkins J D, Bowen I M, Allan E J, Campbell J, Elliott J
Journal: The Veterinary record
Summary
# Editorial Summary: Left-sided Valvular Regurgitation and Equine Mortality A four-year prospective cohort study of 1,153 horses across 19 yards found that whilst left-sided valvular regurgitation (LSVR) was more prevalent in small horses (2.33 times higher than small ponies) and increased slightly with age, the presence of a cardiac murmur indicative of LSVR did not significantly affect overall survival rates. Over the follow-up period, 773 horses were tracked via postal questionnaire, revealing that orthopaedic conditions accounted for 29% of reported deaths and gastrointestinal disease for 23.3%, whereas cardiovascular problems—despite detecting cardiac pathology—represented only 7.9% of mortalities. This discrepancy between the detection of LSVR and its apparent clinical impact on lifespan has important implications for farriers, vets and coaches evaluating the significance of cardiac murmurs during routine examinations: whilst LSVR warrants monitoring, its presence alone should not prompt categorical restrictions on work or life expectancy without supporting clinical signs. The data underscores that musculoskeletal and metabolic health remain far greater determinants of survival and longevity in middle-aged and older horses, suggesting diagnostic effort might be better directed towards early identification and management of orthopaedic and gastrointestinal pathology.
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Practical Takeaways
- •Presence of cardiac murmur indicative of left-sided valvular regurgitation does not significantly increase mortality risk in middle-aged and older horses, suggesting many can continue in service
- •Orthopaedic and gastrointestinal problems, not cardiac disease, are the primary causes of death in older equine populations—focus preventative care accordingly
- •Small horses show higher prevalence of LSVR than small ponies; screening may be warranted in this demographic despite lack of mortality impact
Key Findings
- •No significant difference in mortality between horses with and without left-sided valvular regurgitation over 4 years
- •Small horses had 2.33 times higher odds of LSVR compared to small ponies
- •Older horses were slightly more likely to have LSVR than young horses (OR 1.07)
- •Orthopaedic problems caused 29% of deaths, gastrointestinal problems 23.3%, and cardiovascular problems only 7.9%