Wearable Technology for Remote Monitoring of Exercise Tolerance in Canine Myxomatous Mitral Valve Disease

: An Expanded Cohort Study

Abstract

The administration of pimobendan in dogs with stage B2 myxomatous mitral valve
disease (MMVD) delays the onset of congestive heart failure, improving quantity and quality
of life. However, identifying stage B2 dogs is challenging without access to
echocardiography. As subtle signs of exercise intolerance can develop early in the disease,
monitoring heart rate response during exercise offers a potential marker of disease severity.
Wearable devices offer a non-invasive method of continuous heart rate monitoring at home.
This study investigated differences in wearable device-measured heart rate responses to exercise between stage B1 and B2 MMVD dogs, in the clinic and home environments, to
explore whether change in heart rate during exercise could predict stage B2 disease.
Thirty-three dogs with MMVD were recruited from Langford Vets Small Animal
Referral Hospital, Bristol. A tail-mounted wearable device was used to obtain resting and
exercising heart rates in both environments. Home data were obtained for 15 dogs and clinic
data for 20 dogs. At home, no significant difference in heart rate response to exercise was
observed between stage B1 and B2 dogs. However, stage B2 dogs had significantly higher
resting heart rates compared to stage B1 dogs (p = .023). In the clinic, no significant
differences in heart rate were found between groups. Both groups had significantly higher
resting heart rates in the clinic than at home. Heart murmur grade remained the most reliable
predictor of stage B2 MMVD. Assessment of agreement with ECG showed a Lin’s
concordance correlation coefficient of 0.65, 95% CI [0.37-0.82]), and a Bland Altman mean
difference of -4.85bpm (limits of agreement: -43.55 to 33.86bpm).
Despite variable accuracy, the wearable device detected expected physiological
differences between dogs with stage B1 and B2 MMVD. Wearable devices show potential as
an objective tool for assessing exercise tolerance in dogs with MMVD at home.

Date of Award	12 May 2026
Original language	English
Awarding Institution	University of Bristol
Supervisor	Andrew Dowsey (Supervisor) & Melanie J Hezzell (Supervisor)