Melanie Hezzell, VetMB, PhD
Dr. Melanie Hezzell is the 2013 AKC Canine Health Foundation Clinical-Scientist Fellow from the University of Pennsylvania.
Dr. Hezzell earned her Bachelor of Veterinary Medicine (equivalent to a DVM degree in the United States) at the University of Cambridge in 1997. She has worked in general veterinary practice in the United Kingdom and Australia. Dr. Hezzell completed an internship in small animal medicine and surgery at Royal Veterinary College, University of London and went on to complete the Royal College of Veterinary Surgeons (RCVS) Certificate in Veterinary Cardiology.
In 2012 Dr. Hezzell earned her PhD from Royal Veterinary College, University of London. Her research was on identification of diagnostic tests predictive of progression of mitral valve disease in dogs. She is currently a Resident in Veterinary Cardiology at the University of Pennsylvania. Dr. Hezzell is also a member of the Royal College of Veterinary Surgeons and the European Society of Veterinary Cardiology.
Fellowship Research Project:
The Cavalier King Charles Spaniel is a breed of dog that is highly predisposed to degenerative mitral valve disease, and as such serves as an animal model for mitral disease in both humans and other breeds of dogs. The clinical course of mitral valve disease begins with subtle changes to the valve leaflet including mild thickening and loss of normal collagen structure. Progression of disease is highly variable in individual dogs and predicting risk of heart failure or mortality is very difficult even after using conventional diagnostics such as electrocardiography, echocardiography, and thoracic radiography. In humans with heart disease, blood based markers of cardiac stress such as NT proBNP are increasingly used to stratify risk of morbidity and mortality and to help guide therapy. Dr. Hezzell, and other groups, have prospectively examined the clinical utility of NT proBNP to predict risk of first-time heart failure in dogs with advanced but still asymptomatic disease as well as to predict survival in dogs with chronic congestive heart failure.
In the coming years of her residency here Penn Vet, Dr. Hezzell is planning a prospective multicenter study that will determine if use of blood markers such as NT-proBNP improves the standard of care in dogs with mitral valve disease. Specifically, she will design a predictive equation based on our previous work that yields the percent chance that dogs with advanced but still asymptomatic mitral disease will experience their first episode of heart failure within the subsequent 3 months. The utility of this model will be tested against the current gold standard, which is the opinion of a board-certified cardiology specialist who integrates the results of the conventional diagnostics but without the blood test results. The study will involve 3 sites in the US and 1 site in the UK and follow dogs over a period of up to 2 years. If the blood-based model is successful, it will improve the practice standard for the prediction of heart failure in the Cavalier breed and have implications for other breeds of dogs with mitral valve disease as well as further characterize the Cavalier as a useful model of mitral disease in humans.
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