How to classify dog heart valve disease stages without ultrasound

Abstract

Simple Summary Myxomatous mitral valve disease is dogs’ most common acquired heart disease. The gold standard for its definitive diagnosis is echocardiography. This study aimed to develop a tool that uses a quality of life survey, structured anamnesis, and physical examination to predict the American College of Veterinary Internal Medicine classification stages. Accurately identifying a patient’s stage is crucial to evaluating when treatment should be initiated and tailoring it to their ACVIM stage. The study analysed 1011 dogs from 23 hospitals, and the results showed that the majority of patients were successfully classified into the control group (healthy dogs), stage B (dogs with a heart murmur but are asymptomatic), and stage C (dogs with heart failure). However, efficient results were not obtained to differentiate between stage B1 (dogs with a heart murmur and without heart enlargement) and stage B2 (dogs with a heart murmur and heart enlargement). Further studies should be carried out to implement these techniques and improve their diagnostic value in veterinary cardiology. Abstract Myxomatous mitral valve disease (MMVD) is a prevalent canine cardiac disease typically diagnosed and classified using echocardiography. However, accessibility to this technique can be limited in first-opinion clinics. This study aimed to determine if machine learning techniques can classify MMVD according to the ACVIM classification (B1, B2, C, and D) through a structured anamnesis, quality of life survey, and physical examination. This report encompassed 23 veterinary hospitals and assessed 1011 dogs for MMVD using the FETCH-Q quality of life survey, clinical history, physical examination, and basic echocardiography. Employing a classification tree and a random forest analysis, the complex model accurately identified 96.9% of control group dogs, 49.8% of B1, 62.2% of B2, 77.2% of C, and 7.7% of D cases. To enhance clinical utility, a simplified model grouping B1 and B2 and C and D into categories B and CD improved accuracy rates to 90.8% for stage B, 73.4% for stages CD, and 93.8% for the control group. In conclusion, the current machine-learning technique was able to stage healthy dogs and dogs with MMVD classified into stages B and CD in the majority of dogs using quality of life surveys, medical history, and physical examinations. However, the technique faces difficulties differentiating between stages B1 and B2 and determining between advanced stages of the disease.