Peer-reviewed veterinary case report
Using vertebral left atrial size to stage mitral valve disease in dogs
By Mikawa, S et al.·Published in Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology·2020·Department of Clinical Pathology, Japan·View original on PubMed →
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Original publication title: Use of vertebral left atrial size for staging of dogs with myxomatous valve disease.
- Species:
- dog
Plain-English summary
A group of 97 dogs with myxomatous mitral valve disease (MMVD) were studied to see if measuring the size of the left atrium on X-rays could help determine the disease stage. The researchers found that a vertebral left atrial size (VLAS) of 2.5 or higher was a good indicator that a dog might need further heart tests, specifically echocardiography, to check if they were at stage B2 of MMVD. This stage is important because it suggests that treatment with a medication called pimobendan could be beneficial. The study showed that using VLAS can help veterinarians monitor heart disease in dogs more effectively.
People also search for: dog heart disease treatment · myxomatous mitral valve disease in dogs · pimobendan for dogs with heart problems
Abstract
INTRODUCTION/OBJECTIVES: The American College of Veterinary Internal Medicine (ACVIM) guidelines suggest that pimobendan should be initiated in dogs which meet all criteria of stage B2 myxomatous mitral valve disease (MMVD): murmur intensity ≥ 3/6, left atrial-to-aortic ratio ≥ 1.6, normalized left ventricular internal diameter in diastole ≥ 1.7, and vertebral heart size > 10.5. Recently, a new radiographic index for left atrial enlargement, vertebral left atrial size (VLAS), was proposed. The objective of the present study was to evaluate whether VLAS is useful in staging MMVD and if it can distinguish between ACVIM stages B1 and B2. ANIMALS: Ninety-seven client-owned dogs with MMVD were evaluated and classified as ACVIM stage B1, B2, or C-D. MATERIALS AND METHODS: The echocardiographs and radiographs of all the dogs were retrospectively evaluated to obtain left atrial-to-aortic ratio, normalized left ventricular internal diameter in diastole, and VLAS values. The data were analyzed to assess the correlation between these measurements and VLAS, and the optimal cutoff value of VLAS was determined. RESULTS: A VLAS cutoff value of 2.6 provided the greatest diagnostic accuracy for identification of dogs with ACVIM stage B2 MMVD (area under the curve, 0.96; sensitivity, 95%; specificity, 84%). A VLAS ≥2.5 exhibited the highest sensitivity (sensitivity, 100%; specificity, 78%), and a VLAS ≥ 3.1 exhibited the highest specificity (sensitivity, 47%; specificity, 100%). CONCLUSIONS: VLAS is a helpful index for monitoring MMVD using radiography. A VLAS cutoff value of 2.5 could be used to identify dogs that may benefit from echocardiography to determine if they have reached ACVIM stage B2.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32707334/