Prognostic relevance of left cardiac enlargement in dogs with preclinical myxomatous mitral valve disease

Grosso, Giovanni; Vezzosi, Tommaso; Domenech, Oriol; Tognetti, Rosalba

doi:10.1016/j.jvc.2022.12.004

Cited by 3 publications

(10 citation statements)

References 29 publications

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“…This study aimed to propose cutoff values for radiologic measurements in dogs with MMVD and normal or enlarged LA, especially, when echocardiography is not available. The clinical relevance resides from the previous studies that proved a correlation between left atrial size and disease severity 2,26 . To date, the long‐term predictability of this new classification 5 is unknown.…”

Section: Discussionmentioning

confidence: 96%

“…The clinical relevance resides from the previous studies that proved a correlation between left atrial size and disease severity. 2,26 To date, the long-term predictability of this new classification 5 is unknown. However, one previous study proposed a mitral valve disease severity score using left atrial and ventricle dimension, systolic function, and E-wave velocity grouping dogs into mild, moderate, severe, and end-stage, and the survival time was correlated with the disease severity.…”

Section: Discussionmentioning

confidence: 99%

“…Myxomatous mitral valve disease (MMVD) is the most common acquired cardiac condition in dogs accounting for approximately 75% of all heart diseases 1 . Left atrial (LA) size along with other measurements is an important tool for staging and predicting the outcome in dogs with MMVD 2,3 . Echocardiographic measurement of the LA is considered the gold standard and cutoffs are already available for normal and enlarged LA 4 in dogs, which are further used for staging MMVD 1 …”

Section: Introductionmentioning

confidence: 99%

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Determination of radiographic vertebral heart score and vertebral left atrial size cutoffs based on echocardiographic left atrial size in dogs with myxomatous mitral valve disease

Baisan,

Vulpe

2023

Vet Radiology Ultrasound

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Progression of myxomatous mitral valve disease (MMVD) in dogs is a common cause of left atrial enlargement. Recently, a classification of left atrial (LA) size based on echocardiographic measurement has been proposed. This study aims to determine the radiographic LA size by reporting the cutoff values of VHS and VLAS for different groups of echocardiographic‐measured LA size in dogs with MMVD. This retrospective analytical cross‐sectional study included dogs diagnosed with MMVD grouped based on the echocardiographic LA size into normal (LA/Ao < 1.6), mild (1.6–1.89), moderate (1.9–2.2), and severe enlargement (>2.2) and were compared with ACVIM classification. VHS and VLAS were measured on the right lateral radiograph for each dog and cutoff values were calculated. One hundred and three dogs with MMVD were included in the study. A very strong positive correlation was observed between LA/Ao ratio and VHS (rs, 0.823, P < .01) or VLAS (rs, 0.834, P < .01). For VHS, a cutoff of 10.7 v, 11 v, and 11.5 v were established for echocardiographic LA thresholds of 1.6, 1.9, and 2.2 with a sensitivity of 79%, 92%, and 90% and a specificity of 97%, 90.7%, and 78.1%, respectively. For VLAS, a cutoff of 2.5 v, 2.7 v, and 2.9 v were established for echocardiographic LA cutoffs of 1.6, 1.9, and 2.2 with a sensitivity of 73%, 80%, and 83.3% and a specificity of 94%, 92%, and 86.3%, respectively. The results of this study may facilitate clinical decisions based on radiographic examination in dogs with myxomatous mitral valve disease.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determination of radiographic vertebral heart score and vertebral left atrial size cutoffs based on echocardiographic left atrial size in dogs with myxomatous mitral valve disease

Baisan,

Vulpe

2023

Vet Radiology Ultrasound

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“…In previous studies on MMVD in dogs, the presented data have been mostly based on small-and-medium-sized dogs alone or in mixed groups with large breed dogs [ 7 , 8 , 9 , 14 , 15 , 17 , 18 , 21 , 29 , 30 , 31 , 32 ]. With this study, we provide characteristics, estimated survival times and prognostic variables in a large cohort consisting of only large breed dogs with naturally occurring MMVD.…”

Section: Discussionmentioning

confidence: 99%

“…As most studies only include dogs with a weight of up to 20 kg, this study only included dogs that weighed 20 kg or more [ 8 , 9 , 17 , 18 , 19 , 20 , 21 ]. In addition, they had to be older than 5.5 years and diagnosed with MMVD based on the presence of a heart murmur and one or more of the following echocardiographic findings: mitral valve prolapse, color doppler identification of any degree of mitral valve regurgitation, or mitral valve thickening [ 7 , 8 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Myxomatous Mitral Valve Disease in Large Breed Dogs: Survival Characteristics and Prognostic Variables

Svensson,

Selling,

Dirven

2024

Veterinary Sciences

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Myxomatous mitral valve disease (MMVD) is the most common acquired heart disease in dogs and its occurrence in small-and medium-sized dogs has been extensively investigated. MMVD has been described in large breed dogs as well, but substantial knowledge gaps remain. The aim of this study was to provide characteristics, survival times, and prognostic variables in large breed dogs with MMVD. Medical records of dogs diagnosed with MMVD, between 2012 and 2021, were retrospectively reviewed and 202 dogs were analyzed. Median survival time (MST) for all-cause mortality was 800 days for stage B1 dogs, 274 days for stage B2 dogs, and 184 days for stage C dogs. The MST for cardiac-related death for B1 dogs could not be calculated (because survival was greater than 50% at the last timepoint) and for stage B2 and C dogs the MST were 484 and 252 days, respectively. These findings suggest that the frequency of cardiac-related death is low in large breed dogs with stage B1 MMVD. In addition, increased left atrial and ventricular size, evidence of systolic dysfunction, a thrilling murmur, and increased early trans-mitral peak velocity are predictors of cardiac-related death. Data also suggest that the risk of a negative outcome increases profoundly when large breed dogs advance from ACVIM stage B1 into stage B2 or C.

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The Thoracic Inlet Length as a Reference Point to Radiographically Assess Cardiac Enlargement in Dogs with Myxomatous Mitral Valve Disease

Marbella Fernández,

García,

Santana

et al. 2023

Animals

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The diagnostic value of the vertebral heart size (VHS) in dogs with mitral valve degeneration (MVD) is compromised when middle thoracic vertebral anomalies are present. The objective of this study was to assess the use of the thoracic inlet heart score (TIHS) to identify left heart enlargement (LHE) secondary to MVD. The cardiac silhouette of 50 clinically healthy dogs and 106 MVD dogs in different stages was assessed on a right lateral chest radiograph. The TIHS and VHS value were calculated for each patient and compared. The TIHS was significantly different between the control dogs and the dogs with MMVD, increasing with disease stage, control 2.91 ± 0.23, Stage B1 2.98 ± 0.36, B2 3.25 ± 0.34, and C 3.53 ± 0.36, p < 0.05. A THIS ≥3.3 showed 69% sensitivity and 81% specificity to identify LHE. The TIHS showed moderate correlation with the VHS, LA/Ao, and LVIDDN 0.59, 0.42, and 0.62, respectively. The intraobserver and interobserver agreement were almost perfect, 0.96, and substantial, 0.73. The TIHS method can be used to identify LHE secondary to MMVD on dogs’ thoracic radiographs.

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Prognostic relevance of left cardiac enlargement in dogs with preclinical myxomatous mitral valve disease

Cited by 3 publications

References 29 publications

Determination of radiographic vertebral heart score and vertebral left atrial size cutoffs based on echocardiographic left atrial size in dogs with myxomatous mitral valve disease

Determination of radiographic vertebral heart score and vertebral left atrial size cutoffs based on echocardiographic left atrial size in dogs with myxomatous mitral valve disease

Myxomatous Mitral Valve Disease in Large Breed Dogs: Survival Characteristics and Prognostic Variables

The Thoracic Inlet Length as a Reference Point to Radiographically Assess Cardiac Enlargement in Dogs with Myxomatous Mitral Valve Disease

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