The Mitral INsufficiency Echocardiographic score: A severity classification of myxomatous mitral valve disease in dogs

Abstract

Background: There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables. Hypothesis/Objectives:To propose an easy-to-use echocardiographic classification of severity of MMVD in dogs.Animals: Five hundred and sixty dogs with MMVD.Methods: This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium-to-aorta ratio, left ventricular end-diastolic diameter normalized for body weight, fractional shortening, and E-wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4-5), moderate (score: 6-7), severe (score: 8-12), late stage (score: 13-14).Results: Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877-2810 days), moderate (1882 days, 95% CI 1341-2434 days), severe (623 days, 95% CI 432-710 days), and late stage (157 days, 95% CI 53-257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001). Conclusions and Clinical Importance:The MINE score is a new easy-to-use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.

Association of Paraoxonase-1 and NT-proBNP with Clinical, Clinico-Pathologic and Echocardiographic Variables in Dogs with Mitral Valve Disease

“…On the other hand, lowering of PON-1 activity was associated with an increase in LVIDdn and LVIDsn measurements, as well as MV E/A ratio, which are markers of advanced cardiac disease and decompensated heart failure [ 43 , 44 ], regardless of group. In a recent study, similar conclusions were reached regarding the correlation of PON-1 and left ventricular dimensions [ 12 ].…”

Efficacy of a mitral regurgitation severity index to predict long‐term outcome in dogs with myxomatous mitral valve disease

“…These lines were compared to the length of the patient's vertebral bodies, starting at the cranial endplate of T4 and extending caudally, to the nearest 0.5 mm 26‐28 . The MINE score was calculated for S1 and S2 dogs when all echocardiographic components of the index were available 16 …”

“…[26][27][28] The MINE score was calculated for S1 and S2 dogs when all echocardiographic components of the index were available. 16 for VLAS, 29 and 3.4 for MVLAS). 28 Based on initial exploratory analyses, MRSI was also calculated without age for Stage C visits (Table 1).…”

Prospective pilot study on the predictive significance of plasma miR-30b-5p through the study of echocardiographic modifications in Cavalier King Charles Spaniels affected by different stages of myxomatous mitral valve disease: The PRIME study

“…At the end of the echocardiographic examination, the Mitral INsufficiency Echocardiographic (MINE) score was calculated by assigning a score from 1 to 4 to the left ventricular end-diastolic diameter normalized for body weight (LVIDdN), left atrial-to-aortic root ratio (LA/Ao), E wave peak velocity (E) and fractional shortening (FS%) values. Every patient was classified on the base of the total reached score, as follows: mild (total score = 4–5), moderate (total score = 6–7), severe (total score = 8–12) and late stage (total score = 13–14) [ 32 ].…”