Two radiographic methods for assessing left atrial enlargement and cardiac remodeling in dogs with myxomatous mitral valve disease

Vezzosi, Tommaso; Puccinelli, Caterina; Citi, Simonetta; Tognetti, Rosalba

doi:10.1016/j.jvc.2021.01.002

Cited by 12 publications

(36 citation statements)

References 21 publications

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“…The reason for analyzing only these two measurements was because presently these are widely used and proposed as radiographic criteria in the diagnosis and prognosis of the MMVD, 19 despite the findings of a previous study showing that RLAD is a better predictor for MMVD stage B2 diagnosis. 22 In conclusion, we found that breed-specific reference values for VHS and VLAS in our sample of Maltese dogs were not influenced by sex, age or BW and differed from previously reported standard threshold values. Results of this study provided reference interval data for future use in evaluations of Maltese dogs presenting for suspected cardiac disease, especially when echocardiography may be unavailable.…”

Section: Discussioncontrasting

confidence: 78%

“…19 Several studies have assessed the accuracy of this technique to diagnose dogs with left atrial enlargement due to MMVD. [20][21][22][23][24] Also, previous studies have shown good intraand interobserver agreements for these measurements, supporting their application for clinical patients. 3,4,25,26 To date, limited data exist regarding the variability of VLAS among breeds.…”

supporting

confidence: 64%

“…Also, out of all measurements described in the literature, the present study aimed to report the reference ranges only for VHS and VLAS. The reason for analyzing only these two measurements was because presently these are widely used and proposed as radiographic criteria in the diagnosis and prognosis of the MMVD, 19 despite the findings of a previous study showing that RLAD is a better predictor for MMVD stage B2 diagnosis 22 …”

Section: Discussionmentioning

confidence: 99%

“…The VLAS measurement method was more recently described 3 and has been included in the American College of Veterinary Internal Medicine (ACVIM) consensus for MMVD diagnosis 19 . Several studies have assessed the accuracy of this technique to diagnose dogs with left atrial enlargement due to MMVD 20–24 . Also, previous studies have shown good intra‐ and interobserver agreements for these measurements, supporting their application for clinical patients 3,4,25,26 .…”

Section: Introductionmentioning

confidence: 98%

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Vertebral heart size and vertebral left atrial size reference ranges in healthy Maltese dogs

Baisan

Vulpe

2021

Vet Radiology Ultrasound

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The most common cardiac measurements on thoracic radiography in veterinary medicine are vertebral heart size (VHS) and vertebral left atrial size (VLAS). Previously published studies have demonstrated evidence that reference ranges for these measures vary among different dog breeds, however reference ranges for Maltese breed dogs are currently lacking. We hypothesized that VHS and VLAS in healthy Maltese dogs would not be influenced by sex, age, or bodyweight. This retrospective, reference interval study aimed to describe reference intervals for VHS and VLAS in a sample of clinically healthy Maltese dogs and assess the intra-and interobserver variabilities for VLAS and VHS measurements. A total of 81 clinically healthy Maltese dogs were included, with healthy status being based on a complete cardiologic examination. Thoracic radiography in right lateral recumbency was performed for all dogs. The intra-and interobserver variability assessments of VHS and VLAS were based on measurements independently performed by three observers. The mean VHS was 9.53 ± 0.46 vertebrae (v). The median and interquartile range (IQR) for VLAS was 2 v (IQR, 1.8-2.1v). A statistically significant moderate positive correlation was observed between VHS and VLAS (P < .01, r = 0.416). Both VHS and VLAS showed an almost perfect intraobserver agreement. Interobserver agreement was almost perfect for VHS and substantial for VLAS. Findings supported previous studies recommending the use of breed-specific reference values for VHS and VLAS, and provided background data for future radiographic evaluations of Maltese dogs with clinical signs of cardiac disease.

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Section: Discussioncontrasting

confidence: 78%

supporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Vertebral heart size and vertebral left atrial size reference ranges in healthy Maltese dogs

Baisan

Vulpe

2021

Vet Radiology Ultrasound

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“…The importance of evaluating LA size is based on the fact that LA enlargement is a crucial factor in assessing the risk of present or future congestive heart failure (CHF) [ 3 , 7 , 13 ]. Additionally, detection of LA enlargement can help to distinguish stage B1 patients from stage B2 patients [ 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Methods of Radiographic Measurements of Heart and Left Atrial Size in Dogs with and without Myxomatous Mitral Valve Disease: Intra- and Interobserver Agreement and Practicability of Different Methods

Levicar

Nolte

Granados-Soler

et al. 2022

Animals

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Dogs suffering from Myxomatous Mitral Valve Disease (MMVD) show a potential heart enlargement, especially in the left atrium, detectable by radiography. Due to digital radiography, different radiographic measurements estimate cardiac size quite uncomplicatedly. The Vertebral Heart Size (VHS), Radiographic Left Atrial Dimension (RLAD), Left Atrial Width (LAWidth), and the Vertebral Left Atrial Size (VLAS) used anatomical landmarks for measuring cardiac size in relation to the vertebral column. This study aimed to compare VHS, RLAD, LAWidth, and VLAS measured in conventional and inverted radiographs by veterinarians with different levels of experience in healthy dogs and dogs with MMVD. The reliability and user-friendliness of these measurements were evaluated, and the staging was compared to the echocardiography staging. A total of 50 unaffected dogs and 150 dogs with MMVD in stages B1, B2, and C were assessed. Three veterinarians with different levels of experience examined 200 conventional radiographs and their corresponding inverted radiographs blinded to the echocardiographic and clinical examination results. Analyses were performed to compare the measurements’ grading and determine anatomical landmarks with measurement difficulties. Additionally, inter- and intraobserver agreement was assessed using intraclass correlation coefficient, and the agreement between radiographic and echocardiographic staging was compared using the kappa coefficient. The VHS, LAWidth, and VLAS were easier to define than the RLAD. The interobserver agreement was almost perfect for VHS (0.962) and good for the other radiographic measurements (RLAD: 0.778, LAWidth: 0.772, VLAS: 0.858). The VHS assigned the most dogs to the correct stage. However, VHS, RLAD, LAWidth, and VLAS presented an almost perfect intraobserver agreement. The dorsal left atrial margin of the RLAD was the most difficult measurement point to identify. The VHS is the most reproducible radiographic method for measuring the canine heart size and shows the highest agreement with echocardiography. An observer-related influence could be detected for RLAD, LAWidth, and VLAS.

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Comparison of different radiographic scores with associated echocardiographic measurements and prediction of heart enlargement in dogs with and without myxomatous mitral valve disease

Levicar

Granados-Soler

Freise

et al. 2022

Journal of Veterinary Cardiology

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Two radiographic methods for assessing left atrial enlargement and cardiac remodeling in dogs with myxomatous mitral valve disease

Cited by 12 publications

References 21 publications

Vertebral heart size and vertebral left atrial size reference ranges in healthy Maltese dogs

Vertebral heart size and vertebral left atrial size reference ranges in healthy Maltese dogs

Methods of Radiographic Measurements of Heart and Left Atrial Size in Dogs with and without Myxomatous Mitral Valve Disease: Intra- and Interobserver Agreement and Practicability of Different Methods

Comparison of different radiographic scores with associated echocardiographic measurements and prediction of heart enlargement in dogs with and without myxomatous mitral valve disease

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