Use of vertebral left atrial size for staging of dogs with myxomatous valve disease

Mikawa, Shoma; Nagakawa, Masayoshi; Ogi, Haruka; Akabane, Ryota; Koyama, Yukari; Sakatani, Atsushi; Ogawa, Mizuki; Miyakawa, Hirosumi; Shigemoto, Jin; Tokuriki, Tsuyoshi; Toda, Nobushige; Miyagawa, Yuichi; Takemura, Naoyuki

doi:10.1016/j.jvc.2020.06.001

Cited by 20 publications

(44 citation statements)

References 19 publications

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“…A dog with a VLAS of 2.4 using the original published method would therefore be categorized as 2.5 if it is rounded up to the nearest 0.25 vertebral units. Similar sensitivity but higher specificity of VLAS (≥ 2.4) has been demonstrated in the current study (81% and 97%) than what has been reported in the previous studies (67%/85%, 25 70%/84%, 34 and 86%/84% 36 ) using a VLAS of ≥2.5. The reason for the differences could simply be because of variation in study samples as all studies have demonstrated a good‐excellent ICC for intra‐ and interobserver variability 25 …”

Section: Discussionsupporting

confidence: 91%

“…The results of this study have reinforced the previously described 24,25,34‐36 positive correlation between VLAS and LA/Ao ( r = 0.76, 95% CI 0.64‐0.85, P < .001). The optimal cut‐off value of ≥2.4 vertebrae derived from ROC analyzis in the current study to identify a LA/Ao ≥1.6 was close to the cut‐off value of ≥2.3 vertebrae originally proposed, 25 and the cut‐off value of ≥2.5 vertebrae reported subsequently 34,36 . Direct comparison however is difficult given previously described methodology 34 rounded their measurements to the nearest 0.25 vertebrae as opposed to 0.1 vertebrae used by the other studies.…”

Section: Discussionsupporting

confidence: 90%

“…The optimal cut-off value of ≥2.4 vertebrae derived from ROC analyzis in the current study to identify a LA/Ao ≥1.6 was close to the cut-off value of ≥2.3 vertebrae originally proposed, 25 and the cut-off value of ≥2.5 vertebrae reported subsequently. 34,36 Direct comparison however is difficult given previously described methodology 34 specificity of VLAS (≥ 2.4) has been demonstrated in the current study (81% and 97%) than what has been reported in the previous studies (67%/85%, 25 70%/84%, 34 and 86%/84% 36 ) using a VLAS of ≥2.5. The reason for the differences could simply be because of variation in study samples as all studies have demonstrated a goodexcellent ICC for intra-and interobserver variability.…”

Section: Resultscontrasting

confidence: 70%

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Radiographic quantification of left atrial size in dogs with myxomatous mitral valve disease

Lam

Gavaghan

Meyers

2021

Veterinary Internal Medicne

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Background: In the absence of echocardiography, identification of cardiomegaly via thoracic radiography is a necessary criterion for classification of disease severity in dogs with myxomatous mitral valve disease (MMVD). Objective: Modified-vertebral left atrial size (M-VLAS) facilitates objective radiographic assessment of the left atrium (LA) in 2 dimensions and identifies LA enlargement more accurately than existing methods. Animals: Sixty-four dogs with various stages of MMVD and 6 control healthy dogs. Methods: Retrospective case-control study. Medical records were searched for dogs with varying severity of MMVD. Modified-vertebral left atrial size, vertebral left atrial size (VLAS), vertebral heart size (VHS), and radiographic left atrial dimension (RLAD) were measured from thoracic radiographs and compared with echocardiographically derived measurements.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Resultscontrasting

confidence: 70%

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Radiographic quantification of left atrial size in dogs with myxomatous mitral valve disease

Lam

Gavaghan

Meyers

2021

Veterinary Internal Medicne

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“…where left heart size (by radiography or echocardiography) is useful for clinical staging, [1][2][3][4][5] predicting risk for heart failure, [6][7][8] aiding treatment decisions in the subclinical stage (ACVIM stage B), [9][10][11] and estimating prognosis. 9,[12][13][14][15][16][17] Relative to thoracic radiography, echocardiography represents the clinical reference standard for assessment of cardiac chamber size.…”

mentioning

confidence: 99%

“…Reference intervals for VLAS have recently been published, 19 and a growing body of literature supports the diagnostic utility of VLAS for detecting echocardiographically confirmed left heart enlargement and clinical staging in dogs with MMVD. [2][3][4] A recent study has suggested VHS is more clinically useful compared to VLAS to identify echocardiographic left heart enlargement in dogs with MMVD. 5 In contrast to VHS, there is limited knowledge regarding the clinical utility of VLAS beyond the context of MMVD.…”

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confidence: 99%

Evaluation of radiographic predictors of left heart enlargement in dogs with known or suspected cardiovascular disease

Duler

Visser

Jackson

et al. 2021

Vet Radiology Ultrasound

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Radiographic assessment of heart size is important for clinical management of dogs with cardiovascular disease (CVDz). We sought to compare the ability of vertebral heart size (VHS), vertebral left atrial size (VLAS), and radiologists' assessment of left atrial size (RadLAE) to predict echocardiographic left atrial size (EchoLAE), an important marker of left heart disease severity. We also compared the ability of VHS and VLAS to predict echocardiographic criteria for ACVIM stage B2 (EchoB2) in dogs with myxomatous mitral valve disease (MMVD). This prospective observational study enrolled 183 dogs with known or suspected CVDz that had an echocardiographic examination and thoracic radiographs obtained within 24 h. Compared to increased VHS, VLAS >2.3 was a more accurate predictor of EchoLAE (P = .002). VLAS >2.3 and RadLAE (both P <.0001) were independently associated with EchoLAE but VHS was not (P = .45). Optimal cutoffs for VLAS and VHS to predict EchoLAE were >2.3 vertebrae (sensitivity [Sn] = 90.3%, specificity [Sp] = 73.6%) and >11.1 vertebrae (Sn = 75.8%, Sp = 76.0%), respectively. Diagnostic accuracy of VLAS (AUC 0.84, 95% CI 0.73-0.92) and VHS (AUC 0.78, 95% CI 0.66-0.88) to predict EchoB2 in dogs with subclinical MMVD (n = 64) were not significantly different (P = .17). Results demonstrate that VLAS and RadLAE were superior indicators of EchoLAE compared to VHS in dogs with known or suspected CVDz. Both VLAS and VHS are useful predictors of EchoB2 in dogs with subclinical MMVD. When echocardiography is unavailable, VLAS represents a useful radiographic measurement to aid clinical management of dogs with known or suspected CVDz.

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

Vezzosi

Puccinelli

Citi

et al. 2021

Journal of Veterinary Cardiology

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Use of vertebral left atrial size for staging of dogs with myxomatous valve disease

Cited by 20 publications

References 19 publications

Radiographic quantification of left atrial size in dogs with myxomatous mitral valve disease

Radiographic quantification of left atrial size in dogs with myxomatous mitral valve disease

Evaluation of radiographic predictors of left heart enlargement in dogs with known or suspected cardiovascular disease

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

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