Vertebral Heart Scale for the Brittany Spaniel: Breed-Specific Range and Its Correlation with Heart Disease Assessed by Clinical and Echocardiographic Findings

Abstract

The vertebral heart scale (VHS) was proposed by Buchanan and Bucheler as an objective method for estimating heart size in dogs. However, several studies have reported significant variation between breeds. The purpose of this retrospective study was to evaluate the VHS and to suggest a useful upper limit for normal heart size in Brittany Spaniels. The VHS was measured using a right lateral view in twenty-eight normal dogs and fifteen dogs with myxomatous mitral valve disease. The mean ± SD (standard deviation) VHS was 10.6 ± 0.2 vertebrae (v) in the normal dogs, which differs significantly from the mean VHS of 9.7 ± 0.5 v in Buchanan’s original study with dogs of various breeds. The VHS in the dogs with myxomatous mitral valve disease was 11.9 ± 1.1 v. With a threshold value of 11.1 vertebrae, the sensitivity, specificity, positive and negative predictive values for diagnosing a cardiomegaly are 90%, 72%, 53% and 96%, respectively.

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

“…Only one right lateral radiography was used for both VHS and VLAS measurements. However, most of the previous studies have used the same recumbence for analysis in both healthy and diseased dogs 8,13,23,24,27 . Moreover, some studies reported no significant differences between left and right recumbence 7,28 .…”

“…However, most of the previous studies have used the same recumbence for analysis in both healthy and diseased dogs. 8,13,23,24,27 Moreover, some studies reported no significant differences between left and right recumbence. 7,28 Second, our population was overrepresented by Maltese dogs.…”

Regressive vision transformer for dog cardiomegaly assessment

“…VHS 21 has been used as one of the standard methods to evaluate cardiac silhouette size on thoracic radiographs for animals. However, there are two major issues with the calculation of VHS.…”

The heart to single vertebra ratio: A new objective method for radiographic assessment of cardiac silhouette size in dogs

“…In 1995, Buchanan and Bücheler described the vertebral heart score (VHS) as an objective method for assessing heart size 8 . Since then, a number of studies have evaluated its reliability by assessing the intra‐ and inter‐observer agreement, the effects of sex, breathing, cardiac cycle, body condition score, and recumbency on the measurements, and determined indices for individual breeds that tend to deviate from the initially reported cut‐off values 9–25 . VHS is very useful in clinical practice because it is relatively simple to determine at initial and follow‐up examinations 19,26,27 .…”

“…8 Since then, a number of studies have evaluated its reliability by assessing the intra-and inter-observer agreement, the effects of sex, breathing, cardiac cycle, body condition score, and recumbency on the measurements, and determined indices for individual breeds that tend to deviate from the initially reported cut-off values. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] VHS is very useful in clinical practice because it is relatively simple to determine at initial and follow-up examinations. 19,26,27 However, some limitations exist, including the difficulty of determining VHS in patients with spondylosis deformans, reduced intervertebral disc spaces, or vertebral malformations such as hemivertebrae, butterfly vertebrae or wedge vertebrae.…”