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. 2020 Sep;34(5):1728-1733.
doi: 10.1111/jvim.15854. Epub 2020 Jul 20.

Utility of radiographic measurements to predict echocardiographic left heart enlargement in dogs with preclinical myxomatous mitral valve disease

Megan H Poad  1 , Timothy J Manzi  1 , Mark A Oyama  1 , Anna R Gelzer  1
Affiliations

Utility of radiographic measurements to predict echocardiographic left heart enlargement in dogs with preclinical myxomatous mitral valve disease

Megan H Poad et al. J Vet Intern Med. 2020 Sep.

Abstract

Background: Evaluation of left heart size helps determine disease severity in dogs with myxomatous mitral valve disease (MMVD).

Hypothesis/objectives: Determine the ability of radiographic vertebral heart size (VHS) and vertebral left atrial size (VLAS) to predict LHEECHO in dogs with preclinical MMVD.

Animals: Seventy client-owned dogs with MMVD and no historical or present clinical or radiographic evidence of congestive heart failure (CHF).

Methods: Retrospective cross-sectional study of dogs with same-day echocardiography and thoracic radiography. Receiver-operating characteristic (ROC) curves were used to assess the ability of VHS, VLAS, and VHS + VLAS to discern dogs with and without LHEECHO , and clinically relevant cutpoints for these radiographic measurements were selected.

Results: The ability of VHS and VHS + VLAS to predict LHEECHO was moderate (area under the curve [AUC]VHS = 0.851; 95% CI, 0.762-0.941; AUCVHS + VLAS = 0.865; 0.783-0.947), and performance of VLAS and VHS + VLAS was not different from that of VHS alone. A VHS cutpoint of >10.8 had sensitivity = 91.1% (76.3%-98.1%) and specificity = 69.4% (51.9%-83.7%) for predicting LHEECHO . A cutpoint of >11.7 had sensitivity = 32.4% (17.4%-50.5%) and specificity = 97.2% (85.5%-99.9%) for predicting LHEECHO . Thirty (43%) of the 70 dogs had a VHS value of 10.9 to 11.7.

Conclusions and clinical importance: Vertebral heart size >11.7 identified dogs with LHEECHO and VHS ≤ 10.8 excluded dogs with LHEECHO . A large percentage of dogs had VHS values intermediate to these cutpoints.

Keywords: canine; echocardiography; myxomatous mitral valve disease; radiograph; vertebral heart size; vertebral left atrial size.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Receiver‐operating characteristic curve of A, radiographic vertebral heart size (VHS) and B, the sum of VHS and radiographic vertebral left atrial size (VLAS) to differentiate dogs with normalized echocardiographic left ventricular internal dimension ≥1.7 and left atrial to aortic root ratio ≥ 1.6. The values of various VHS and VHS + VLAS cutpoints along their respective curves are indicated
FIGURE 2
FIGURE 2
Receiver‐operating characteristic curve of radiographic vertebral left atrial size (VLAS) to differentiate dogs with left atrial to aortic root ratio ≥ 1.6. The values of various VLAS cutpoints along their respective curves are indicated
FIGURE 3
FIGURE 3
Correlation between radiographic vertebral left atrial size (VLAS) and echocardiographic left atrial to aortic root dimension ratio (LA:Ao)
See this image and copyright information in PMC

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