Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Sep-Oct;39(5):e70215.
doi: 10.1111/jvim.70215.

Risk Stratification Using Mitral INsufficiency Echocardiographic Score 2 in Dogs With Preclinical Mitral Valve Disease

Tommaso Vezzosi  1 , Giovanni Grosso  1 , Liva Vatne  2 , Francesco Porciello  3 , Elena Dall'Aglio  4 , Carlo Guglielmini  5 , Helena Broch  6 , Dave Dickson  7 , Marta Croce  8 , Valentina Patata  8 , Federica Marchesotti  8 , Rosalba Tognetti  1 , Mark Rishniw  9 , Oriol Domenech  6   8
Affiliations
Multicenter Study

Risk Stratification Using Mitral INsufficiency Echocardiographic Score 2 in Dogs With Preclinical Mitral Valve Disease

Tommaso Vezzosi et al. J Vet Intern Med. 2025 Sep-Oct.

Abstract

Background: Outcome-based cardiac risk stratification schemes are lacking for preclinical myxomatous mitral valve disease (MMVD). The Mitral INsufficiency Echocardiographic (MINE) score was developed as an easy-to-use severity classification of MMVD.

Hypothesis/objectives: The primary aim was to verify the efficacy of the MINE score in stratifying the cardiac risk in preclinical MMVD. Secondary aims were to evaluate a simplification of the original score and propose a definition of "advanced B2".

Animals: Seven hundred forty-nine dogs with preclinical MMVD.

Methods: Retrospective, multicenter, cohort study. Clinical usefulness of the MINE score was tested by evaluating its association with median time to cardiac event. The Cox proportional hazards regression was used to evaluate the echocardiographic independent predictors of cardiac endpoint. Long-term outcome was analyzed using Kaplan-Meier curves and log-rank test.

Results: Based on multivariate analysis, a simplified version of the MINE score was redefined including only the left atrium-to-aorta ratio, the left ventricular end-diastolic diameter, and the E-wave velocity. Mild cases had longer median time to cardiac event [2604 days, 95% confidence interval (CI) 2344-2604 days] in comparison to moderate (1216 days, 95% CI 998-1882 days) and severe cases (718 days, 95% CI 599-980 days; p < 0.001). Among stage B2, severe cases had shorter median time to cardiac event (718 days, 95% CI 599-980 days) in comparison to moderate (1141 days, 95% CI 980-1725 days) and mild cases (not available; p < 0.001).

Conclusions and clinical importance: For this study cohort, the simplified version of the MINE score was clinically effective for risk stratification of preclinical MMVD. Dogs in stage B2 classified as "severe" can be defined "advanced" B2.

Keywords: asymptomatic; cardiology; mitral regurgitation; prognosis; survival.

PubMed Disclaimer

Conflict of interest statement

Authors declare no off‐label use of antimicrobials.

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier curves illustrating the time to cardiac endpoint according to the severity classes of the MINE score 2 (p < 0.001).
FIGURE 2
FIGURE 2
Kaplan–Meier curves illustrating survival time according to the severity classes of the MINE score 2, when all causes of death were considered (p < 0.001).
FIGURE 3
FIGURE 3
Kaplan–Meier curves illustrating the time to cardiac endpoint among dogs in stage B1 classified according to the MINE score 2 (p = 0.24).
FIGURE 4
FIGURE 4
Kaplan–Meier curves illustrating the time to cardiac endpoint among dogs in stage B2 classified according to the MINE score 2 (p < 0.001).
See this image and copyright information in PMC

References

    1. Detweiler D. K. and Patterson D. F., “The Prevalence and Types of Cardiovascular Disease in Dogs,” Annals of the New York Academy of Sciences 127 (1965): 481–516. - PubMed
    1. Buchanan J. W., “Chronic Valvular Disease (Endocardiosis) in Dogs,” Advances in Veterinary Science and Comparative Medicine 21 (1977): 75–106. - PubMed
    1. Borgarelli M., Savarino P., Crosara S., et al., “Survival Characteristics and Prognostic Variables of Dogs With Mitral Regurgitation Attributable to Myxomatous Valve Disease,” Journal of Veterinary Internal Medicine 22 (2008): 120–128. - PubMed
    1. Keene B. W., Atkins C. E., Bonagura J. D., et al., “ACVIM Consensus Guidelines for the Diagnosis and Treatment of Myxomatous Mitral Valve Disease in Dogs,” Journal of Veterinary Internal Medicine 33 (2019): 1127–1140. - PMC - PubMed
    1. Borgarelli M., Crosara S., Lamb K., et al., “Survival Characteristics and Prognostic Variables of Dogs With Preclinical Chronic Degenerative Mitral Valve Disease Attributable to Myxomatous Degeneration,” Journal of Veterinary Internal Medicine 26 (2012): 69–75. - PubMed

Publication types

LinkOut - more resources