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  • Title: Utility of radiographic measurements to predict echocardiographic left heart enlargement in dogs with preclinical myxomatous mitral valve disease.
    Author: Poad MH, Manzi TJ, Oyama MA, Gelzer AR.
    Journal: J Vet Intern Med; 2020 Sep; 34(5):1728-1733. PubMed ID: 32686167.
    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.
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