Use of vertebral left atrial size for staging of dogs with myxomatous valve disease
| Autor: | Hirosumi Miyakawa, Tsuyoshi Tokuriki, Jin Shigemoto, Masayoshi Nagakawa, Yukari Koyama, Noriko Toda, Yuichi Miyagawa, Mizuki Ogawa, Ryota Akabane, Atsushi Sakatani, Shoma Mikawa, Haruka Ogi, Naoyuki Takemura |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty 040301 veterinary sciences Physiology Radiography Diastole 030204 cardiovascular system & hematology Sensitivity and Specificity Severity of Illness Index 0403 veterinary science 03 medical and health sciences Dogs 0302 clinical medicine Internal medicine medicine Left atrial enlargement Animals Cutoff Dog Diseases Heart Atria Stage (cooking) General Veterinary business.industry Area under the curve Mitral Valve Insufficiency Records 04 agricultural and veterinary sciences medicine.disease Pimobendan Cardiology Female Radiography Thoracic Mitral valve regurgitation business medicine.drug |
| Zdroj: | Journal of Veterinary Cardiology. 30:92-99 |
| ISSN: | 1760-2734 |
| Popis: | Introduction/Objectives The American College of Veterinary Internal Medicine (ACVIM) guidelines suggest that pimobendan should be initiated in dogs which meet all criteria of stage B2 myxomatous mitral valve disease (MMVD): murmur intensity ≥ 3/6, left atrial-to-aortic ratio ≥ 1.6, normalized left ventricular internal diameter in diastole ≥ 1.7, and vertebral heart size > 10.5. Recently, a new radiographic index for left atrial enlargement, vertebral left atrial size (VLAS), was proposed. The objective of the present study was to evaluate whether VLAS is useful in staging MMVD and if it can distinguish between ACVIM stages B1 and B2. Animals Ninety-seven client-owned dogs with MMVD were evaluated and classified as ACVIM stage B1, B2, or C-D. Materials and Methods The echocardiographs and radiographs of all the dogs were retrospectively evaluated to obtain left atrial-to-aortic ratio, normalized left ventricular internal diameter in diastole, and VLAS values. The data were analyzed to assess the correlation between these measurements and VLAS, and the optimal cutoff value of VLAS was determined. Results A VLAS cutoff value of 2.6 provided the greatest diagnostic accuracy for identification of dogs with ACVIM stage B2 MMVD (area under the curve, 0.96; sensitivity, 95%; specificity, 84%). A VLAS ≥2.5 exhibited the highest sensitivity (sensitivity, 100%; specificity, 78%), and a VLAS ≥ 3.1 exhibited the highest specificity (sensitivity, 47%; specificity, 100%). Conclusions VLAS is a helpful index for monitoring MMVD using radiography. A VLAS cutoff value of 2.5 could be used to identify dogs that may benefit from echocardiography to determine if they have reached ACVIM stage B2. |
| Databáze: | OpenAIRE |
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