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Published on: May 19, 2020
Vertebral left atrial ventral: a new prognostic marker in dogs with mitral valve disease
Tamyris Beluque1, Mariangela Endrighi2, Stephany Buba Lucina2
1Department of Veterinary Clinic and Surgery, School of Agricultural and Veterinary Sciences, São Paulo State University, Jaboticabal, São Paulo, Brazil.
Objective:
To compare previously described radiographic measurements to identify dogs in stage B2, cutoff values, propose a new measurement and evaluate their ability to predict survival in dogs with mitral valve disease (MVD).
Methods:
This observational, retrospective, and prospective study included dogs without heart disease (control) or diagnosed with MVD by Doppler echocardiography. Radiographic measurements included left atrial width (LAwidth), radiographic left atrial dimension (RLAD), vertebral left atrial size (VLAS), modified VLAS (M-VLAS), vertebral left atrial ventral (VLAV), and vertebral heart score (VHS). All dogs underwent complete echocardiographic and radiographic examinations. Dogs with hemivertebrae, cardiac or pulmonary neoplasia, or poor-quality examinations were excluded. Examinations performed between November 2017 and April 2024 were evaluated.
Results:
Examinations were evaluated in 191 dogs. VLAS, M-VLAS, LAwidth, and RLAD differed between stages B1, B2, and C/D. VLAV differed between control and stage B1 from stages B2 and C/D. VLAV accurately identified dogs with stage B2 MVD, showing good diagnostic performance (AUC, 0.82; 95% CI, 0.76-0.88), and was similar to the other measurements. Cutoff values for identifying left cardiomegaly were defined for all measures (VLAS > 2.48; M-VLAS > 3.4; LAwidth > 2.11; RLAD > 2.7; VLAV > 2.99). Repeatability and reproducibility were good to excellent.
Conclusions:
VLAS and M-VLAS reliably identified increased LA/Ao ratio and suspected stage B2 MVD. Higher values of VLAS, M-VLAS, LAwidth, and VLAV were associated with shorter survival, with VLAV ≥ 3.0 indicating an unfavorable outcome.
Clinical Relevance:
These measures may be considered to screen which patients will undergo echocardiography and to assist in predicting survival time.
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