Comparison of different radiographic scores with associated echocardiographic measurements and prediction of heart enlargement in dogs with and without myxomatous mitral valve disease

C Levicar; J L Granados-Soler; F Freise; J F Raue; I Nolte; J-P Bach

doi:10.1016/j.jvc.2022.08.004

Comparison of different radiographic scores with associated echocardiographic measurements and prediction of heart enlargement in dogs with and without myxomatous mitral valve disease

J Vet Cardiol. 2022 Dec:44:1-12. doi: 10.1016/j.jvc.2022.08.004. Epub 2022 Sep 6.

Authors

C Levicar¹, J L Granados-Soler¹, F Freise², J F Raue¹, I Nolte³, J-P Bach¹

Affiliations

¹ Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559 Hannover, Germany.
² Institute for Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health at the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Bünteweg 2, 30559 Hannover, Germany.
³ Clinic for Small Animals, University of Veterinary Medicine Hannover, Bünteweg 9, 30559 Hannover, Germany. Electronic address: ingo.nolte.ir@tiho-hannover.de.

PMID: 36174296
DOI: 10.1016/j.jvc.2022.08.004

Abstract

Introduction: Staging of myxomatous mitral valve disease (MMVD) requires an echocardiographic examination along with thoracic radiographs. The aims of this study were to calculate mean values for radiographic scores vertebral heart size (VHS), left atrial width (LA_Width), radiographic left atrial dimension (RLAD), and vertebral left atrial size (VLAS) in conventional and grayscale inverted images in healthy dogs and dogs with different stages of MMVD, and to find cutoff values for a stage assignment.

Animals: One hundred fifty dogs in different stages of MMVD and 50 unaffected dogs were evaluated.

Methods: Radiographic scores, echocardiographic left atrium-to-aorta ratio and normalized left ventricular internal dimension at end-diastole, and results of a clinical examination were obtained. Analyses were performed to evaluate the correlation between radiographic scores and echocardiographic values, to determine cutoff values for a radiographic stage assignment, and to compare measurements in conventional and inverted radiographs.

Results: After excluding breed-specific higher VHS, the means of VHS, LA_Width, RLAD, and VLAS were similar in the control group and stage B1. All radiographic scores increased in stages B2 and C. The cutoff values identifying heart enlargement, and therefore differentiating stages B1 and B2, were 11.0 for VHS, 1.8 for LA_Width, 2.0 for RLAD, and 2.3 for VLAS. Besides RLAD, scores were similar in conventional and inverted radiographs.

Conclusion: Cutoff values for the different radiographic scores for stage assignment were calculated. Radiographic cardiac scores using either conventional or inverted grayscale could be a tool to differentiate between different stages of MMVD when echocardiography is unavailable.

Keywords: Cardiology; Left atrial width; Radiographic left atrial dimension; Vertebral heart size; Vertebral left atrial size.

MeSH terms

Animals
Atrial Fibrillation* / veterinary
Cardiomegaly / veterinary
Dog Diseases* / diagnostic imaging
Dogs
Echocardiography / veterinary
Heart Valve Diseases* / veterinary
Mitral Valve / diagnostic imaging