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Huguet EE, Vilaplana Grosso F, Lamb WR, Sleeper MM, Mattoon J, Nelson N, Brown J, Deddens B, Heng HG, Knapp S, Levesque M, Rivas R, Colee JC, Berry CR. Interpretation of cardiac chamber size on canine thoracic radiographs is limited and may result in the false identification of right-sided cardiomegaly in the presence of severe left-sided cardiomegaly. Vet Radiol Ultrasound 2021; 62:637-646. [PMID: 34296488 DOI: 10.1111/vru.13006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Qualitative assessment of individual cardiac chamber enlargement on thoracic radiographs was assessed using echocardiography as the gold standard in dogs. Using this method, the presence of severe left-sided cardiomegaly was hypothesized to contribute to the false identification of right-sided cardiomegaly on radiographs. 175 dogs with three-view thoracic radiographs were retrospectively included in this diagnostic accuracy study if echocardiography was done within 24 h, and no rescue therapy was provided in the interim. All radiographic studies were reviewed by two groups of five board-certified veterinary radiologists with greater and less than 10 years of experience for grading of cardiac chamber enlargement as normal or mildly, moderately, or severely enlarged. The agreement, sensitivity, and specificity of the radiologists' interpretation of cardiac chamber size on thoracic radiographs to measured echocardiographic grades were evaluated. A total of 147 cases had complete echocardiographic data available for analysis. Intragroup agreement was moderate for the evaluation of left atrial enlargement and slight to fair for all other cardiac chambers. Between the mode of the radiologists' responses in the two groups and the echocardiographic grades, there was slight agreement for all cardiac chambers with higher severity grades reported using echocardiography. When moderate to severe left-sided cardiomegaly was identified on echocardiography, the sensitivity, specificity, and accuracy of radiographs were low, identifying dogs with radiographic evidence of right-sided cardiomegaly in the absence of corresponding right-sided cardiomegaly on echocardiography. Therefore, thoracic radiographs should be used with caution for the evaluation of cardiac chamber enlargement, particularly in the presence of severe left-sided cardiomegaly.
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Affiliation(s)
- Elodie E Huguet
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA
| | | | - Whitney R Lamb
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Margaret M Sleeper
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA
| | - John Mattoon
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Nathan Nelson
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - James Brown
- IDEXX Laboratories, Inc., Clackamas, Oregon, USA
| | - Bennett Deddens
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Hock Gan Heng
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, Indiana, USA
| | - Stephanie Knapp
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Maureen Levesque
- Veterinary Specialty Hospital of the Carolinas, Cary, North Carolina, USA
| | - Rudy Rivas
- Columbia Veterinary Emergency Trauma and Specialty, Columbia, South Carolina, USA
| | - James C Colee
- Institute of Farm and Agricultural Sciences, Statistics Consulting Unit, University of Florida, Gainesville, Florida, USA
| | - Clifford R Berry
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Sánchez Salguero X, Prandi D, Llabrés-Díaz F, Manzanilla EG, Bussadori C. A radiographic measurement of left atrial size in dogs. Ir Vet J 2018; 71:25. [PMID: 30568788 PMCID: PMC6297992 DOI: 10.1186/s13620-018-0137-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background The dimensions of the left atrium in cases with mitral regurgitation are an indirect measurement of its severity. The objective of this study was to evaluate the value of a new radiographic measurement, the radiographic left atrial dimension (RLAD), for detecting left atrial enlargement (LAE) in dogs. Thirty one dogs without LAE and 46 dogs with LAE were recruited in a prospective fashion. Reference left atrium dimension was measured by standard left atrium to aorta ratio (LA/Ao) by 2D echocardiography. LAE was considered if LA/Ao > 1.6. Left atrium dimension was then quantified on lateral radiographs by measuring RLAD. Vertebral heart size (VHS) was measured and RLAD was obtained by drawing a line bisecting the 90 degrees angle defined by the long and short cardiac axes lines of the VHS, up to the dorsal edge of the left atrium and comparing its length to T4’s vertebral body length. The correlation of VHS and RLAD methods with LA/Ao was estimated, as well as their sensitivity and specificity for detecting LAE. Receiver Operating Characteristic (ROC) curves were used to estimate the optimal decision criteria for each method. Results A positive correlation was observed between RLAD and LA/Ao (r = 0.82). RLAD’s sensitivity and specificity for detecting LAE when evaluated at the optimal cut-off value, 1.8 vertebrae, were 93.5 and 96.8% respectively. RLAD showed high reproducibility and repeatability. Conclusion RLAD appears to be a clinically useful radiographic measurement for evaluating left atrial dimensions. RLAD would provide clinicians with a simple and cost-effective tool for evaluating and monitoring LAE.
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Affiliation(s)
- Xavier Sánchez Salguero
- 1Animal Science Department, Escola Tècnica Superior d'Enginyeria Agrària, Universitat de Lleida, Lleida, Spain
| | - David Prandi
- Betulia Veterinary Clinic, Barcelona, Spain.,3Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | - Edgar Garcia Manzanilla
- 5Animal and Grassland Research Centre, Teagasc, Moorepark, Fermoy Republic of Ireland.,6School of Veterinary Medicine, University College Dublin, Belfield, Republic of Ireland
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Baron Toaldo M, Poser H, Menciotti G, Battaia S, Contiero B, Cipone M, Diana A, Mazzotta E, Guglielmini C. Utility of Tissue Doppler Imaging in the Echocardiographic Evaluation of Left and Right Ventricular Function in Dogs with Myxomatous Mitral Valve Disease with or without Pulmonary Hypertension. J Vet Intern Med 2018; 30:697-705. [PMID: 27177623 PMCID: PMC4913565 DOI: 10.1111/jvim.13940] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 02/02/2016] [Accepted: 03/07/2016] [Indexed: 11/29/2022] Open
Abstract
Background In human medicine, right ventricular (RV) functional parameters represent a tool for risk stratification in patients with congestive heart failure caused by left heart disease. Little is known about RV alterations in dogs with left‐sided cardiac disorders. Objectives To assess RV and left ventricular (LV) function in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH). Animals One‐hundred and fourteen dogs: 28 healthy controls and 86 dogs with MMVD at different stages. Methods Prospective observational study. Animals were classified as healthy or having MMVD at different stages of severity and according to presence or absence of PH. Twenty‐eight morphological, echo‐Doppler, and tissue Doppler imaging (TDI) variables were measured and comparison among groups and correlations between LV and RV parameters were studied. Results No differences were found among groups regarding RV echo‐Doppler and TDI variables. Sixteen significant correlations were found between RV TDI and left heart echocardiographic variables. Dogs with PH had significantly higher transmitral E wave peak velocity and higher E/eʹ ratio of septal (sMV) and lateral (pMV) mitral annulus. These 2 variables were found to predict presence of PH with a sensitivity of 84 and 72%, and a specificity of 71 and 80% at cut‐off values of 10 and 9.33 for sMV E/eʹ and pMV E/eʹ, respectively. Conclusions and clinical importance No association between variables of RV function and different MMVD stage and severity of PH could be detected. Some relationships were found between echocardiographic variables of right and left ventricular function.
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Affiliation(s)
- M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - H Poser
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - G Menciotti
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - S Battaia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - M Cipone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - A Diana
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Ozzano Emilia, Italy
| | - E Mazzotta
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - C Guglielmini
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
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Chapel EH, Scansen BA, Schober KE, Bonagura JD. Echocardiographic Estimates of Right Ventricular Systolic Function in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med 2017; 32:64-71. [PMID: 29224256 PMCID: PMC5787149 DOI: 10.1111/jvim.14884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/01/2017] [Accepted: 10/19/2017] [Indexed: 01/01/2023] Open
Abstract
Background Right ventricular (RV) dysfunction independently predicts outcomes in human myxomatous mitral valve disease (MMVD). There is limited information regarding RV systolic function in dogs with MMVD. Hypothesis Right ventricular systolic function differs among stages of disease, decreasing in decompensated MMVD. Animals Thirty‐sixclient‐owned dogs with MMVD not receiving oral cardiovascular medications. Methods Prospective clinical study. Dogs were categorized according to disease severity as ACVIM Stage B1, B2, or C. Seven echocardiographic indices of RV systolic function were measured. Groups were compared by 1‐way ANOVA and Tukey's HSD test. Frequencies of cases with cardiac remodeling falling outside previously established reference intervals were compared using Fisher's exact test. Intra‐ and interobserver measurement variability was calculated for each RV function index. Results The indices TAPSE (P = 0.029), RV StL (P = 0.012), and RV StRL (P = 0.041) were significantly different between groups. A greater proportion of B2 dogs (7 of 12) had TAPSE values above reference intervals compared with B1 (2 of 12) or C (2 of 12) dogs (P = 0.027). Measurement variability of TAPSE, RV S', and RV StG was clinically acceptable. Conclusions and Clinical Importance Right ventricular systolic function differs between stages of MMVD, increasing in stage B2, and declining in stage C. The prognostic importance of RV function indices, particularly TAPSE, might be worth evaluating in dogs with MMVD.
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Affiliation(s)
- E H Chapel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - B A Scansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - K E Schober
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - J D Bonagura
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
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Poser H, Berlanda M, Monacolli M, Contiero B, Coltro A, Guglielmini C. Tricuspid annular plane systolic excursion in dogs with myxomatous mitral valve disease with and without pulmonary hypertension. J Vet Cardiol 2017; 19:228-239. [PMID: 28579307 DOI: 10.1016/j.jvc.2017.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 03/02/2017] [Accepted: 03/07/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate tricuspid annular plane systolic excursion (TAPSE) in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH) and to study the correlations with clinical and echocardiographic parameters. ANIMALS The study population included 99 dogs with MMVD and tricuspid regurgitation. METHODS This is a prospective clinical study. All dogs received a transthoracic echocardiographic evaluation, including 2D, M-mode, echo-Doppler, and tissue Doppler measurements. The TAPSE was measured from the left apical four-chamber view and normalized for the effect of body weight (nTAPSE). The dogs were grouped according to the severity of MMVD (American College of Veterinary Internal Medicine guidelines) and presence/absence and severity of PH. Significant differences between TAPSE or nTAPSE and echocardiographic parameters were analyzed among the MMVD and PH severity groups. Correlations between TAPSE or nTAPSE and echocardiographic parameters were calculated. RESULTS Tricuspid annular plane systolic excursion or nTAPSE were not significantly different among dogs of the MMVD or PH severity groups. Significant correlations were obtained between TAPSE and body weight, left ventricular and atrial dimensions, early diastolic septal and early diastolic and systolic tricuspid annulus velocity (p<0.001); nTAPSE was significantly correlated with normalized end-diastolic left ventricular dimension and fractional shortening (p<0.001). CONCLUSIONS The results show that neither TAPSE nor nTAPSE are reduced in dogs with MMVD with or without PH. It remains unclear if the right ventricle function is not reduced or if a reduced right ventricle function is masked by the contraction of the left ventricle through ventricular interdependence.
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Affiliation(s)
- H Poser
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy.
| | - M Berlanda
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - M Monacolli
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - B Contiero
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - A Coltro
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
| | - C Guglielmini
- University of Padua, Department of Animal Medicine, Production and Health, Viale dell'Università, 16, 35020, Legnaro PD, Italy
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Nakamura K, Morita T, Osuga T, Morishita K, Sasaki N, Ohta H, Takiguchi M. Prognostic Value of Right Ventricular Tei Index in Dogs with Myxomatous Mitral Valvular Heart Disease. J Vet Intern Med 2016; 30:69-75. [PMID: 26789419 PMCID: PMC4913668 DOI: 10.1111/jvim.13820] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 10/29/2015] [Accepted: 11/24/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The right ventricular (RV) Tei index (TX) has a significant correlation with the severity of pulmonary hypertension. However, the role of RV dysfunction in dogs with myxomatous mitral valvular heart disease (MMVD) has not been addressed. OBJECTIVES To investigate the correlation between right ventricular Tei-index (RVTX) and the prognosis for dogs with MMVD. ANIMALS Thirty client-owned dogs with MMVD. METHODS Clinical cohort study. Dogs were divided into two groups on the basis of the onset of cardiac-related death within 1 year of the first echocardiographic examination. Physical examination and echocardiographic variables were compared between the groups. Receiver operating characteristic (ROC) curves and multivariate logistic analysis were used to assess the comparative accuracy when identifying dogs with cardiac-related death. RESULTS The highest accuracy was obtained for RVTX with an area under the ROC curve (AUC) of 0.95 (95% confidence interval [CI] 0.81-0.99) followed by the left atrial to aortic root ratio with an AUC of 0.91 (95% CI 0.74-0.98), peak early diastolic mitral inflow velocity with an AUC of 0.84 (95% CI 0.64-0.94), and Doppler estimates of systolic pulmonary artery pressure with an AUC of 0.84 (95% CI 0.61-0.95). According to the multivariate logistic regression analysis, RVTX was the only independent correlate of cardiac-related death within 1 year. CONCLUSIONS AND CLINICAL IMPORTANCE Right ventricular Tei-index has a strong correlation with the prognosis for dogs with MMVD. The most significant independent predictor of death was RVTX in this study.
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Affiliation(s)
- K Nakamura
- Veterinary Teaching Hospital, Hokkaido University, Sapporo, Hokkaido, Japan
| | - T Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - T Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - K Morishita
- Veterinary Teaching Hospital, Hokkaido University, Sapporo, Hokkaido, Japan
| | - N Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - H Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - M Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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Zha W, Schiros CG, Reddy G, Feng W, Denney TS, Lloyd SG, Dell'Italia LJ, Gupta H. Improved Right Ventricular Performance with Increased Tricuspid Annular Excursion in Athlete's Heart. Front Cardiovasc Med 2015; 2:8. [PMID: 26664880 PMCID: PMC4671336 DOI: 10.3389/fcvm.2015.00008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 02/13/2015] [Indexed: 11/19/2022] Open
Abstract
Background Marathon runners (MTH) and patients with mitral regurgitation (MR) exhibit left ventricular (LV) overload, and LV geometric changes in these groups have been reported. In this study, right ventricular (RV) adaptation to chronic volume overload was evaluated in MTH and MR and normal controls together with interventricular septal remodeling and tricuspid annulus (TA) motion. Methods A total of 60 age-matched subjects (including 19 MTH, 17 isolated chronic compensated MR patients, and 24 normal subjects) underwent conventional cine and tagged cardiac magnetic resonance imaging. Myocardial strain and curvature were computed on the interventricular septum and RV free wall. A dual-propagation technique was applied to construct RV volume-time curves for a single cardiac cycle. Similarly, the TA was tracked throughout the cardiac cycle to create displacement over time curve. Results Septal curvature was significantly lower in MTH and MR compared to controls. No significant differences in RV free-wall strain or RV ejection fraction were noted among the three groups. However, longitudinal TA excursion was significantly higher in MTH compared to controls (p = 0.0061). The peak late diastolic TA velocity in MR was significantly faster than MTH (p = 0.0031) and controls (p = 0.020). Conclusion Increased TA kinetics allows for improved RV performance in MTH. Septal remodeling was observed in both MR and MTH, therefore a direct relationship of septal remodeling to TA kinetics in athlete’s heart could not be elucidated in this study.
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Affiliation(s)
- Wei Zha
- Department of Medical Physics, University of Wisconsin-Madison , Madison, WI , USA
| | - Chun G Schiros
- Department of Medicine, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Gautam Reddy
- Department of Medicine, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Wei Feng
- Department of Biomedical Engineering, Wayne State University , Detroit, MI , USA
| | - Thomas S Denney
- Department of Electrical and Computer Engineering, Auburn University , Auburn, AL , USA
| | - Steven G Lloyd
- Department of Medicine, University of Alabama at Birmingham , Birmingham, AL , USA ; Birmingham Veteran Affairs Medical Center , Birmingham, AL , USA
| | - Louis J Dell'Italia
- Department of Medicine, University of Alabama at Birmingham , Birmingham, AL , USA ; Birmingham Veteran Affairs Medical Center , Birmingham, AL , USA
| | - Himanshu Gupta
- Department of Medicine, University of Alabama at Birmingham , Birmingham, AL , USA ; Birmingham Veteran Affairs Medical Center , Birmingham, AL , USA
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Silva A, Muzzi R, Muzzi L, Ferreira D, Oberlender G, Oliveira M, Nogueira R, Ticle L. Use of discriminant analysis based on echocardiography for classification of congestive heart failure in dogs with myxomatous mitral valve disease. ARQ BRAS MED VET ZOO 2014. [DOI: 10.1590/1678-6800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mixomatous mitral valve disease (MMVD) is one of the most common cardiac abnormalities in dogs and humans that can lead to cardiac heart failure (CHF). Its diagnosis remains based on echocardiography and clinical signs. However, the early diagnose of MMVD can contribute to a better prognosis and avoid CHF. The aim of this study was to evaluate the clinical, radiographic and echocardiographic presence of CHF in dogs with MMVD in combination with a statistical model as a mathematical tool. For this purpose, dogs were divided into three groups (healthy; MMVD without CHF; and MMVD with CHF), according the clinical, radiographic and echocardiographic evaluation findings. Thus, linear discriminant functions were obtained by analyzing the variables weight, body surface area, aortic diameter, the ratio of the left atrium/aortic diameter, the ratio between the mitral regurgitation jet area and the left atrial area, vena contracta diameter and mitral valve proximal isovelocity surface area. Then, mathematical equations were established for each group of dogs. Statistical functions obtained in this study enabled to classify the dogs, regarding the presence of CHF with a probability of correct classification of 90.4%. Thus the statistical model demonstrated that it could be used as an auxiliary method for identifying CHF in dogs with MMVD.
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Mikawa S, Miyagawa Y, Toda N, Tominaga Y, Takemura N. Predictive model for the detection of pulmonary hypertension in dogs with myxomatous mitral valve disease. J Vet Med Sci 2014; 77:7-13. [PMID: 25319513 PMCID: PMC4349532 DOI: 10.1292/jvms.14-0050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Pulmonary hypertension (PH) often occurs due to a left heart disease, such as
myxomatous mitral valve disease (MMVD), in dogs and is diagnosed using Doppler
echocardiography and estimated pulmonary arterial pressure. Diagnosis of PH in dogs
requires expertise in echocardiography: however, the examination for PH is difficult to
perform in a clinical setting. Thus, simple and reliable methods are required for the
diagnosis of PH in dogs. The purpose of this study was to develop models using multiple
logistic regression analysis to detect PH due to left heart disease in dogs with MMVD
without echocardiography. The medical records of dogs with MMVD were retrospectively
reviewed, and 81 dogs were included in this study and classified into PH and non-PH
groups. Bivariate analysis was performed to compare all parameters between the groups, and
variables with P values of <0.25 in bivariate analysis were included
in multiple logistic regression analysis to develop models for the detection of PH. In
multiple logistic regression analysis, the model included a vertebral heart scale short
axis of >5.2 v, and a length of sternal contact of >3.3 v was considered suitable
for the detection of PH. The predictive accuracy of this model (85.9%) was judged
statistically adequate, and therefore, this model may be useful to screen for PH due to
left heart disease in dogs with MMVD without echocardiography.
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Affiliation(s)
- Shoma Mikawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, Tokyo 180-8602, Japan
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Streitberger A, Hocke V, Modler P. Measurement of pulmonary transit time in healthy cats by use of ultrasound contrast media "Sonovue®": feasibility, reproducibility, and values in 42 cats. J Vet Cardiol 2013; 15:181-7. [PMID: 23933477 DOI: 10.1016/j.jvc.2013.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 05/01/2013] [Accepted: 05/06/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the feasibility of measuring pulmonary transit time (PTT) in healthy cats by transthoracic echocardiography using the ultrasound contrast agent Sonovue(®). To determine normalized PTT (nPTT) values in 42 healthy cats and to estimate the interobserver variability and the within-day repeatability of nPTT measurements. ANIMALS Forty-two privately owned healthy cats of different breeds, gender and age presented for cardiac examination. METHODS A bolus injection of contrast agent (Sonovue(®)) was administered intravenously. The right parasternal short axis echocardiographic view was used to record the contrast agent's transit time from the pulmonary artery to the left atrium. Pulmonary transit time and nPTT were determined independently by three examiners with different levels of experience. RESULTS Normalized PTT was 4.12 ± 1.0 (mean ± SD) in our population. The median interobserver variability across our population was 6.8%, the median within-day variability for the three observers were 13.1%, 12.7% and 13%. No effect of the observer's experience on nPTT measurement was identified. Age, sex and body weight did not significantly influence nPTT. CONCLUSIONS This study demonstrates that nPTT measurement is feasible in cats using ultrasound and the blood pool contrast media Sonovue(®). Measurements of nPTT can be performed in a clinical setting. Normalized PTT values in healthy cats are comparable with those reported in healthy dogs.
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le Tourneau T. Right ventricle impairment: are we changing the paradigm in organic mitral regurgitation? Arch Cardiovasc Dis 2013; 106:419-22. [PMID: 23906678 DOI: 10.1016/j.acvd.2013.06.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Thierry le Tourneau
- Inserm, UMR 1087, Institut du Thorax, Nantes, France; Laboratoire d'explorations fonctionnelles, Hôtel Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex, France.
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Guglielmini C, Diana A, Santarelli G, Torbidone A, Di Tommaso M, Baron Toaldo M, Cipone M. Accuracy of radiographic vertebral heart score and sphericity index in the detection of pericardial effusion in dogs. J Am Vet Med Assoc 2013; 241:1048-55. [PMID: 23039979 DOI: 10.2460/javma.241.8.1048] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of radiographically derived measurements of vertebral heart score (VHS) and sphericity index (SI) in the detection of pericardial effusion (PE) in dogs. DESIGN Retrospective case-control study. Animals-51 dogs with PE associated with various cardiac disorders, 50 dogs with left- or right-sided cardiac disorders without PE, 50 dogs with bilateral cardiac disorders without PE, and 50 healthy dogs. PROCEDURES Measurements of VHS on lateral (lateral VHS) and ventrodorsal (ventrodorsal VHS) radiographs, SI on lateral (lateral SI) and ventrodorsal (ventrodorsal SI) radiographs, and global SI (mean of lateral SI and ventrodorsal SI) were obtained. Receiver operating characteristic curves were calculated to evaluate the diagnostic accuracy of the radiographic indexes at differentiating dogs with PE from those with other cardiac disorders without PE. RESULTS Measurements of lateral and ventrodorsal VHS were significantly higher in dogs with PE, compared with values for all dogs without PE. Measurements of lateral, ventrodorsal, and global SI were significantly lower in dogs with PE, compared with values for all dogs without PE. Cutoff values of > 11.9, > 12.3, and ≤ 1.17 for lateral VHS, ventrodorsal VHS, and global SI, respectively, were the most accurate radiographic indexes for identifying dogs with PE. CONCLUSIONS AND CLINICAL RELEVANCE Cardiac silhouettes of dogs with PE were larger and more rounded, compared with those of dogs with other cardiac disorders without PE. Objective radiographic indexes of cardiac size and roundness were only moderately accurate at distinguishing dogs with PE from dogs with other cardiac disorders without PE.
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Affiliation(s)
- Carlo Guglielmini
- Department of Veterinary Clinical Sciences, University of Teramo, 64100 Teramo, Italy.
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Chetboul V, Tissier R. Echocardiographic assessment of canine degenerative mitral valve disease. J Vet Cardiol 2012; 14:127-48. [PMID: 22366573 DOI: 10.1016/j.jvc.2011.11.005] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/30/2011] [Accepted: 11/01/2011] [Indexed: 10/28/2022]
Abstract
Degenerative mitral valve disease (MVD), the most common acquired heart disease in small-sized dogs, is characterized by valvular degeneration resulting in systolic mitral valve regurgitation (MR). Worsening of MR leads to several combined complications including cardiac remodeling, increased left ventricular filling pressure, pulmonary arterial hypertension, and myocardial dysfunction. Conventional two-dimensional, M-mode, and Doppler examination plays a critical role in the initial and longitudinal assessment of dogs affected by MVD, providing information on mitral valve anatomy, MR severity, left ventricular (LV) size and function, as well as cardiac and vascular pressures. Several standard echocardiographic variables have been shown to be related to clinical outcome. Some of these markers (e.g., left atrium to aorta ratio, regurgitation fraction, pulmonary arterial pressure) may also help in identifying asymptomatic MVD dogs at higher risk of early decompensation, which remains a major issue in practice. However, both afterload and preload are altered during the disease course. This represents a limitation of conventional techniques to accurately assess myocardial function, as most corresponding variables are load-dependent. Recent ultrasound techniques including tissue Doppler imaging, strain and strain rate imaging, and speckle tracking echocardiography, provide new parameters to assess regional and global myocardial performance (e.g., myocardial velocities and gradients, deformation and rate of deformation, and mechanical synchrony). As illustration, the authors present new data obtained from a population of 91 dogs (74 MVD dogs, 17 age-matched controls) using strain imaging, and showing a significant longitudinal systolic alteration at the latest MVD heart failure stage.
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Affiliation(s)
- Valérie Chetboul
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie d'Alfort (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), 7 avenue du général de Gaulle, 94704 Maisons-Alfort cedex, France.
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Eriksson A, Hansson K, Häggström J, Järvinen AK, Lord P. Pulmonary Blood Volume in Mitral Regurgitation in Cavalier King Charles Spaniels. J Vet Intern Med 2010; 24:1393-9. [DOI: 10.1111/j.1939-1676.2010.0619.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lord P, Hansson K, Kvart C, Häggström J. Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation. J Small Anim Pract 2010; 51:210-8. [DOI: 10.1111/j.1748-5827.2010.00910.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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