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Baisan RA, Vulpe V. Determination of radiographic vertebral heart score and vertebral left atrial size cutoffs based on echocardiographic left atrial size in dogs with myxomatous mitral valve disease. Vet Radiol Ultrasound 2024; 65:54-61. [PMID: 38148480 DOI: 10.1111/vru.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 11/04/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Progression of myxomatous mitral valve disease (MMVD) in dogs is a common cause of left atrial enlargement. Recently, a classification of left atrial (LA) size based on echocardiographic measurement has been proposed. This study aims to determine the radiographic LA size by reporting the cutoff values of VHS and VLAS for different groups of echocardiographic-measured LA size in dogs with MMVD. This retrospective analytical cross-sectional study included dogs diagnosed with MMVD grouped based on the echocardiographic LA size into normal (LA/Ao < 1.6), mild (1.6-1.89), moderate (1.9-2.2), and severe enlargement (>2.2) and were compared with ACVIM classification. VHS and VLAS were measured on the right lateral radiograph for each dog and cutoff values were calculated. One hundred and three dogs with MMVD were included in the study. A very strong positive correlation was observed between LA/Ao ratio and VHS (rs , 0.823, P < .01) or VLAS (rs , 0.834, P < .01). For VHS, a cutoff of 10.7 v, 11 v, and 11.5 v were established for echocardiographic LA thresholds of 1.6, 1.9, and 2.2 with a sensitivity of 79%, 92%, and 90% and a specificity of 97%, 90.7%, and 78.1%, respectively. For VLAS, a cutoff of 2.5 v, 2.7 v, and 2.9 v were established for echocardiographic LA cutoffs of 1.6, 1.9, and 2.2 with a sensitivity of 73%, 80%, and 83.3% and a specificity of 94%, 92%, and 86.3%, respectively. The results of this study may facilitate clinical decisions based on radiographic examination in dogs with myxomatous mitral valve disease.
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Affiliation(s)
- Radu Andrei Baisan
- Clinic Department, Faculty of Veterinary Medicine, Iași University of Life Sciences "Ion Ionescu de la Brad", Iași, Romania
| | - Vasile Vulpe
- Clinic Department, Faculty of Veterinary Medicine, Iași University of Life Sciences "Ion Ionescu de la Brad", Iași, Romania
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Vereb M, Atkins CE, Adin D, Blondel T, Coffman M, Lee S, Guillot E, Ward JL. Efficacy of a mitral regurgitation severity index to predict long-term outcome in dogs with myxomatous mitral valve disease. J Vet Intern Med 2024; 38:51-60. [PMID: 37909399 PMCID: PMC10800232 DOI: 10.1111/jvim.16923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Predicting progression of myxomatous mitral valve disease (MMVD) in dogs can be challenging. HYPOTHESIS/OBJECTIVES The mitral regurgitation severity index (MRSI) will predict time to congestive heart failure (CHF) and all-cause death in dogs with MMVD. ANIMALS Eight hundred sixty-nine client-owned dogs. METHODS Retrospective study pooling data from 4 previous samples including dogs with MMVD stage B2 or C. MRSI was calculated as: (heart rate [HR]/120) × left atrium-to-aorta ratio (LA:Ao) × (age in years/10) × 100. Alternative MRSI formulas substituting radiographic measures of left atrial size were also calculated. Cox proportional hazard modeling and time-dependent receiver-operator characteristic curves quantified prognostic performance. RESULTS For Stage B2 pooled samples, MRSI > 156 was predictive of time to CHF (median 407 vs 1404 days; area under the curve [AUC] 0.68; hazard ratio 3.02 [95% CI 1.9-4.9]; P < .001). MRSI > 173 was predictive of all-cause death (median survival 868 vs 1843 days; AUC 0.64; hazard ratio 4.26 [95% CI 2.4-7.5]; P < .001). MRSI showed superior predictive value compared to the individual variables of HR, LA:Ao, and age. Variations of the MRSI equation substituting radiographic vertebral left atrial size for LA:Ao were also significantly predictive of outcome in stage B2. MRSI was not consistently predictive of outcome in Stage C. CONCLUSIONS AND CLINICAL IMPORTANCE MRSI was predictive of outcome (onset of CHF and all-cause death) in MMVD Stage B2, demonstrating utility as a useful prognostic tool. Echocardiographic LA:Ao can be effectively replaced by radiographically determined LA size in the MRSI formula.
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Affiliation(s)
- Michelle Vereb
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineIowa State UniversityAmesIowaUSA
| | - Clarke E. Atkins
- Department of Clinical Sciences, College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Darcy Adin
- Department of Large Animal Clinical Sciences, College of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
| | | | | | | | | | - Jessica L. Ward
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineIowa State UniversityAmesIowaUSA
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Marbella Fernández D, Montoya-Alonso JA. Radiographic Left Atrial Size Measurement of Dogs in Different Mitral Valve Disease Stages with Four Different Methods. Animals (Basel) 2023; 13:3835. [PMID: 38136872 PMCID: PMC10741156 DOI: 10.3390/ani13243835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
The left atrial size increases (LAS) in patients with mitral valve disease (MVD) as the disease progresses. The vertebral left atrial size (VLAS), the modified-vertebral left atrial size (M-VLAS), and the radiographic left atrial dimension (RLAD) are methods reported to assess LAS on dogs' radiographs. All these methods transform the LAS into vertebral units. The thoracic inlet (TI) has been used as a reliable reference point to measure the cardiac silhouette of dogs with MVD in different stages. The objective of this study was to assess the clinical utility of measuring a dog LAS on right thoracic X-rays using the TI as a reference and determine whether it could differentiate dogs in different MVD stages. LAS was divided by the TI to obtain the thoracic inlet left atrial score (TILAS). This was a retrospective observational study including 135 apparently healthy dogs performed to assess their LAS with four different methods: VLAS, M-VLAS, RLAD, and TILAS. Thirty-six dogs from the general population were selected and compared to 100 dogs in different MVD stages. The TILAS was significantly different between the control dogs and MVD dogs, increasing with the disease stage: control dogs 0.51 ± 0.08, B1 0.57 ± 0.14, B2 0.75 ± 0.13, and C 0.84 ± 0.18. VLAS, M-VLAS, and RLAD also increased as the disease progressed, as shown in previous studies. The TILAS accuracy to distinguish MVD dogs with cardiac enlargement was comparable to VLAS, M-VLAS, and RLAD (AUC 0.91 vs. 0.93, 0.90, and 0.94 respectively). A TILAS > 0.8 can identify dogs with cardiac enlargement secondary to MVD.
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Affiliation(s)
- David Marbella Fernández
- Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, 35413 Las Palmas de Gran Canaria, Spain
- CEU Small Animal Hospital, 46115 Valencia, Spain
| | - Jose Alberto Montoya-Alonso
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35413 Las Palmas de Gran Canaria, Spain;
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Ross ES, Visser LC, Sbardellati N, Potter BM, Ohlendorf A, Scansen BA. Utility of vertebral left atrial size and vertebral heart size to aid detection of congestive heart failure in dogs with respiratory signs. J Vet Intern Med 2023; 37:2021-2029. [PMID: 37882250 PMCID: PMC10658574 DOI: 10.1111/jvim.16918] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Differentiating cardiogenic vs noncardiogenic causes of respiratory signs can be challenging when echocardiography is unavailable. Radiographic vertebral left atrial size (VLAS) and vertebral heart size (VHS) have been shown to predict echocardiographic left heart size, with VLAS specifically estimating left atrial size. HYPOTHESIS/OBJECTIVES Compare the diagnostic accuracy of VLAS and VHS to predict left-sided congestive heart failure (CHF) in dogs presenting with respiratory signs. ANIMALS One-hundred fourteen dogs with respiratory signs and radiographic pulmonary abnormalities. METHODS Retrospective cross-sectional study. Dogs had to have an echocardiogram and thoracic radiographs obtained within 24 hours. Diagnosis of CHF was confirmed based on the presence of respiratory signs, cardiac disease, LA enlargement, and cardiogenic pulmonary edema. RESULTS Fifty-seven dogs had CHF and 57 did not have CHF. Compared to VHS (area under the curve [AUC] 0.85; 95% confidence interval [CI], 0.77-0.91), VLAS was a significantly (P = .03) more accurate predictor of CHF (AUC, 0.92; 95% CI, 0.85-0.96). Optimal cutoff for VLAS was >2.3 vertebrae (sensitivity, 93.0%; specificity, 82.5%). Murmur grade (P = .02) and VLAS (P < .0001) were independently associated with CHF and VHS was not. Increased VHS (54%) was significantly (P = .01) more common than increased VLAS (24%) in dogs without CHF. Results were similar in a subsample of older and smaller dogs. CONCLUSIONS AND CLINICAL IMPORTANCE When echocardiography is unavailable, VLAS and murmur grade have clinically utility to aid in differentiating cardiogenic from noncardiogenic respiratory signs. These findings might be especially useful to help rule out CHF in dogs with increased VHS that present with respiratory signs.
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Affiliation(s)
- Evan S. Ross
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
| | - Lance C. Visser
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
| | - Nicholas Sbardellati
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
| | - Brianna M. Potter
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
| | - Alex Ohlendorf
- Department of Environmental and Radiological Health SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
| | - Brian A. Scansen
- Department of Clinical SciencesCollege of Veterinary Medicine and Biomedical Sciences, Colorado State UniversityFort CollinsColoradoUSA
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Methods of Radiographic Measurements of Heart and Left Atrial Size in Dogs with and without Myxomatous Mitral Valve Disease: Intra- and Interobserver Agreement and Practicability of Different Methods. Animals (Basel) 2022; 12:ani12192531. [PMID: 36230272 PMCID: PMC9559670 DOI: 10.3390/ani12192531] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Dogs suffering from Myxomatous Mitral Valve Disease (MMVD) show a potential heart enlargement, especially in the left atrium, detectable by radiography. Due to digital radiography, different radiographic measurements estimate cardiac size quite uncomplicatedly. The Vertebral Heart Size (VHS), Radiographic Left Atrial Dimension (RLAD), Left Atrial Width (LAWidth), and the Vertebral Left Atrial Size (VLAS) used anatomical landmarks for measuring cardiac size in relation to the vertebral column. This study aimed to compare VHS, RLAD, LAWidth, and VLAS measured in conventional and inverted radiographs by veterinarians with different levels of experience in healthy dogs and dogs with MMVD. The reliability and user-friendliness of these measurements were evaluated, and the staging was compared to the echocardiography staging. A total of 50 unaffected dogs and 150 dogs with MMVD in stages B1, B2, and C were assessed. Three veterinarians with different levels of experience examined 200 conventional radiographs and their corresponding inverted radiographs blinded to the echocardiographic and clinical examination results. Analyses were performed to compare the measurements’ grading and determine anatomical landmarks with measurement difficulties. Additionally, inter- and intraobserver agreement was assessed using intraclass correlation coefficient, and the agreement between radiographic and echocardiographic staging was compared using the kappa coefficient. The VHS, LAWidth, and VLAS were easier to define than the RLAD. The interobserver agreement was almost perfect for VHS (0.962) and good for the other radiographic measurements (RLAD: 0.778, LAWidth: 0.772, VLAS: 0.858). The VHS assigned the most dogs to the correct stage. However, VHS, RLAD, LAWidth, and VLAS presented an almost perfect intraobserver agreement. The dorsal left atrial margin of the RLAD was the most difficult measurement point to identify. The VHS is the most reproducible radiographic method for measuring the canine heart size and shows the highest agreement with echocardiography. An observer-related influence could be detected for RLAD, LAWidth, and VLAS.
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Ogawa M, Ogi H, Miyakawa H, Hsu HH, Miyagawa Y, Takemura N. Evaluation of the association between electrocardiogram parameters and left cardiac remodeling in dogs with myxomatous mitral valve disease. Vet World 2022; 15:2072-2083. [PMID: 36313845 PMCID: PMC9615506 DOI: 10.14202/vetworld.2022.2072-2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Electrocardiography (ECG) is an adjunct for cardiac enlargement diagnosis. However, its efficacy in assessing left cardiac remodeling (left atrial and left ventricular enlargement) in dogs with myxomatous mitral valve disease (MMVD) remains unclear. This study aimed to evaluate the association between ECG parameters and left cardiac remodeling and to investigate whether the rate of change in ECG waveforms in the same individual reflected left cardiac remodeling in dogs with MMVD.
Materials and Methods: This retrospective study included 20 healthy dogs and 140 dogs with MMVD. Data on clinical variables were obtained through physical examination, thoracic radiography, and echocardiography. The ECG parameters were the P-wave duration, PR interval, QRS complex duration, P-wave amplitude, R-wave amplitude, and mean electrical axis. Dogs with examination data that could be obtained multiple times during the study period were classified into the non-progressive and progressive groups.
Results: Only the P-wave and QRS complex durations were selected as significant variables associated with imaging test parameters (p < 0.05); they had a relatively higher discriminatory ability for the left cardiac remodeling than other ECG parameters. The rates of change in the PR interval and R-wave amplitude were significantly higher in the progressive group than in the non-progressive group.
Conclusion: In dogs with MMVD, the P-wave and QRS complex durations were significantly correlated with the left cardiac remodeling indicators. Furthermore, an increased rate of change in the PR interval and R-wave amplitude in the same individual may indicate left cardiac remodeling.
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Affiliation(s)
- Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Haruka Ogi
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Huai-Hsun Hsu
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
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Mektrirat R, Rueangsri T, Keeratichandacha W, Soonsawat S, Boonyapakorn C, Pongkan W. Polyunsaturated Fatty Acid EAB-277 ® Supplementation Improved Heart Rate Variability and Clinical Signs in Tracheal Collapse Dogs. Front Vet Sci 2022; 9:880952. [PMID: 35909680 PMCID: PMC9330478 DOI: 10.3389/fvets.2022.880952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/15/2022] [Indexed: 11/20/2022] Open
Abstract
Canine tracheal collapse is a progressive disease in small breed dogs resulting from chronic inflammation of the tracheal mucosal lining. Polyunsaturated fatty acid EAB-277® is one of the nutraceuticals that can alleviate inflammation and oxidative stress. Heart rate variability (HRV) is a prognostic tool related to sympathovagal balance and oxidative stress level, which is widely used with cardiorespiratory diseases. However, the effect of EAB-277® on HRV in tracheal collapse dogs has rarely been investigated. In this study, 26 tracheal collapse dogs were divided into two groups. In the control group, the dogs received the standard treatment, whereas the dogs in the EAB-277® group received standard treatment combined with EAB-277®. After being treated for 5 weeks, changes in radiographic findings, blood profiles, serum malondialdehyde, inflammatory markers, and HRV were evaluated. This study found that clinical signs were improved in both groups (p < 0.05). However, serum malondialdehyde (MDA), Interleukin-6 (IL-6), and Tumor necrosis factor-alpha (TNF-α) were decreased only in the EAB-277® group after treatment for five weeks (p < 0.05) and the mean percent change of MDA, IL-6, and TNF-α at week five compared to baseline in the EAB-277® group was greater than in the control group (p < 0.05). Additionally, greater sympathovagal imbalance indicated by decreased standard deviation of all normal R-R intervals (SDNN) and standard deviation of the averaged R-R intervals for all 5-minutes segments (SDANN) was found in the control group at week five compared to baseline (P < 0.05), whereas EAB-277® improved SDNN and SDANN and decreased low frequency/high-frequency component (LF/HF ratio) after being treated for five weeks (P < 0.05). This study demonstrates that EAB-277® improves clinical signs and attenuates HRV impairment by reducing oxidative stress and inflammation in tracheal collapse dogs.
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Affiliation(s)
- Raktham Mektrirat
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Integrative Research Center for Veterinary Circulatory Sciences, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thareerat Rueangsri
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Waraporn Keeratichandacha
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sasiwimon Soonsawat
- Veterinary Diagnostic Laboratory, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chavalit Boonyapakorn
- Integrative Research Center for Veterinary Circulatory Sciences, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Companion Animal and Wildlife Clinic, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Veterinary Cardiopulmonary Clinic, Small Animal Hospital, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wanpitak Pongkan
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Integrative Research Center for Veterinary Circulatory Sciences, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Veterinary Cardiopulmonary Clinic, Small Animal Hospital, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Veterinary Biosciences, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
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Establishment of Multiple Parameter Reference Intervals for Different Age Groups in Qingdao, China. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1966798. [PMID: 35310179 PMCID: PMC8926536 DOI: 10.1155/2022/1966798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 11/17/2022]
Abstract
In this article, we have explored the establishment of multiple parameter reference intervals for different age groups in Qingdao, China. According to the age of subjects, the healthy adult population of different ages in Qingdao was randomly selected as the research object. According to the age of subjects, they were divided into 18–24-year-old, 25–39-year-old, 40–49-year-old, 50–64-year-old, and >65-year-old groups, respectively. The sample size of each age group was 120 male and female samples, and 60 male and female samples of >65-year-old subjects were selected. The data of subjects were collected, a questionnaire survey was completed, serum samples were collected, and the parameters of male and female groups of different ages in Qingdao were compared. The parameters of the male and female groups were compared in the same age group. The reference intervals of parameters of the male and female groups were compared in different ages. There were significant differences in the levels of FBG, AST, BUN, Cr, Hb, FT3, TT3, FT4, TT4, VB12, PROG, CYFRA 21-1, and SCC among men of different ages (P < 0.05). Among them, the levels of FBG, AST, BUN, VB12, CYFRA 21-1, and SCC in >65-year-old men were significantly higher than those in 18–24-years-old men, and the levels of Hb, FT3, TT3, FT4, TT4 in >65-year-old men were significantly lower than those in 18–24-year-old men (P < 0.05). There were significant differences in FBG, ALT, AST, BUN, Cr, Hb, TSH, FT3, TT3, FT4, TT4, VB12, CYFRA 21-1, anti-TPO, and ferritin levels among women of different ages (P < 0.05). Among them, the levels of FBG, ALT, AST, BUN, and ferritin in women aged >65 were significantly higher than those in women aged 18–24 (P < 0.05). The levels of FBG, ALT, AST, BUN, Cr, Hb, FT3, TT3, FT4, TT4, and VB12 in women aged 50–64 were significantly higher than those in women aged 25–39, and the levels of TSH were significantly lower than those in women aged 25–39 and significantly higher than those of the female population aged 40–49 (P < 0.05). The levels of ALT, AST, BUN, Cr, Hb, FT3, TT3, FT4 and ferritin in males aged 18–24 were significantly higher than those in females, while the levels of TSH, VB12 in males aged 18–24 were significantly lower than those in females (P < 0.05). The levels of FBG, ALT, AST, BUN, Cr, Hb, FT3, TT3, FT4 and ferritin in males aged 25–39 were significantly higher than those in females, while the levels of TSH, VB12, CYFRA 21-1 in males aged 25–39 were significantly lower than those in females (P < 0.05). The levels of FBG, ALT, AST, BUN, Cr, Hb, FT3, TT3, FT4, CYFRA 21-1 and ferritin in males aged 40-49 were significantly higher than those in females, and the levels of VB12, anti-TG, anti-TPO in males aged 40-49 were significantly lower than those in females (P < 0.05). The levels of FBG, ALT, BUN, Cr, FT3, TT3 and ferritin in males aged 50-64 were significantly higher than those in females, while the levels of VB12, anti-TG in males aged 50-64 were significantly lower than those in females (P < 0.05). The levels of Cr, Hb and ferritin in males >65 years old were significantly higher than those in females (P < 0.05). The reference intervals of various parameters are different among different ages and genders. The establishment of multiparameter reference intervals for different age groups in Qingdao, China, is of great significance for the early diagnosis and evaluation of various diseases in Qingdao, China, so as to reduce the missed diagnosis rate of diseases and improve people's quality of life.
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Vertebral Heart Scale for the Brittany Spaniel: Breed-Specific Range and Its Correlation with Heart Disease Assessed by Clinical and Echocardiographic Findings. Vet Sci 2021; 8:vetsci8120300. [PMID: 34941827 PMCID: PMC8708192 DOI: 10.3390/vetsci8120300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/18/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022] Open
Abstract
The vertebral heart scale (VHS) was proposed by Buchanan and Bucheler as an objective method for estimating heart size in dogs. However, several studies have reported significant variation between breeds. The purpose of this retrospective study was to evaluate the VHS and to suggest a useful upper limit for normal heart size in Brittany Spaniels. The VHS was measured using a right lateral view in twenty-eight normal dogs and fifteen dogs with myxomatous mitral valve disease. The mean ± SD (standard deviation) VHS was 10.6 ± 0.2 vertebrae (v) in the normal dogs, which differs significantly from the mean VHS of 9.7 ± 0.5 v in Buchanan’s original study with dogs of various breeds. The VHS in the dogs with myxomatous mitral valve disease was 11.9 ± 1.1 v. With a threshold value of 11.1 vertebrae, the sensitivity, specificity, positive and negative predictive values for diagnosing a cardiomegaly are 90%, 72%, 53% and 96%, respectively.
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Bagardi M, Locatelli C, Manfredi M, Bassi J, Spediacci C, Ghilardi S, Zani DD, Brambilla PG. Breed-specific vertebral heart score, vertebral left atrial size, and radiographic left atrial dimension in Cavalier King Charles Spaniels: Reference interval study. Vet Radiol Ultrasound 2021; 63:156-163. [PMID: 34796576 PMCID: PMC9299495 DOI: 10.1111/vru.13036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022] Open
Abstract
Cavalier King Charles Spaniels (CKCS) are predisposed to developing myxomatous mitral valve disease (MMVD), with radiographs frequently used to screen for evidence of left-sided cardiomegaly secondary to MMVD. Vertebral heart size (VHS), vertebral left atrial size (VLAS), modified VLAS (M-VLAS), and radiographic left atrial dimension (RLAD) are reported as objective measurements of global heart size and left atrial size. Normal VHS in CKCS (10.6 ± 0.5) is reportedly higher than the non-breed-specific value (9.7±0.5). Breed-specific VLAS, M-VLAS, and RLAD cut-offs have not been reported in CKCS. The aim of this prospective reference interval study was to describe the VHS, VLAS, M-VLAS, and RLAD values for 30 clinically healthy adult CKCS. Inclusion criteria were unremarkable physical examination, normal echocardiography, and thoracic radiographs without malposition/abnormalities. There were 22 female and eight male dogs. Ages ranged from 1 to 6 years. The VHS mean value in our sample was 10.08 ± 0.56 (95% range, 9.87-10.29). This was significantly greater than a previously published general canine reference value of 9.7 ± 0.5 and significantly less than a previously published CKCS breed-specific value of 10.6 ± 0.5 (P < 0.01). Mean VLAS, M-VLAS, and the RLAD values in our study were 1.79 ± 0.3 (95% range, 1.68-1.9), 2.23 ± 0.44 (95% range, 2.06-2.39), and 1.2 ± 0.34 (95% range, 1.07-1.33), respectively. These were significantly less than previously published reference interval values (P < 0.001). The VHS, M-VLAS, and the RLAD were not affected by sex, body weight, or BCS; whereas the VLAS was moderately affected by body weight. Findings from this study can be used as background for future thoracic radiographic assessments in CKCS.
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Affiliation(s)
- Mara Bagardi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Chiara Locatelli
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Martina Manfredi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Jessica Bassi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Carlotta Spediacci
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Sara Ghilardi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Davide D Zani
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
| | - Paola G Brambilla
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Lodi, Italy
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Baisan RA, Vulpe V. Vertebral heart size and vertebral left atrial size reference ranges in healthy Maltese dogs. Vet Radiol Ultrasound 2021; 63:18-22. [PMID: 34585453 DOI: 10.1111/vru.13027] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022] Open
Abstract
The most common cardiac measurements on thoracic radiography in veterinary medicine are vertebral heart size (VHS) and vertebral left atrial size (VLAS). Previously published studies have demonstrated evidence that reference ranges for these measures vary among different dog breeds, however reference ranges for Maltese breed dogs are currently lacking. We hypothesized that VHS and VLAS in healthy Maltese dogs would not be influenced by sex, age, or bodyweight. This retrospective, reference interval study aimed to describe reference intervals for VHS and VLAS in a sample of clinically healthy Maltese dogs and assess the intra- and interobserver variabilities for VLAS and VHS measurements. A total of 81 clinically healthy Maltese dogs were included, with healthy status being based on a complete cardiologic examination. Thoracic radiography in right lateral recumbency was performed for all dogs. The intra- and interobserver variability assessments of VHS and VLAS were based on measurements independently performed by three observers. The mean VHS was 9.53 ± 0.46 vertebrae (v). The median and interquartile range (IQR) for VLAS was 2 v (IQR, 1.8-2.1v). A statistically significant moderate positive correlation was observed between VHS and VLAS (P < .01, r = 0.416). Both VHS and VLAS showed an almost perfect intraobserver agreement. Interobserver agreement was almost perfect for VHS and substantial for VLAS. Findings supported previous studies recommending the use of breed-specific reference values for VHS and VLAS, and provided background data for future radiographic evaluations of Maltese dogs with clinical signs of cardiac disease.
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Affiliation(s)
- Radu Andrei Baisan
- Department of Clinics, Faculty of Veterinary Medicine, University of Applied Life Sciences and Environment "Ion Ionescu de la Brad", Iași, Romania
| | - Vasile Vulpe
- Department of Clinics, Faculty of Veterinary Medicine, University of Applied Life Sciences and Environment "Ion Ionescu de la Brad", Iași, Romania
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Duler L, Visser LC, Jackson KN, Phillips KL, Pollard RE, Wanamaker MW. Evaluation of radiographic predictors of left heart enlargement in dogs with known or suspected cardiovascular disease. Vet Radiol Ultrasound 2021; 62:271-281. [PMID: 33439529 DOI: 10.1111/vru.12949] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022] Open
Abstract
Radiographic assessment of heart size is important for clinical management of dogs with cardiovascular disease (CVDz). We sought to compare the ability of vertebral heart size (VHS), vertebral left atrial size (VLAS), and radiologists' assessment of left atrial size (RadLAE) to predict echocardiographic left atrial size (EchoLAE), an important marker of left heart disease severity. We also compared the ability of VHS and VLAS to predict echocardiographic criteria for ACVIM stage B2 (EchoB2) in dogs with myxomatous mitral valve disease (MMVD). This prospective observational study enrolled 183 dogs with known or suspected CVDz that had an echocardiographic examination and thoracic radiographs obtained within 24 h. Compared to increased VHS, VLAS >2.3 was a more accurate predictor of EchoLAE (P = .002). VLAS >2.3 and RadLAE (both P <.0001) were independently associated with EchoLAE but VHS was not (P = .45). Optimal cutoffs for VLAS and VHS to predict EchoLAE were >2.3 vertebrae (sensitivity [Sn] = 90.3%, specificity [Sp] = 73.6%) and >11.1 vertebrae (Sn = 75.8%, Sp = 76.0%), respectively. Diagnostic accuracy of VLAS (AUC 0.84, 95% CI 0.73-0.92) and VHS (AUC 0.78, 95% CI 0.66-0.88) to predict EchoB2 in dogs with subclinical MMVD (n = 64) were not significantly different (P = .17). Results demonstrate that VLAS and RadLAE were superior indicators of EchoLAE compared to VHS in dogs with known or suspected CVDz. Both VLAS and VHS are useful predictors of EchoB2 in dogs with subclinical MMVD. When echocardiography is unavailable, VLAS represents a useful radiographic measurement to aid clinical management of dogs with known or suspected CVDz.
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Affiliation(s)
- Laetitia Duler
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Kristina N Jackson
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Kathryn L Phillips
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Rachel E Pollard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Mason W Wanamaker
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California, USA
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Puccinelli C, Citi S, Vezzosi T, Garibaldi S, Tognetti R. A radiographic study of breed-specific vertebral heart score and vertebral left atrial size in Chihuahuas. Vet Radiol Ultrasound 2020; 62:20-26. [PMID: 33111364 DOI: 10.1111/vru.12919] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/30/2022] Open
Abstract
Although echocardiography is the gold standard for the diagnosis of cardio-structural disease, thoracic radiography is a rapid, cost-effective, and widely accessible method for evaluating cardiac size in dogs. The vertebral heart score (VHS) and the vertebral left atrial size (VLAS) are established as objective measures of cardiomegaly on thoracic radiographs. However, several studies have shown significant variations in the VHS among different breeds. The Chihuahua is predisposed to both congenital and acquired cardiac diseases. The aim of this prospective, single-center, cross sectional study was thus to evaluate the VHS and the VLAS in healthy adult Chihuahua dogs. A total of 30 Chihuahuas were included. The VHS values in our sample population of Chihuahuas were 10.0 ± 0.6 (95% range, 8.9-11.0). This was significantly greater than the canine reference value of 9.7 ± 0.5 established by Buchanan and Bücheler (P = .002). The VLAS of Chihuahuas in our study was 1.8 ± 0.2 (95% range, 1.3-2.1). This was significantly lower than the values previously reported by Malcolm et al (2.07 ± 0.25; P = .0004). The VHS and the VLAS were not influenced by sex, body weight, short or long hair, and body condition score in normal Chihuahuas. Our results indicated that breed-specific reference values for radiographic VHS and VLAS are needed. In Chihuahuas, the values found in this study can be used as a normal reference in order to help avoid overinterpretation of cardiomegaly in these dogs.
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Affiliation(s)
| | - Simonetta Citi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Tommaso Vezzosi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Silvia Garibaldi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Rosalba Tognetti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
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