Macedonian Veterinary Review

Original Scientific Article

Radiographic evaluation of left atrial size in Cavalier King Charles spaniel dogs with mitral valve disease

Gonul Remzi *

Hande Sağoğlu

Murat Suzan

Mac Vet Rev 2023; 46 (2): 165 - 170

10.2478/macvetrev-2023-0023

Received: 31 March 2023

Received in revised form: 12 June 2023

Accepted: 12 June 2023

Available Online First: 19 July 2023

Published on: 15 October 2023

Correspondence: Gonul Remzi, gonul@iuc.edu.tr

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Abstract

Myxomatous mitral valve disease (MMVD) is one of the most common heart diseases in Cavalier King Charles spaniel (CKCS) dogs. The American College of Veterinary Internal Medicine (ACVIM) uses clinical, echocardiographic, and radiographic criteria to diagnose the disease, but measurement of vertebral left atrial size (VLAS) provides a simpler assessment. The aim of this study was to determine VLAS values in MMVD cases of CKCS and to investigate their clinical significance at different MMVD stages. Eighteen CKCS dogs of both sexes, different ages and weights, and different MMVD stages (6 at B1 stage, 6 at B2 stage, and 6 at C stage) were included in the study, as well as 6 healthy CKCS as control group A. We performed clinical, radiological, and echocardiographic examinations. VHS and VLAS values were significantly higher in the MMVD group than in the control group (p<0.001). VLAS showed high diagnostic accuracy in the detection of LA enlargement (area under the curve [AUC]: 0.98, cutoff ≥ 2.25, sensitivity: 88%, specificity: 100%, p<0.001). We also found high positive correlations between the VLAS and other values (LA /Ao, LVIDDn, and VHS) (r=0.88, r=0.88, and r=0.86, respectively) (p<0.001). It has been concluded that a VLAS value ≥2.25 can provide a meaningful diagnosis of left atrial enlargement in dogs with MMVD CKCS.

Keywords: left atrial size, cavalier, myxomatous mitral valve

References

1. Borgarelli, M., Haggström, J. (2010). Canine degenerative myxomatous mitral valve disase: natural history, clinical presentation and therapy. Vet Clin Small Anim Pract. 40(4): 651-663. https://doi.org/10.1016/j.cvsm.2010.03.008 PMid:20610017

2. Höllmer, M., Willesen, J.L., Tolver, A., Koch, J. (2017). Left atrial volume and function in dogs with naturally occurring myxomatous mitral valve disease. J Vet Cardiol. 19, 24-34. https://doi.org/10.1016/j.jvc.2016.08.006 PMid:27825670

3. Keene, B.W., Atkins, C.E., Bonagura, J.D., Fox, P.R., Haggstrom, J., Fuentes, V.L., Oyama, M.A., et al. (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 33:1127e40. https://doi.org/10.1111/jvim.15488 PMid:30974015 PMCid:PMC6524084

4. Parker, H.G., Kilroy-Glynn, P. (2012). Myxomatous mitral valve disease in dogs: Does size matter? J Vet Cardiol. 14(1): 19-29. https://doi.org/10.1016/j.jvc.2012.01.006 PMid:22356836 PMCid:PMC3307894

5. Gordon, S.G., Saunders, A.B., Wesselowski, S.R. (2017). Asymptomatic canine degenerative valve disease: current and future therapies. Vet Clin North Am Small Anim Pract. 47(5): 955-975. https://doi.org/10.1016/j.cvsm.2017.04.003 PMid:28669433

6. Häggström, J., Hansson, K., Kvart, C., Swenson, L. (1992). Chronic valvular disease in the Cavalier King Charles spaniel in Sweden. Vet Rec. 131(24): 549-553. PMid: 1481344
7. Haggstrom, J., Hamlin, R., Hansson, K., Kvart, C. (1996). Heart rate variability in relation to severity of mitral regurgitation in Cavalier King Charles spaniels. J Small Anim Pract. 37, 69-75. https://doi.org/10.1111/j.1748-5827.1996.tb01941.x PMid:8656596
8. Lewis, T., Swift, S., Woolliams, J.A., Blotta, S. (2011). Heritability of premature mitral valve disease in Cavalier King Charles spaniels. Vet J. 188(1): 73-76. https://doi.org/10.1016/j.tvjl.2010.02.016 PMid:20347358
9. Kim, S.H., Seo, K.W., Song, K.H. (2020). An assessment of vertebral left atrial size in relation to the progress of myxomatous mitral valve disease in dogs. J Vet Clin. 37(1): 9-14. https://doi.org/10.17555/jvc.2020.02.37.1.9
10. Malcolm, E.L., Visser, L.C., Phillips, K.L., Johnson, L.R. (2018). Diagnostic value of vertebral left atrial size as determined from thoracic radiographs for assessment of left atrial size in dogs with myxomatous mitral valve disease. J Am Vet Med Assoc. 253:1038e45. https://doi.org/10.2460/javma.253.8.1038 PMid:30272515
11. Mikawa, S., Nagakawa, M., Ogi, H., Akabane, R., Koyama, Y., Sakatani, A., Ogawa, M., et al. (2020). Use of vertebral left atrial size for staging of dogs with myxomatous valve disease. J Vet Cardiol. 30, 92e99. https://doi.org/10.1016/j.jvc.2020.06.001 PMid:32707334
12. Vezzosi, T., Puccinelli, C., Citi, S., Tognetti, R. (2021). Two radiographic methods for assessing left atrial enlargement and cardiac remodeling in dogs with myxomatous mitral valve disease. J Vet Cardiol. 34, 55e63. https://doi.org/10.1016/j.jvc.2021.01.002 PMid:33581663
13. Hansson, K., Haggstrom, J., Kvart, C., Lord, P. (2002). Left atrial to aortic root indices using twodimensional and M-mode echocardiography in Cavalier King Charles spaniels with and without left atrial enlargement. Vet Radiol Ultrasound. 43:568e75. https://doi.org/10.1111/j.1740-8261.2002.tb01051.x PMid:12502113
14. Thomas, W.P., Gaber, C.E., Jacobs, G.J., Kaplan, P.M., Lombard, C.W., Moise, N.S., Moses, B.L. (1993). Recommendations for standards in transthoracic two-dimensional echocardiography in the dog and cat. Echocardiography committee of the specialty of cardiology, American College of Veterinary Internal Medicine. J Vet Intern Med. 7:247e52. https://doi.org/10.1111/j.1939-1676.1993.tb01015.x PMid:8246215
15. Cornell, C.C., Kittleson, M.D., Torre, P.D., Haggstrom, J., Lombard, C.W., Pedersen, H.D., Vollmar, A., Wey, A. (2004). Allometric scaling of M‐mode cardiac measurements in normal adult dogs. J Vet Intern Med. 18, 311-321. https://doi.org/10.1111/j.1939-1676.2004.tb02551.x PMid:15188817
16. Buchanan, J.W., Bücheler, J. (1995). Vertebral scale system to measure canine heart size in radiographs. J Am Vet Med Assoc. 206(2): 194e9
17. Beardow, A.W., Buchanan, J.W. (1993). Chronic mitral valve disease in Cavalier King Charles spaniels: 95 cases (1987-1991). J Am Vet Med Assoc. 203(7): 1023-9.
18. Birkegard, A.C., Reimann, M.J., Martinussen, T., Häggström, J., Pedersen, H.D., Olsen, L.H. (2016). Breeding restrictions decrease the prevalence of myxomatous mitral valve disease in Cavalier King Charles Spaniels over an 8- to 10-Year Period. J Vet Intern Med. 30(1): 63-68. https://doi.org/10.1111/jvim.13663 PMid:26578464 PMCid:PMC4913653
19. Ware, W.A. (2014). Cardiovascular system disorders. In: R.W. Nelson, C.G. Couto (Eds.), Small animal internal medicine (pp. 139-150). USA: Mosby, Inc.
20. Bagardi, M., Locatelli, C., Manfredi, M., Bassi, J., Spediacci, C., Ghilardi, S., Zani D.D., Brambilla, P.G. (2022). 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. 63, 156-163. https://doi.org/10.1111/vru.13036 PMid:34796576 PMCid:PMC9299495

Copyright

© 2023 Saridag G. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Conflict of Interest Statement

The authors declared that they have no potential lict of interest with respect to the authorship and/or publication of this article.

Citation Information

Macedonian Veterinary Review. Volume 46, Issue 2, Pages 165-170, e-ISSN 1857-7415, p-ISSN 1409-7621, DOI: 10.2478/macvetrev-2023-0023