Key result
Radiographic scores differentiated stage B1 from B2 myxomatous mitral valve disease with cutoff values of 11.0 for VHS, 1.8 for LAWidth, 2.0 for RLAD, and 2.3 for VLAS.
Why the study?
Staging of MMVD requires echocardiography alongside thoracic radiographs, prompting investigation into radiographic scores on conventional and grayscale inverted images to establish cutoff values for stage assignment.
Can radiographic cardiac scores accurately predict heart enlargement and differentiate between stages of myxomatous mitral valve disease in dogs when echocardiography is unavailable?
Cross-Sectional (n=200)
Can radiographic cardiac scores accurately predict heart enlargement and differentiate between stages of myxomatous mitral valve disease in dogs when echocardiography is unavailable?
Radiographic cardiac scores can effectively differentiate between stages of myxomatous mitral valve disease in dogs, providing a valuable diagnostic tool when echocardiography is unavailable.
Radiographic cutoffs may aid MMVD staging when echocardiography is limited; leaves open prospective validation against echo in larger cohorts.
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 (LAWidth), 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. One hundred fifty dogs in different stages of MMVD and 50 unaffected dogs were evaluated. 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. After excluding breed-specific higher VHS, the means of VHS, LAWidth, 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 LAWidth, 2.0 for RLAD, and 2.3 for VLAS. Besides RLAD, scores were similar in conventional and inverted radiographs. 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.
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Levicar et al. (2022) conducted a cross-sectional in Myxomatous mitral valve disease (MMVD) (n=200). Radiographic scores (VHS, LAWidth, RLAD, VLAS) vs. Unaffected dogs and stage B1 dogs was evaluated on Cutoff values identifying heart enlargement (differentiating stages B1 and B2). Radiographic scores differentiated stage B1 from B2 myxomatous mitral valve disease with cutoff values of 11.0 for VHS, 1.8 for LAWidth, 2.0 for RLAD, and 2.3 for VLAS.
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