DOI QR코드

DOI QR Code

An Assessment of Vertebral Left Atrial Size in Relation to the Progress of Myxomatous Mitral Valve Disease in Dogs

  • Kim, Sun Hwa (College of Veterinary Medicine, Chungnam National University) ;
  • Seo, Kyoung Won (College of Veterinary Medicine, Chungnam National University) ;
  • Song, Kun Ho (College of Veterinary Medicine, Chungnam National University)
  • 투고 : 2020.01.18
  • 심사 : 2020.02.05
  • 발행 : 2020.02.28

초록

Left atrial enlargement (LAE) is an important diagnostic factor in dogs with myxomatous mitral valve disease (MMVD). It is associated with the onset of congestive heart failure (CHF). Recently, a new radiographic left atrial measurement called vertebral left atrial size (VLAS) was introduced. This can be considered as a left atrial enlargement above 2.3. It appears to be related to the severity of MMVD. However, serial changes in VLAS in relation to disease progression and improvement in patients have yet to be studied. This study aims to assess the value of VLAS as a left atrial size monitoring indicator by examining correlations with VHS, LA/Ao ratio and LVIDDN, and comparing serial changes in dogs. A total of 126 dogs were studied with their owners' consent. The dogs were classified into four MMVD groups (Control, B1, B2, C-D) following the ACVIM Guideline by performing a physical examination, radiography and echocardiography. Besides, 24 and 17 dogs were reevaluated to compare values in relation to the progression and improvement of MMVD. VLAS showed significant increase according to the progress of the MMVD stage. This was the same in the Maltese breed group. A strong positive correlation was found between LVIDDN, VHS, LA/Ao ratio, and VLAS. The results of this study found VLAS to be significantly different according to left atrium size, and there was a correlation between disease progression and VLAS levels in each dog. Therefore, VLAS may be used to detect changes in left atrium size as an additional monitoring index of MMVD.

키워드

참고문헌

  1. Abbott JA. Acquired valvular disease. Manual of canine and feline cardiology. Philadelphia: Elsevier Saunders. 2008: 110-138.
  2. Atkins C, Bonagura J, Ettinger S, Fox P, Gordon S, Haggstrom J, Hamlin R, Keene B, Luis-Fuentes V, Stepien R. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 2009; 23: 1142-1150. https://doi.org/10.1111/j.1939-1676.2009.0392.x
  3. Borgarelli M, Crosara S, Lamb K, Savarino P, La Rosa G, Tarducci A, Haggstrom J. Survival characteristics and prognostic variables of dogs with preclinical chronic degenerative mitral valve disease attributable to myxomatous degeneration. J Vet Intern Med 2012; 26: 69-75. https://doi.org/10.1111/j.1939-1676.2011.00860.x
  4. Borgarelli M, Haggstrom J. Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy. Vet Clin North Am Small Anim Pract 2010; 40: 651-663. https://doi.org/10.1016/j.cvsm.2010.03.008
  5. Boswood A, Haeggstroem J, Gordon SG, Wess G, Stepiens RL, Oyama MA, Keene BW, Bonagura J, MacDonald KA, Patteson M. Die Wirkung von Pimobendan bei Hunden mit praklinischer myxomatoser Mitralklappenerkrankung und Kardiomegalie: Die EPIC-Studie-Eine randomisierte klinische Studie. Kleintierpraxis. 2017: 64-87.
  6. Boswood A, Haggstrom J, Gordon SG, Wess G, Stepien RL, Oyama MA, Keene BW, Bonagura J, MacDonald KA, Patteson M, Smith S, Fox PR, Sanderson K, Woolley R, Szatmari V, Menaut P, Church WM, O'Sullivan ML, Jaudon JP, Kresken JG, Rush J, Barrett KA, Rosenthal SL, Saunders AB, Ljungvall I, Deinert M, Bomassi E, Estrada AH, Fernandez Del Palacio MJ, Moise NS, Abbott JA, Fujii Y, Spier A, Luethy MW, Santilli RA, Uechi M, Tidholm A, Watson P. Effect of Pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: The EPIC Study-A randomized clinical trial. J Vet Intern Med 2016; 30: 1765-1779. https://doi.org/10.1111/jvim.14586
  7. Buchanan JW, Bucheler J. Vertebral scale system to measure canine heart size in radiographs. J Am Vet Med Assoc 1995; 206: 194-194.
  8. Chetboul V, Tissier R. Echocardiographic assessment of canine degenerative mitral valve disease. J Vet Cardiol 2012; 14: 127-148. https://doi.org/10.1016/j.jvc.2011.11.005
  9. Cornell CC, Kittleson MD, Torre PD, Haggstrom J, Lombard CW, Pedersen HD, Vollmar A, Wey A. Allometric scaling of M-mode cardiac measurements in normal adult dogs. J Vet Intern Med 2004; 18: 311-321. https://doi.org/10.1892/0891-6640(2004)18<311:ASOMCM>2.0.CO;2
  10. Detweiler DK, Patterson DF. The prevalence and types of cardiovascular disease in dogs. Ann N Y Acad Sci 1965; 127: 481-516. https://doi.org/10.1111/j.1749-6632.1965.tb49421.x
  11. Diana A, Guglielmini C, Pivetta M, Sanacore A, Di Tommaso M, Lord PF, Cipone M. Radiographic features of cardiogenic pulmonary edema in dogs with mitral regurgitation: 61 cases (1998-2007). J Am Vet Med Assoc 2009; 235: 1058-1063. https://doi.org/10.2460/javma.235.9.1058
  12. Hansson K, Haggstrom J, Kvart C, Lord P. Interobserver variability of vertebral heart size measurements in dogs with normal and enlarged hearts. Vet Radiol Ultrasound 2005; 46: 122-130. https://doi.org/10.1111/j.1740-8261.2005.00024.x
  13. Hansson K, Haggstrom J, Kvart C, Lord P. Left atrial to aortic root indices using two-dimensional and M-mode echocardiography in cavalier King Charles spaniels with and without left atrial enlargement. Vet Radiol Ultrasound 2002; 43: 568-575. https://doi.org/10.1111/j.1740-8261.2002.tb01051.x
  14. Hollmer M, Willesen J, Tolver A, Koch J. Comparison of four echocardiographic methods to determine left atrial size in dogs. J Vet Cardiol 2016; 18: 137-145. https://doi.org/10.1016/j.jvc.2016.02.001
  15. Keene BW, Atkins CE, Bonagura JD, Fox PR, Haggstrom J, Fuentes VL, Oyama MA, Rush JE, Stepien R, Uechi M. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med 2019; 33: 1127-1140. https://doi.org/10.1111/jvim.15488
  16. Le Roux A, Rademacher N, Saelinger C, Rodriguez D, Pariaut R, Gaschen L. Value of tracheal bifurcation angle measurement as a radiographic sign of left atrial enlargement in dogs. Vet Radiol Ultrasound 2012; 53: 28-33. https://doi.org/10.1111/j.1740-8261.2011.01871.x
  17. Lester SJ, Ryan EW, Schiller NB, Foster E. Best method in clinical practice and in research studies to determine left atrial size. Am J Cardiol 1999; 84: 829-832. https://doi.org/10.1016/s0002-9149(99)00446-4
  18. Malcolm EL, Visser LC, Phillips KL, Johnson LR. 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 2018; 253: 1038-1045. https://doi.org/10.2460/javma.253.8.1038
  19. Rishniw M, Erb HN. Evaluation of four 2-dimensional echocardiographic methods of assessing left atrial size in dogs. J Vet Intern Med 2000; 14: 429-435. https://doi.org/10.1892/0891-6640(2000)014<0429:EOFEMO>2.3.CO;2
  20. Salguero XS, Prandi D, Llabres-Diaz F, Manzanilla EG, Bussadori C. A radiographic measurement of left atrial size in dogs. Ir Vet J 2018; 71: 25. https://doi.org/10.1186/s13620-018-0137-x
  21. Sanchez X, Prandi D, Badiella L, Vazquez A, Llabres-Diaz F, Bussadori C, Domenech O. A new method of computing the vertebral heart scale by means of direct standardisation. J Small Anim Pract 2012; 53: 641-645. https://doi.org/10.1111/j.1748-5827.2012.01288.x
  22. Suh I-W, Song J-M, Lee E-Y, Kang S-H, Kim M-J, Kim J-J, Kang DH, Song JK. Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. J Am Soc Echocardiogr 2008; 21: 439-445. https://doi.org/10.1016/j.echo.2007.09.002

피인용 문헌

  1. Correlation between Vertebral Left Atrial Size and NT-proBNP in Dogs with Myxomatous Mitral Valve Disease vol.38, pp.5, 2021, https://doi.org/10.17555/jvc.2021.38.5.215