• Journal of Veterinary Clinics
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• v.39 no.2
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• pp.45-50
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• 2022

Vertebral left atrial size can be used as a radiographic tool to evaluate left atrial size in dogs. Vertebral left atrial size has been studied in dogs; however, few studies have been conducted on breed-specific differences in healthy dogs. To study the median vertebral left atrial size differences by breed and to investigate the association between age, sex, body condition score, thoracic depth-to-width ratio, and vertebral left atrial size. A total of 220 dogs of the following breeds: Maltese (n = 73), Beagle (n = 30), Poodle (n = 41), Shih-tzu (n = 44), and Mongrel (n = 32) were reviewed retrospectively. Sex, body weight, age, and body condition score of each dog were collected. Thoracic radiography was conducted for dorsoventral and right/left lateral views in all dogs to measure the vertebral heart score, vertebral left atrial size, and thoracic depth-to-width ratio. No significant differences in the median vertebral left atrial size were found among the breeds. There were no effects of sex, age, body condition score, and thoracic depth-to-width ratio on vertebral left atrial size. There was a significant positive correlation between the vertebral heart score and vertebral left atrial size. Breed, age, sex, and chest conformation did not correlate with vertebral left atrial size.

• Journal of Veterinary Clinics
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• v.38 no.1
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• pp.16-20
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• 2021

Recently, a new method of evaluating left atrial size called vertebral left atrial size (VLAS) was introduced in dogs. Total 155 dogs were examined at the Veterinary Medical Teaching Hospital of Chungnam National University. In this study, myxomatous mitral valve disease (MMVD) stage and VLAS showed a significant correlation in those dogs. Also, the relationship between C-reactive protein (CRP) and VLAS has yet to be examined. We found a strong positive correlation between VLAS and CRP-a significant increase in CRP was observed with increasing VLAS values. Thus, it would be beneficial to measure VLAS besides employing the current radiological and echocardiographic methods when evaluating heart size. Measuring VLAS could be an additional diagnostic tool for diagnosing MMVD in dogs.

• Journal of Veterinary Clinics
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• v.37 no.1
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• pp.9-14
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• 2020

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.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.287-293
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• 2022

Radiographic left atrial dimension (RLAD) is a useful measurement to assess left atrial enlargement in dogs. There are studies on the use of RLAD on various breeds of dogs, but no study on a specific breed with myxomatous mitral valve disease (MMVD). This study was conducted to compare RLAD measurements in Maltese dogs with MMVD ACVIM stage B1 and B2, and also to investigate the correlation of RLAD with the LA:Ao ratio. A total of 29 Maltese dogs were the subjects of this study. Each dog was diagnosed with MMVD ACVIM stage B1 or B2 based on physical examination, thoracic radiography, and echocardiography. The vertebral heart size (VHS), RLAD, LVIDDn, and LA:Ao ratio were measured and compared to evaluate the differences. There were significant differences in the RLAD, LVIDDn, and LA:Ao ratio between dogs with MMVD ACVIM stage B1 and those with stage B2. There was a significant correlation between the LA:Ao ratio and both the RLAD and VHS measurements, but the correlation coefficient was higher for RLAD. The RLAD scores exhibited a significant difference between dogs with ACVIM Stage B1 and with those with B2, and these scores had a higher correlation with the LA:Ao ratio measured by echocardiography than with VHS.

• Journal of Veterinary Clinics
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• v.40 no.1
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• pp.31-37
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• 2023

Vertebral left atrial size (VLAS) is an important indicator to predict myxomatous mitral valve degeneration (MMVD) in dogs. When the caudal margin of cardiac silhouette and the dorsal margin of caudal vena cava (CdVC) could not be seen exactly, another way to evaluate VLAS is needed. The objective of this study was to assess whether a new modified VLAS (m-VLAS) could be used as an indicator to predict MMVD in 57 small breed dogs with MMVD. The m-VLAS was also used to classify American College of Veterinary Internal Medicine staging groups and left heart enlargement confirmed with echocardiograph (EchoLHE) groups. The m-VLAS was measured as the distance from the ventral aspect of the carina to the dorsal aspect of the intersection of the cardiac silhouette and the farthest LA caudal margin, not the CdVC, followed by drawing the same line beginning at the cranial edge of T4. Based on VLAS values and m-VLAS values measured for dogs with MMVD, correlations between these values and left heart enlargement groups were then evaluated. There were significant differences in both the VLAS and the m-VLAS between EchoLHE groups. The AUC of the ROC curve of the m-VLAS to detect EchoLHE was higher than that of the VLAS. The optimal cutoff value for the m-VLAS was >2.7, which had a higher specificity (86.84%) than the VLAS specificity (71.05%). This study reveals that a new m-VLAS is a more specific indicator than the VLAS for predicting left side heart enlargement in small breed dogs. Therefore, the m-VLAS can be used as a clinically useful radiographic measurement alternative to or better than the VLAS.

• Journal of Veterinary Clinics
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• v.38 no.2
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• pp.103-103
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• 2021

• Journal of Veterinary Clinics
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• v.38 no.5
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• pp.215-220
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• 2021

The purpose of this study was to investigate the correlation between vertebral left atrial size (VLAS) and NT-proBNP levels. Sixty-three dogs with myxomatous mitral valve disease (MMVD) were recruited for this study. The MMVD group was classified according to the ACVIM stage based on medical history, clinical signs, and thoracic radiography and echocardiography findings. The N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured using fluorescent immunoassay. VLAS and VHS values were measured using a digital caliper in the right lateral view. There were significant differences in VLAS for each American college of veterinary internal medicine (ACVIM) stage (p < 0.01). As the ACVIM stage increased, it tended to increase. Vertebral heart score (VHS) also showed a tendency to increase with the ACVIM stage (p < 0.01). VLAS was divided into three groups: VLAS <2.6, 2.6≤ VLAS <3.1, and VLAS ≥3.1. NT-proBNP values were significantly different between the three groups (p < 0.01), and VLAS and NT-proBNP values showed a strong positive correlation (r = 0.756, p < 0.01). In conclusion, there were significant differences among ACVIM stages B1 and B2, B1 and C-D, and B2 and C-D groups regarding VLAS. Furthermore, NT-proBNP increased proportionally as VLAS increased. Measurements of VLAS may be helpful in the diagnosis of MMVD in addition to the existing radiological and echocardiographic methods.

• Journal of Veterinary Science
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• v.22 no.5
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• pp.60.1-60.9
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• 2021

Background: Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease. Objectives: To establish the normal echocardiographic parameters for Maltese dogs. Methods: In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis. Results: The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight. Conclusion: This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.