Department of Veterinary Sciences, University of Pisa, Via Livornese lato monte, 56122 San Piero a Grado, Pisa, Italy.
Department of Veterinary Sciences, University of Pisa, Via Livornese lato monte, 56122 San Piero a Grado, Pisa, Italy.
J Vet Cardiol. 2021 Apr;34:55-63. doi: 10.1016/j.jvc.2021.01.002. Epub 2021 Jan 15.
Two radiographic measures of the left atrial (LA) size, the vertebral left atrial size (VLAS) and the radiographic left atrial dimension (RLAD), have been described in dogs. The aim of this study was to determine their feasibility and diagnostic value in the prediction of LA enlargement and clinical stage in dogs with myxomatous mitral valve disease (MMVD).
111 client-owned dogs affected by MMVD.
Retrospective study. In each dog, VLAS, RLAD, vertebral heart score (VHS), and left atrium-to-aorta-ratio (LA/Ao) were measured. The correlation between VLAS, RLAD, and LA/Ao was evaluated. The diagnostic accuracy of VLAS and RLAD was assessed for the detection of LA enlargement and clinical staging using the receiver operating characteristic curve analysis.
A positive correlation was observed between VLAS, RLAS, and LA/Ao (r = 0.816 and r = 0.855, respectively; p<0.0001). Both VLAS (area under the curve [AUC], 0.93; p<0.0001) and RLAD (AUC, 0.98; p<0.0001) showed high diagnostic accuracy in the detection of LA enlargement. In the stage B, the RLAD (AUC, 0.99; cutoff, ≥1.8; sensitivity, 100%; specificity 93%) performed better than VLAS (AUC, 0.90; cutoff, ≥2.4; sensitivity, 66%; specificity 100%) and VHS (AUC, 0.89; cutoff, ≥10.7; sensitivity, 88%; specificity 83%) in the detection of dogs fulfilling the echocardiographic criteria for stage B2.
VLAS and RLAD represent useful radiological tools for the detection of LA enlargement in dogs with MMVD. In asymptomatic dogs, the RLAD performs better than VLAS and VHS in the prediction of those fulfilling the echocardiographic criteria for stage B2.
已有描述用于测量左心房（LA）大小的两种影像学指标，即椎骨左心房大小（VLAS）和影像学左心房径线（RLAD）。本研究旨在确定这两种指标在预测患有黏液样变性二尖瓣疾病（MMVD）的犬 LA 增大和临床分期中的可行性和诊断价值。
111 只患有 MMVD 的患犬。
回顾性研究。在每只犬中，测量 VLAS、RLAD、椎骨心脏评分（VHS）和左心房与主动脉比值（LA/Ao）。评估 VLAS、RLAD 与 LA/Ao 之间的相关性。使用受试者工作特征曲线分析评估 VLAS 和 RLAD 检测 LA 增大和临床分期的诊断准确性。
观察到 VLAS、RLAS 和 LA/Ao 之间存在正相关（r=0.816 和 r=0.855，均 P<0.0001）。VLAS（曲线下面积 [AUC]，0.93；P<0.0001）和 RLAD（AUC，0.98；P<0.0001）在检测 LA 增大方面均表现出较高的诊断准确性。在 B 阶段，RLAD（AUC，0.99；临界值，≥1.8；敏感性，100%；特异性 93%）的性能优于 VLAS（AUC，0.90；临界值，≥2.4；敏感性，66%；特异性 100%）和 VHS（AUC，0.89；临界值，≥10.7；敏感性，88%；特异性 83%）在检测符合超声心动图 B2 阶段标准的犬方面。
VLAS 和 RLAD 是检测 MMVD 犬 LA 增大的有用影像学工具。在无症状犬中，RLAD 在预测符合超声心动图 B2 阶段标准的犬方面优于 VLAS 和 VHS。
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