Department of Veterinary Sciences, University of Pisa, Pisa, Italy.
Department of Cardiology, Anicura Istituto Veterinario Novara, Granozzo con Monticello, Italy.
J Vet Intern Med. 2021 May;35(3):1238-1244. doi: 10.1111/jvim.16131. Epub 2021 May 5.
There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables.
HYPOTHESIS/OBJECTIVES: To propose an easy-to-use echocardiographic classification of severity of MMVD in dogs.
Five hundred and sixty dogs with MMVD.
This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium-to-aorta ratio, left ventricular end-diastolic diameter normalized for body weight, fractional shortening, and E-wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4-5), moderate (score: 6-7), severe (score: 8-12), late stage (score: 13-14).
Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877-2810 days), moderate (1882 days, 95% CI 1341-2434 days), severe (623 days, 95% CI 432-710 days), and late stage (157 days, 95% CI 53-257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001).
The MINE score is a new easy-to-use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.
目前尚无基于常规获取的超声心动图变量的普遍共识的黏液样心肌二尖瓣疾病（MMVD）严重程度评分。
假设/目的：提出一种易于使用的 MMVD 严重程度的超声心动图分类方法。
560 只患有 MMVD 的狗。
这是一项回顾性、多中心、观察性研究。提出的二尖瓣反流超声心动图（MINE）评分基于 4 个超声心动图变量：左心房与主动脉比值、左心室舒张末期直径按体重标准化、分数缩短和 E 波经二尖瓣峰值速度。具体的超声心动图截止值基于先前关于 MMVD 的预后研究确定，并分配严重程度评分如下：轻度（评分：4-5）、中度（评分：6-7）、重度（评分：8-12）、晚期（评分：13-14）。
中位生存时间在提出的严重程度类别之间有显著差异（P <.05）：轻度（2344 天，95%置信区间 [CI] 1877-2810 天）、中度（1882 天，95% CI 1341-2434 天）、重度（623 天，95% CI 432-710 天）和晚期（157 天，95% CI 53-257 天）。MINE 评分 >8 预测心脏死亡（曲线下面积 = 0.85；P <.0001；敏感性 87%，特异性 73%）。在多变量分析中，MINE 评分的所有超声心动图变量都是心脏病死亡的独立预测因素（P <.001）。
MINE 评分是一种新的易于使用的 MMVD 严重程度的超声心动图分类方法，已被证明具有临床有效性，因为它与生存相关。这种分类提供了预后信息，可用于 MMVD 的客观超声心动图评估。
