Ferri Carlotta, Besso Juliette, Gaillot Hugues, Ruel Yannick, Agoulon Albert, Bourguignon Christophe, Mey Clémence, Gouni Vassiliki
ADVETIA Veterinary Hospital, 9 Avenue Louis Breguet, 78140 Vélizy-Villacoublay, France.
Vetradmobile, 97 Rue Monge, 75005 Paris, France.
Vet Sci. 2025 Jun 24;12(7):615. doi: 10.3390/vetsci12070615.
The present study aimed to compare pulmonary vein (PV) diameters between Cavalier King Charles Spaniels (CKCSs) with myxomatous mitral valve disease (MMVD) and healthy CKCSs, assess correlations between PV diameters and echocardiographic parameters, and identify the optimal PV diameter cut-off value that distinguishes stage C from stage B2. CKCSs were recruited both retrospectively and prospectively and classified according to the ACVIM guidelines (stages A, B1, B2, and C). From a left apical view, the diameters of three PVs (PV1, PV2, and PV3) were measured with high reproducibility. In healthy dogs, the PV2 diameter showed no correlation with body weight. The PV2 diameter was significantly higher in stage B2 compared to B1 and in stage C compared to B2, while no difference was found between stages A and B1. The median (IQR) PV2 diameters were 4.9 mm (3.9-5.2) in stage A, 5.1 mm (4.0-6.0) in stage B1, 9.3 mm (7.3-11.1) in stage B2, and 13.7 mm (9.9-15.1) in stage C. Positive correlations were observed between the PV2 diameter and the left ventricular internal diameter normalized for body weight, the left atrium-to-aorta ratio, mitral E wave peak velocity, tricuspid regurgitation pressure gradient, and regurgitant fraction. A PV2 diameter cut-off value of 12.8 mm discriminated stage C from stage B2 with 57% sensitivity and 93% specificity. The PV2 diameter is a reproducible echocardiographic measure that increases with MMVD severity and could assist in the early detection of congestive heart failure. However, the modest sensitivity observed reflects the overlap of PV2 measurements between stages B2 and C. Therefore, PV2 should be interpreted with caution and considered a supportive, rather than exclusive, tool in disease staging and therapeutic decision-making.
本研究旨在比较患有黏液瘤性二尖瓣疾病（MMVD）的骑士查理王小猎犬（CKCS）与健康CKCS的肺静脉（PV）直径，评估PV直径与超声心动图参数之间的相关性，并确定区分C期与B2期的最佳PV直径临界值。通过回顾性和前瞻性方式招募CKCS，并根据ACVIM指南（A、B1、B2和C期）进行分类。从左心尖视图测量三个PV（PV1、PV2和PV3）的直径，具有高度可重复性。在健康犬中，PV2直径与体重无相关性。与B1期相比，B2期的PV2直径显著更高，与B2期相比，C期的PV2直径显著更高，而A期和B1期之间未发现差异。A期的PV2直径中位数（IQR）为4.9mm（3.9 - 5.2），B1期为5.1mm（4.0 - 6.0），B2期为9.3mm（7.3 - 11.1），C期为13.7mm（9.9 - 15.1）。观察到PV2直径与体重标准化的左心室内径、左心房与主动脉比值、二尖瓣E波峰值速度、三尖瓣反流压力梯度和反流分数之间呈正相关。PV2直径临界值为12.8mm时，区分C期与B2期的灵敏度为57%，特异性为93%。PV2直径是一种可重复的超声心动图测量指标，随MMVD严重程度增加而增大，有助于早期发现充血性心力衰竭。然而，观察到的适度灵敏度反映了B2期和C期PV2测量值的重叠。因此，在疾病分期和治疗决策中，应谨慎解释PV2，并将其视为一种辅助而非唯一的工具。
