van Opstal Kira Y, Kittleson Mark D, Teske Erik, Auriemma Edoardo, van den Broek Henk, Spattini Giliola, Vilaplana Grosso Federico R, Szatmári Viktor
Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands.
Veterinary Information Network and School of Veterinary Medicine and Epidemiology, University of California, Davis, CA 95616, USA.
Animals (Basel). 2025 Aug 26;15(17):2510. doi: 10.3390/ani15172510.
Some dogs with severe mitral valve regurgitation can have chronic cough, but its cause is unclear. Many of these dogs exhibit left principal (synonym mainstem) bronchial collapse or compression. Some clinicians believe that an enlarged heart, particularly the dilated left atrium, compresses the left principal bronchus, while others argue that a healthy bronchus cannot be compressed and that the cough is due to concurrent airway disease, such as bronchomalacia. In this study, we aimed to investigate the correlation between chronic cough and radiographic signs of bronchial narrowing in dogs with cardiomegaly secondary to primary mitral valve regurgitation.
Four radiologists independently evaluated 51 sets of thoracic radiographs from client-owned dogs with cardiomegaly due to severe mitral valve regurgitation, including 26 sets of radiographs belonging to dogs with chronic (>8 weeks) cough and 25 without cough. The presence or absence of bronchial narrowing was assessed while the radiologists were blinded to patient characteristics and each other's findings.
Interobserver variability was high, and the radiologists could not reliably predict which dogs had a chronic cough. Dogs with left atrial enlargement and airway narrowing sometimes coughed and sometimes did not. Likewise, some dogs with left atrial enlargement but no signs of airway compression or collapse coughed, and some did not. It was impossible to distinguish the groups based on these features.
Bronchial compression by an enlarged heart and left atrium is an unlikely cause of chronic cough in dogs with severe primary mitral valve regurgitation.
一些患有严重二尖瓣反流的犬会出现慢性咳嗽，但其病因尚不清楚。这些犬中有许多表现出左主支气管塌陷或受压。一些临床医生认为，心脏增大，尤其是左心房扩张，会压迫左主支气管，而另一些人则认为健康的支气管不会被压迫，咳嗽是由于并发气道疾病，如支气管软化症。在本研究中，我们旨在调查患有原发性二尖瓣反流继发心脏肥大的犬慢性咳嗽与支气管狭窄影像学表现之间的相关性。
四位放射科医生独立评估了51组因严重二尖瓣反流导致心脏肥大的客户拥有的犬的胸部X光片，其中包括26组属于患有慢性（>8周）咳嗽犬的X光片和25组无咳嗽犬的X光片。在放射科医生对患者特征和彼此的检查结果不知情的情况下，评估是否存在支气管狭窄。
观察者间的变异性很高，放射科医生无法可靠地预测哪些犬患有慢性咳嗽。左心房扩大且气道狭窄的犬有时咳嗽，有时不咳嗽。同样，一些左心房扩大但无气道受压或塌陷迹象的犬咳嗽，而一些则不咳嗽。基于这些特征无法区分这些组。
心脏和左心房扩大引起的支气管压迫不太可能是患有严重原发性二尖瓣反流的犬慢性咳嗽的原因。
