• 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.

• Korean Journal of Veterinary Research
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• v.64 no.2
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• pp.9.1-9.7
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• 2024

Myxomatous mitral valve disease (MMVD) is a degenerative disease of the valve leaflets, causing left atrial dilatation and eccentric hypertrophy of the left ventricle by hemodynamic instability. Red cell distribution width (RDW) is a hematologic parameter that indicates the variation of red blood cell volume and size, reflecting anisocytosis. Human studies have found that anisocytosis is associated with poor prognosis in heart disease patients, and recent veterinary studies have also confirmed that the increase in RDW is associated with high mortality in MMVD patients. Medical records of 37 Maltese dogs with MMVD were retrospectively reviewed. When comparing RDW among the MMVD stage groups, there was a significant difference between stage B1, B2 and C. A significant and strong correlation between RDW and the left atrial-to-aortic ratio was identified. RDW was significantly correlated with the reticulocyte count independent of hematocrit, and the reticulocyte count exhibited a significant increase at stage C. This suggests that the congestive heart failure secondary to MMVD could be a contributory factor leading to an elevation in RDW. In conclusion, elevated RDW may associated with left atrial enlargement and progression of MMVD.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.153-156
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• 2020

A 14-year-old intact female Cocker Spaniel dog, weighing 6.8 kg, presented with chief complaints of severe cough, dyspnea, anorexia, and exercise intolerance. It had the characteristics of a blood clot, the evidence of mitral regurgitation, a high left atrial/aortic root ratio, and pericardial effusion with a left atrial rupture due to myxomatous mitral valve degeneration (MMVD) was strongly suspected. Traditional therapy (pimobendan, furosemide, enalapril, and spironolactone) for heart failure with MMVD was provided twice a day orally, and partial pericardiectomy was performed for pericardial effusion. The medical prescriptions for MMVD were continued, and the patient's heart disease was well-controlled. However, it suddenly died 3 months after the operation.

• Korean Journal of Veterinary Research
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• v.56 no.4
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• pp.205-208
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• 2016

The aim of the present study is to investigate the potential influence of obesity as a factor in 5-hydroxytryptamine (5-HT) concentration in myxomatous mitral valve disease (MMVD) dogs. Fifty-five client-owned dogs were enrolled in a randomized trial. Dogs were classified by echocardiography into healthy (control), mild, and moderate to severe MMVD groups. Each group was subclassified by using a 9-point body condition score (BCS); lean (BCS 5-6/9) and obese groups (BCS 7.5-9/9). Dogs with moderate to severe MMVD had lower serotonin (5-HT) concentrations than the control group (p = 0.03). Dogs with moderate to severe MMVD (p = 0.017) had lower serum 5-HT concentrations than the control group in the obese group (BCS 7.5-9/9). Significant difference was found between the lean and obese groups (p = 0.015) which are not consider severe in the MMVD group. These results suggested that 5-HT concentration was decreased with the increasing severity of MMVD, and obesity might be taken into consideration when interpreting the serotonin concentration in MMVD dogs.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.273-278
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• 2001

Chronic mitral valvular insufficiency (CMVI) is the most common heart disease in dogs. The prevalence of CMVI is age-dependent. CMVI is usually affected to small to medium size breeds. It is more prevalent in males than females. The characteristic lesions of CMVI are caused by an acquired chronic structural degeneration of the mitral valve defined as endocardiosis or myxomatous degeneration. The main clinical signs are cough, respiratory distress, weakness and pleural effusion and ascites by secondary right-sided heart failure. The most prominent clinical finding is a systolic heart murmur. The thoracic radiography and echocardiography are useful methods in diagnosis of CMVI. Thoracic radiographic findings are left atrial enlargement, left main stem bronchial compression and pulmonary edema. Echocardiography is confirmed to increased left atrial and ventricular dimension, mitral regurgitation, mitral valve thickening and abnormal movement. Thoracic radiography and echocardiography are used to obtain a definite diagnosis of CMVI, and then to study the progression of the condition.

• Journal of Biomedical and Translational Research
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• v.19 no.4
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• pp.79-85
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• 2018

Echocardiography is one of the most useful diagnostic techniques for differentiating heart disease as well as mitral valve lesion. Forty client-owned small breed dogs (weight, 2.3-13.2 kg) aged between 8-17 years with myxomatous mitral valve degeneration (MMVD) were included in the present study. The diagnosis of MMVD in dogs was made based on the clinical signs, chest radiography data, and echocardiographic findings. Echocardiographic examinations were conducted in accordance with recommended standards for dogs. M-mode, Doppler, and 2D echocardiography were performed in left and right lateral recumbency. 2D echocardiography was used to measure LA and Ao diameter from 2D short axis at the level of the aortic valve. In the comparison of conventional echocardiography indices in dogs with different stages of heart failure with MMVD, significant differences were observed in E/A ratio (p=0.005), EDV (p<0.001), EDVI (p<0.001), E-peak velocity (p= 0.001), ESV (p=0.028), ESVI (p=0.004), LA (p<0.001), LA/Ao Ratio (p<0.001), LVIDd (p<0.001), LVIDd/Ao Ratio (p<0.001), LVIDs (p=0.036), LVIDs/Ao Ratio (p=0.002), and MR Velocity (p=0.026). In addition, distinct correlations were found in EDV (r=0.712), LA/Ao ration (r=0.830), LVIDd (r=0.724), and LVIDd/Ao ratio (r=0.759). This study found that known conventional echocardiographic indices, including EDV, LA/Ao ratio, LVIDd dimension, and LVIDd/Ao ratio correlated with the severity of MMVD in point of significant differences and distinct correlations.

• 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.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.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 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.