The work was done at the Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences.
Radiographic Heart Size and Its Rate of Increase as Tests for Onset of Congestive Heart Failure in Cavalier King Charles Spaniels with Mitral Valve Regurgitation
Article first published online: 13 SEP 2011
Copyright © 2011 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 25, Issue 6, pages 1312–1319, November-December 2011
How to Cite
Lord, P.F., Hansson, K., Carnabuci, C., Kvart, C. and Häggström, J. (2011), Radiographic Heart Size and Its Rate of Increase as Tests for Onset of Congestive Heart Failure in Cavalier King Charles Spaniels with Mitral Valve Regurgitation. Journal of Veterinary Internal Medicine, 25: 1312–1319. doi: 10.1111/j.1939-1676.2011.00792.x
No grant support.
Not presented at a meeting.
- Issue published online: 16 NOV 2011
- Article first published online: 13 SEP 2011
- Manuscript Accepted: 1 AUG 2011
- Manuscript Revised: 28 JUN 2011
- Manuscript Received: 16 DEC 2010
- Likelihood ratio;
- Vertebral heart scale
In canine mitral regurgitation (MR) the rate of heart enlargement increases in the last year before congestive heart failure (CHF). Measurement of heart size and its rate of increase may be useful tests for CHF in MR.
To determine the value of vertebral heart scale (VHS) and its rate of increase (∆VHS units/month) for diagnosing the presence and predicting the onset of CHF.
Longitudinal study of 94 Cavalier King Charles Spaniels (CKCS).
VHS was measured at intervals before CHF. ∆VHS/month was calculated from sequential pairs of VHS measurements and the interval between them. Diagnostic accuracy and utility were determined by the areas under receiver operating characteristic plots (AUROC), and likelihood ratios (LR).
AUROC for VHS at the onset of CHF was 0.93 (95% CI, 0.96–0.90), to predict CHF 1–12 months before CHF was 0.74 (95% CI, 0.81–0.66), and for ∆VHS/month at CHF was 0.98 (95% CI, 0.99–0.96). Interval LRs and their cutoff values for CHF were for VHS: 13 (95% CI, 20–7.3) at ≥12.7; 1.2 (95% CI, 2.0–0.68) between 12.7 and 12.0; 0.04 (95% CI, 0.18–0.01) at ≤12.0, and for ∆VHS/month: 15 (95% CI, 30–7.7) at ≥0.08; 0.72 (95% CI, 2.0–0.25) between 0.08 and 0.06; and 0.05 (95% CI, 0.13–0.02) at ≤0.06.
Conclusions and Clinical Importance
Under the conditions of this study, VHS and particularly ∆VHS/month are useful measurements for detecting onset of CHF in CKCS with MR.