The work was performed at the Veterinary Teaching Hospital at the Virginia-Maryland Regional College of Veterinary Medicine and the Veterinary Teaching Hospital at the Kansas State University College of Veterinary Medicine.
Discrepancies in Identification of Left Atrial Enlargement Using Left Atrial Volume versus Left Atrial-to-Aortic Root Ratio in Dogs
Article first published online: 23 JUL 2014
Copyright © 2014 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 28, Issue 5, pages 1527–1533, September/October 2014
How to Cite
Wesselowski, S., Borgarelli, M., Bello, N.M. and Abbott, J. (2014), Discrepancies in Identification of Left Atrial Enlargement Using Left Atrial Volume versus Left Atrial-to-Aortic Root Ratio in Dogs. Journal of Veterinary Internal Medicine, 28: 1527–1533. doi: 10.1111/jvim.12410
The study was presented in abstract form at the 2013 ACVIM Forum, Seattle, WA.
- Issue published online: 1 OCT 2014
- Article first published online: 23 JUL 2014
- Manuscript Accepted: 11 JUN 2014
- Manuscript Revised: 31 MAR 2014
- Manuscript Received: 27 JAN 2014
- Biplane area-length method;
- Myxomytous mitral valve disease
Left atrial size is prognostically important in dogs with myxomatous mitral valve disease (MMVD).
To compare the level of agreement in identification of left atrial enlargement (LAE) between the left atrial-to-aortic root ratio (LA : Ao) and left atrial volume using the biplane area-length method indexed to body weight (LA Vol/BW).
Sixty dogs with MMVD and 22 normal dogs were prospectively studied with 2-dimensional echocardiography.
The upper limit of normal for LA Vol/BW was defined as 1.1 mL/kg. LA : Ao was deemed normal if ≤1.5. To define overall disease severity, each dog was assigned a mitral regurgitation severity score (MRSS) based on echocardiographic parameters that did not include left atrial size. ACVIM staging also was utilized.
Of 60 affected dogs, 20 were ACVIM Stage B1, 25 were Stage B2, and 15 were Stage C. LA Vol/BW identified LAE in 12 cases in which LA : Ao was normal; 7 of these were Stage B1 and 5 were Stage B2. This diagnostic disagreement was significant (P = .00012). Of the 12 cases in which diagnostic discrepancies were identified, 5/5 of the B2 dogs and 3/7 B1 dogs had a moderate MRSS, whereas 4/7 B1 dogs had a mild MRSS. No diagnostic discrepancies between LA : Ao and LA Vol/BW were apparent in dogs with a severe MRSS.
Conclusions and Clinical Importance
This study shows evidence of diagnostic disagreement between LA : Ao and LA Vol/BW for assessment of LAE. LA Vol/BW may be superior to LA : Ao for identification of mild LAE.