Discrepancies in Identification of Left Atrial Enlargement Using Left Atrial Volume versus Left Atrial‐to‐Aortic Root Ratio in Dogs. (23rd July 2014)

• Record Type: Journal Article
• Authors: Wesselowski, S.; Borgarelli, M.; Bello, N.M.; Abbott, J.
• Is Part Of: Journal of veterinary internal medicine. Volume 28:Number 5(2014:Sep./Oct.)
• Page Start: 1527
• Page End: 1533
• Publication Date: 2014-07-23
• Subjects: Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.12410
• Languages: English
• ISSNs: 0891-6640

Abstract

<abstract abstract-type="main" id="jvim12410-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jvim12410-sec-0001" sec-type="section"> <title>Background</title> <p>Left atrial size is prognostically important in dogs with myxomatous mitral valve disease (MMVD).</p> </sec> <sec id="jvim12410-sec-0002" sec-type="section"> <title>Hypothesis/Objectives</title> <p>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).</p> </sec> <sec id="jvim12410-sec-0003" sec-type="section"> <title>Animals</title> <p>Sixty dogs with MMVD and 22 normal dogs were prospectively studied with 2‐dimensional echocardiography.</p> </sec> <sec id="jvim12410-sec-0004" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="jvim12410-sec-0005" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = .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.</p> </sec> <sec id="jvim12410-sec-0006" sec-type="section"> <title>Conclusions and Clinical Importance</title> <p>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.</p> </sec> </abstract>