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Heart to spine measurements to detect left atrial enlargement in dogs with mitral insufficiency
Sánchez Salguero, Xavier Prandi, David Llabrés-Díaz, Francisco Garcia Manzanilla, Edgar Badiella, Llorenç Bussadori, Claudio
Sánchez Salguero, Xavier
Prandi, David
Llabrés-Díaz, Francisco
Garcia Manzanilla, Edgar
Badiella, Llorenç
Bussadori, Claudio
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2019-11-20
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Sánchez Salguero, X., Prandi, D., Llabrés-Díaz, F. et al. Heart to spine measurements to detect left atrial enlargement in dogs with mitral insufficiency. Ir Vet J 72, 14 (2019). https://doi.org/10.1186/s13620-019-0152-6
Abstract
Background: Radiography is useful to determine left atrial (LA) size when echocardiography is not available.
Recently, the authors have described Radiographic Left Atrial Dimension (RLAD) as a new radiographic
measurement to assess LA size. The objective of this study was to assess the clinical usefulness of 2 new
radiographic measurements to detect and quantify left atrial enlargement (LAE) compared to RLAD and using left
atrium to aortic root (LA/Ao) ratio as gold standard. These new measurements, bronchus-to-spine (Br-Spine) and
RLAD-to-spine (RLAD-Spine) may be more precise in cases were LA boundaries are not well defined. Fifty dogs, 25
with and 25 without LAE were recruited. Reference LA/Ao ratio was assessed by 2D echocardiography and LAE was
considered if LA/Ao > 1.6. Br-spine was measured as a straight vertical line from the main stem bronchus to the
ventral border of the vertebra situated immediately dorsal to the heart base. RLAD-Spine was measured from RLAD
endpoint perpendicularly to spine. The correlation of RLAD, Br-Spine and RLAD-Spine methods with LA/Ao and
their sensitivity and specificity for detecting LAE were calculated. Receiver Operating Characteristic (ROC) curves
were used to estimate the optimal cut-off for each method.
Results: Correlations between Br-Spine, RLAD-Spine, RLAD and LA/Ao ratio were − 0.66, − 0.76 and 0.89 respectively
(P < 0.001). Sensitivity at the optimal cut-off values for detecting LAE were 32.0, 64.0 and 96.0%, respectively.
Specificity was 96.0% in all cases.
Conclusion: Br-Spine and RLAD-Spine were less sensitive radiographic measurements than RLAD in detecting LAE
in dogs. Both Br-Spine and RLAD-Spine may not be good alternatives to RLAD.