Vertebral left atrial ventral: a new prognostic marker in dogs with mitral valve disease.

A VLAV ≥ 3.0 on thoracic radiographs indicates unfavorable prognosis in dogs with mitral valve disease.

This observational, retrospective and prospective study evaluated radiographic measurements for identifying dogs with stage B2 mitral valve disease (MVD) and predicting survival. A total of 191 dogs were included, comprising healthy controls and dogs diagnosed with MVD via Doppler echocardiography, staged according to ACVIM guidelines. Six radiographic measurements were assessed: left atrial width (LAwidth), radiographic left atrial dimension (RLAD), vertebral left atrial size (VLAS), modified VLAS (M-VLAS), the newly proposed vertebral left atrial ventral (VLAV), and vertebral heart score (VHS). VLAS, M-VLAS, LAwidth, and RLAD all demonstrated significant differences across MVD stages B1, B2, and C/D. The novel VLAV measurement successfully differentiated stage B2 and C/D from control and stage B1 dogs, achieving good diagnostic accuracy (AUC 0.82). Defined cutoff values were established for all measurements to identify left cardiomegaly. Repeatability and reproducibility were rated good to excellent for all indices. Importantly, higher values of VLAS, M-VLAS, LAwidth, and VLAV were significantly associated with shortened survival time. A VLAV threshold of ≥3.0 was specifically identified as indicative of an unfavorable prognosis. The authors conclude that these radiographic measurements, particularly VLAV, can serve as practical screening tools to guide echocardiographic referral decisions and assist clinicians in predicting survival in dogs with MVD, offering valuable utility in practice settings where echocardiography may not be immediately available.

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