Diagnostic accuracy of right pulmonary vein-to-pulmonary artery ratio to identify congestive heart failure in dogs affected by myxomatous mitral valve disease.

RPV/T-wave-to-Ao ratio >1.07 shows moderate accuracy for detecting canine stage C MMVD.

This prospective study evaluated the diagnostic accuracy of right pulmonary vein-to-pulmonary artery (RPV/RPA) ratio and RPV indexed to aortic root (Ao) in identifying congestive heart failure (stage C) in dogs with myxomatous mitral valve disease (MMVD). The study enrolled 155 dogs across three disease stages: 58 in stage B1, 38 in stage B2, and 59 in stage C. Measurements were obtained at multiple cardiac cycle points. Results showed that RPV/RPA at end of T wave achieved high sensitivity (96.6%) but poor specificity (36.8%) for detecting stage C disease. The RPV/T wave-to-Ao ratio >1.07 provided superior diagnostic accuracy with 83.1% sensitivity and 71.1% specificity, though this remained comparable to the established left-atrial-to-aortic ratio. The authors acknowledged potential measurement bias from pulmonary hypertension misclassification and post-treatment evaluation effects. Overall, while RPV/RPA shows limited diagnostic value, the indexed RPV measurement demonstrates clinically useful accuracy for identifying MMVD dogs in stage C, supporting its application in clinical practice for heart failure detection.

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