A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease

Myxomatous mitral valve disease (MMVD) is the most common heart disease in small-breed dogs, and accurate assessment of the left atrial (LA) size is essential for diagnosis and management. The traditional echocardiographic method, LA-to-Aorta (LA/Ao) ratio, is widely used, but evaluates LA size in o...

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Main Authors: Minsuk Kim, Minwoong Seo, Chul Park
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Animals
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Online Access:https://www.mdpi.com/2076-2615/15/12/1820
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author Minsuk Kim
Minwoong Seo
Chul Park
author_facet Minsuk Kim
Minwoong Seo
Chul Park
author_sort Minsuk Kim
collection DOAJ
description Myxomatous mitral valve disease (MMVD) is the most common heart disease in small-breed dogs, and accurate assessment of the left atrial (LA) size is essential for diagnosis and management. The traditional echocardiographic method, LA-to-Aorta (LA/Ao) ratio, is widely used, but evaluates LA size in only one view. This study introduces a novel index—the modified-LA/Ao (M-LA/Ao) ratio—which combines two echocardiographic views to better reflect the true LA size. This study retrospectively analyzed thoracic radiographs and echocardiograms from 136 dogs, including healthy controls and dogs with MMVD classified into stages B1, B2, and C according to ACVIM guidelines. The ability of the M-LA/Ao ratio is compared to conventional indices using correlation analysis and receiver operating characteristic (ROC) curves. The M-LA/Ao ratio showed a strong correlation with existing indices and slightly improved discrimination between ACVIM stages B1 and B2, although performance between stages B2 and C was similar to the LA/Ao ratio. Intra- and interobserver variability were also acceptable. Our findings suggest that the M-LA/Ao ratio may provide a practical and sensitive method to evaluate LA enlargement in early-stage MMVD, helping clinicians detect subtle cardiac remodeling before progression to advanced disease.
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spelling doaj-art-97848068f1dc46da971b442ff598ff2b2025-08-20T03:26:24ZengMDPI AGAnimals2076-26152025-06-011512182010.3390/ani15121820A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve DiseaseMinsuk Kim0Minwoong Seo1Chul Park2Department of Veterinary Internal Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Jeonbuk, Republic of KoreaDepartment of Veterinary Internal Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Jeonbuk, Republic of KoreaDepartment of Veterinary Internal Medicine, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Jeonbuk, Republic of KoreaMyxomatous mitral valve disease (MMVD) is the most common heart disease in small-breed dogs, and accurate assessment of the left atrial (LA) size is essential for diagnosis and management. The traditional echocardiographic method, LA-to-Aorta (LA/Ao) ratio, is widely used, but evaluates LA size in only one view. This study introduces a novel index—the modified-LA/Ao (M-LA/Ao) ratio—which combines two echocardiographic views to better reflect the true LA size. This study retrospectively analyzed thoracic radiographs and echocardiograms from 136 dogs, including healthy controls and dogs with MMVD classified into stages B1, B2, and C according to ACVIM guidelines. The ability of the M-LA/Ao ratio is compared to conventional indices using correlation analysis and receiver operating characteristic (ROC) curves. The M-LA/Ao ratio showed a strong correlation with existing indices and slightly improved discrimination between ACVIM stages B1 and B2, although performance between stages B2 and C was similar to the LA/Ao ratio. Intra- and interobserver variability were also acceptable. Our findings suggest that the M-LA/Ao ratio may provide a practical and sensitive method to evaluate LA enlargement in early-stage MMVD, helping clinicians detect subtle cardiac remodeling before progression to advanced disease.https://www.mdpi.com/2076-2615/15/12/1820canineechocardiographyleft atriummyxomatous mitral valve disease
spellingShingle Minsuk Kim
Minwoong Seo
Chul Park
A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease
Animals
canine
echocardiography
left atrium
myxomatous mitral valve disease
title A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease
title_full A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease
title_fullStr A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease
title_full_unstemmed A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease
title_short A Novel Echocardiographic Index (Modified-Left-Atrium-to-Aorta Ratio) for Quantifying Left Atrial Size and Differentiating Stages in Dogs with Myxomatous Mitral Valve Disease
title_sort novel echocardiographic index modified left atrium to aorta ratio for quantifying left atrial size and differentiating stages in dogs with myxomatous mitral valve disease
topic canine
echocardiography
left atrium
myxomatous mitral valve disease
url https://www.mdpi.com/2076-2615/15/12/1820
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