Vertebral Heart Scale for the Brittany Spaniel: Breed-Specific Range and Its Correlation with Heart Disease Assessed by Clinical and Echocardiographic Findings

The vertebral heart scale (VHS) was proposed by Buchanan and Bucheler as an objective method for estimating heart size in dogs. However, several studies have reported significant variation between breeds. The purpose of this retrospective study was to evaluate the VHS and to suggest a useful upper limit for normal heart size in Brittany Spaniels. The VHS was measured using a right lateral view in twenty-eight normal dogs and fifteen dogs with myxomatous mitral valve disease. The mean ± SD (standard deviation) VHS was 10.6 ± 0.2 vertebrae (v) in the normal dogs, which differs significantly from the mean VHS of 9.7 ± 0.5 v in Buchanan’s original study with dogs of various breeds. The VHS in the dogs with myxomatous mitral valve disease was 11.9 ± 1.1 v. With a threshold value of 11.1 vertebrae, the sensitivity, specificity, positive and negative predictive values for diagnosing a cardiomegaly are 90%, 72%, 53% and 96%, respectively.

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Comparison of traditional and sensor-based electronic stethoscopes in beagle dogs

Acta Veterinaria Hungarica ◽

10.1556/avet.2012.049 ◽

2013 ◽

Vol 61 (1) ◽

pp. 19-29

Author(s):

Viktória Szilvási ◽

Károly Vörös ◽

Ferenc Manczur ◽

Jenő Reiczigel ◽

István Novák ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Valve Disease ◽

Mitral Valve Insufficiency ◽

Valve Disease ◽

Beagle Dogs ◽

Electronic Stethoscope ◽

Electronic Sensor ◽

Valve Insufficiency ◽

The Mean ◽

The Right

The objective of this study was to compare the auscultatory findings using traditional and electronic sensor-based stethoscopes. Thirty-three adult healthy Beagles (20 females, 13 males, mean age: 4.8 years, range 1.4–8 years) were auscultated by four investigators with different experiences (INVEST-1, -2, -3 and -4) independently with both stethoscopes. Final cardiological diagnoses were established by echocardiography. Mitral murmurs were heard with both stethoscopes by all investigators and echocardiography revealed mild mitral valve insufficiency in 7 dogs (21%, 4 females, 3 males). The statistical sensitivity (Se) in recognising cardiac murmurs proved to be 82% using the traditional stethoscope and 75% using the electronic one in the mean of the four examiners, whilst statistical specificity (Sp) was 99% by the traditional and 100% by the electronic stethoscope. The means of the auscultatory sensitivity differences between the two stethoscopes were 0.36 on the left and 0.59 on the right hemithorax, demonstrating an advantage for the electronic stethoscope being more obvious above the right hemithorax (P = 0.0340). The electronic stethoscope proved to be superior to the traditional one in excluding cardiac murmurs and especially in auscultation over the right hemithorax. Mitral valve disease was relatively common in this clinically healthy research Beagle population.

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Concomitant Left Atrial Reduction in Rheumatic Mitral Valve Disease with Giant Left Atrium

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000559 ◽

2018 ◽

Vol 13 (5) ◽

pp. 349-355 ◽

Cited By ~ 1

Author(s):

Sudhir Adalti ◽

Kartik G. Patel ◽

Chirag P. Doshi ◽

Chandrashekhar Ananthnarayanan ◽

Chintan N. Mehta ◽

...

Keyword(s):

Mitral Valve ◽

Left Atrium ◽

Mitral Valve Disease ◽

Normal Sinus Rhythm ◽

Heart Association ◽

Persistent Atrial Fibrillation ◽

Valve Disease ◽

Aortic Cross Clamp Time ◽

Giant Left Atrium ◽

The Mean

Objective The giant left atrium is a frequent finding with rheumatic heart disease. The enlarged left atrium was found to be a risk factor for early mortality and postoperative higher thromboembolic events, but its management remains controversial. Most of the surgeons just do the mitral valve procedure without any intervention for enlarged left atrium. We present our center's experience of patients with giant left atrium who underwent a newer technique of left atrium reduction concomitant with mitral valve procedure. Methods Between January 2012 and February 2015, 25 patients, who underwent surgery for concomitant left atrium reduction with mitral valve disease, were included in the study after institute's ethics committee clearance. Patients having combined aortic and mitral valve disease were excluded. Preoperative, intraoperative, and postoperative data were collected. All the patients were also followed up clinically and echocardiographically in postoperative period. Results There were 15 (60%) females. The mean ± SD age of the patients was 36.92 ± 5.4 years. Preoperatively, all patients were in long-standing persistent atrial fibrillation. The mean ± SD bypass and aortic cross-clamp time were 74.56 ± 3.85 and 51.72 ± 4.32 minutes, respectively. There was a significant reduction of left atrium diameter and volume from 94.48 ± 11.0 mm to 40.08 ± 1.35 mm and 348.3 ± 121.1 to 26.57 ± 2.9 mL/m2, respectively. There was no early or late mortality. At a mean ± SD follow-up of 42.28 ± 12.1 months, all patients were in New York Heart Association I or II class and 24 (96%) patients were in normal sinus rhythm. Conclusions Concurrent left atrium reduction with mitral valve procedure is a feasible and effective technique for event-free survival of the patients having giant left atrium with mitral disease.

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Echocardiographic findings in rheumatic mitral valve disease with chordal rupture

Journal of Clinical Ultrasound ◽

10.1002/jcu.1870100209 ◽

1982 ◽

Vol 10 (2) ◽

pp. 79-81

Author(s):

Anthony J. Mourant ◽

John Weaver ◽

Keith Johnston

Keyword(s):

Mitral Valve ◽

Mitral Valve Disease ◽

Valve Disease ◽

Echocardiographic Findings

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Mitraclip for high risk patients with barlow mitral valve disease

European Heart Journal ◽

10.1093/ehjci/ehaa946.1918 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Gavazzoni ◽

M Taramasso ◽

D Voci ◽

A Pozzoli ◽

M Miura ◽

...

Keyword(s):

Mitral Valve ◽

Left Ventricle ◽

Mitral Valve Disease ◽

Nyha Class ◽

Valve Disease ◽

Volume Index ◽

Barlow’S Disease ◽

The Mean ◽

Procedural Success

Abstract Background No data have been published to now about the outcomes of MitraClip in inoperable patients with Barlow's Mitral Valve Disease. Despite the technical advantages of the new generation of MitraClips, the length and the thickness of the mitral leaflets and presence of flails with complete eversion and pseudo-cleft are challenging MitraClip procedure. Purpose To analyse the results of MitraClip in inoperable patients with Barlow's disease of Mitral valve. Methods We retrospectively collected the cases of MR in Barlow's disease treated with MitraClip in our institution from 2012 to 2018. The case were included in the analysis in presence of the following characteristics: bileaflet billowing or prolapse [or both], excessive leaflet tissue, and annular dilatation with or without calcification. Results We included in this analysis 59 patients (mean age 78±8 years, STS mortality score 4±2.9%). Echo data at baseline showed normal left ventricle ejection fraction and diastolic volume and increased left atrial volume index. Half of the included patients had a chordal rupture (n=27, 47%) and in 14 patients (23%) calcification of annulus and/or leaflet was diagnosed. The mean procedural time was 92±41min with a technical success (M-VARC) of 100% and more than 80% of patients requiring more than 1 clip. At 30 days follow-up the device success and the procedural success were respectively 59% and 56%. The mean diastolic mitral valve gradient was 3.1±1.5mmHg. At 30 days follow-up, 91% of the patients were NYHA class II stable patients; no death and no hospitalization occurred. During a median follow-up time of 412 days (IQR: 209–992 days) death for any cause occurred in 23% of the patients (n=14) and 16% of the patients (n=10) died because of a cardiovascular cause; 10 patients were re-hospitalized for heart failure and 5% of the patients (n=3) underwent an open-heart surgery at follow-up time. At univariate cox regression analysis the 1-Y composite end-point (death for any cause, HF re-hospitalization, MV surgery) was predicted by LV dimensions and 30 days procedural success. Conclusions To our knowledge, this is the first analysis of outcomes of Barlow's disease treated with MitraClip. Despite a high incidence of MR recurrence, we observed a good clinical response in term of NYHA class and mortality rate. Left ventricle size and 30-day procedural success predict outcomes. Funding Acknowledgement Type of funding source: None

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Heart valve disease (mitral valve disease): mitral stenosis

10.1093/med/9780198726012.003.0035 ◽

2016 ◽

Author(s):

Bogdan A. Popescu ◽

Shantanu P. Sengupta ◽

Niloufar Samiei ◽

Anca D. Mateescu

Keyword(s):

Mitral Valve ◽

Mitral Stenosis ◽

Three Dimensional ◽

Reference Method ◽

Valve Disease ◽

Heart Valve Disease ◽

Mean Pressure ◽

The Mean ◽

The Relationship ◽

Echocardiographic Findings

The most common cause of mitral stenosis (MS) is rheumatic fever followed by degenerative MS. Echocardiography is the key method to diagnose and evaluate MS. Echocardiographic findings are closely related to aetiology. In rheumatic disease echocardiography shows thickening of leaflet tips with restricted opening caused by commissural fusion resulting in ‘doming’ of the mitral valve in diastole. Quantitation of MS severity includes measuring mitral valve area (MVA) by planimetry (anatomical area, by two-/three-dimensional echo), or by the pressure half-time (PHT) method (functional area, by Doppler), and the mean pressure gradient. Planimetry is considered the reference method to determine MVA as it is relatively load independent. The PHT method is widely used due to its simplicity, but different factors influence the relationship between PHT and MVA. Other indices of MS severity are rarely used in clinical practice. Echocardiography also helps in the assessment of consequences of MS, and of associated valvular lesions. Exercise Doppler is recommended when there is discrepancy between the resting echocardiography findings and the clinical picture. Echocardiography is crucial in determining the timing and type of intervention in patients with MS. When considering percutaneous mitral commissurotomy (PMC) valve morphology should be comprehensively evaluated for mobility, thickness, calcifications, and subvalvular apparatus. The echo findings may determine the suitability for PMC, guide the procedure, and assess its results.

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Small Animal Review

Companion Animal ◽

10.12968/coan.2020.0021 ◽

2020 ◽

Vol 25 (3) ◽

pp. 1-1

Author(s):

Bryn BVSc PhD MRCVS

Keyword(s):

Mitral Valve ◽

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Mitral Valve Disease ◽

Small Animal ◽

Valve Disease ◽

Plasma Atrial Natriuretic Peptide ◽

Echocardiographic Findings ◽

Atrial Natriuretic

Summary: Plasma atrial natriuretic peptide and troponin concentrations interpreted together are useful in assessing the severity of mitral valve disease in the dog and are useful measures to augment echocardiographic findings.

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