Utility of vertebral left atrial size and vertebral heart size to aid detection of congestive heart failure in dogs with respiratory signs

Evan S. Ross, Lance C. Visser, Nicholas Sbardellati, Brianna M. Potter, Alex Ohlendorf, Brian A. Scansen 

Background: The page is a scientific article published in the Journal of Veterinary Internal Medicine in 2023. It aims to compare the diagnostic accuracy of vertebral left atrial size (VLAS) and vertebral heart size (VHS) to predict left‐sided congestive heart failure (CHF) in dogs with respiratory signs.

Study: The authors conducted a retrospective cross-sectional study of 114 dogs that had an echocardiogram and thoracic radiographs within 24 hours of each other. The dogs were grouped according to a diagnosis of CHF (yes/no) based on clinical, echocardiographic, and radiographic criteria.

Methods: The authors measured VLAS and VHS from the right lateral thoracic radiographs using a digital caliper. They also measured echocardiographic left atrial size using two different techniques: LA/Ao_Sx and LAD/AoD_Lx. They performed receiver operator characteristic curve analyses and logistic regression analyses to assess the diagnostic accuracy, optimal cut-offs, and independent predictors of CHF for VLAS and VHS.

Results: The authors found that VLAS was a significantly more accurate predictor of CHF than VHS (AUC 0.92 vs 0.85, P = .03). The optimal cut-off for VLAS was >2.3 vertebrae (sensitivity 93.0%, specificity 82.5%). Murmur grade and VLAS were independently associated with CHF, whereas VHS was not. Increased VHS was more common than increased VLAS in dogs without CHF (54% vs 24%, P = .01). The results were similar in a subsample of older and smaller dogs.

Limitations: The authors acknowledged the limitations of their retrospective study design, such as the possibility of misdiagnosis of CHF, the variability of radiographic measurements, the effects of medications on cardiac size and function, and the lack of external validity of their results.

Conclusions: The authors concluded that VLAS and murmur grade have clinical utility to aid in differentiating cardiogenic from noncardiogenic respiratory signs, especially to help rule out CHF in dogs with increased VHS. They suggested that VLAS could help optimize management and outcome of dogs with respiratory signs when echocardiography is not available.

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