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Research article2022Peer reviewedOpen access

Prediction of clinically important acquired cardiac disease without an echocardiogram in large breed dogs using a combination of clinical, radiographic and electrocardiographic variables

Wesselowski, S.; Gordon, S. G.; Meddaugh, N.; Saunders, A. B.; Haeggstrom, J.; Cusack, K.; Janacek, B. W.; Matthews, D. J.


Introduction: Large breed (LB) dogs develop dilated cardiomyopathy (DCM) and myxomatous mitral valve disease (MMVD). Echocardiography is required for a definitive diagnosis but is not always available. Our objective was to assess the clinical utility of thoracic radiographs alone and in combination with physical examination and electrocardiography findings for the prediction of clinically important DCM or MMVD in LB dogs. Animals: Four hundred fifty-five client-owned dogs >20 kg with concurrent thoracic radiographs and echocardiogram. Materials and methods: Medical records were reviewed and stored thoracic radio-graphs and echocardiographic images were measured to classify dogs as normal heart size (NHS), preclinical DCM, clinical DCM, preclinical MMVD (with cardiome-galy), clinical MMVD, or equivocal. Dogs with preclinical MMVD, without cardiome-galy, were classified as NHS. Vertebral heart size (VHS) and vertebral left atrial size (VLAS) were measured. Receiver operating characteristic curves and prediction models were derived. Results: Prevalence of MMVD (39 .3%) was higher than the prevalence of DCM (24.8%), though most MMVD dogs (67.0%) lacked cardiomegaly and were classified as NHS for analysis. The area under the curve for VHS to discriminate between NHS and clinical DCM/MMVD or preclinical DCM/MMVD was 0.861 and 0.712, respec-tively, while for VLAS, it was 0.891 and 0.722, respectively. Predictive models incor-porating physical examination and electrocardiography findings in addition to VHS/ VLAS increased area under the curve to 0.978 (NHS vs. clinical DCM/MMVD) and 0.829 (NHS vs. preclinical DCM/MMVD). Conclusions: Thoracic radiographs were useful for predicting clinically important DCM or MMVD in LB dogs, with improved discriminatory ability when physical exam-ination abnormalities and arrhythmias were accounted for.@ 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (


Dilated cardiomyopa-thy; Myxomatous mitral valve disease; VHS; VLAS; Murmur

Published in

Journal of Veterinary Cardiology
2022, Volume: 40, pages: 126-141
Publisher: ELSEVIER

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    Clinical Science

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