{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:32:39Z","timestamp":1793331159931,"version":"4.5.0"},"reference-count":21,"publisher":"American Veterinary Medical Association (AVMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2018,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE<\/jats:bold>\n                    To describe vertebral left atrial size (VLAS), a quantitative method to estimate left atrial (LA) size radiographically, and to determine its diagnostic value for prediction of echocardiographic LA enlargement in dogs with myxomatous mitral valve disease (MMVD) of varying severity.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DESIGN<\/jats:bold>\n                    Prospective observational study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>ANIMALS<\/jats:bold>\n                    103 client-owned dogs with a left-sided systolic murmur.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>PROCEDURES<\/jats:bold>\n                    For each dog, 3-view thoracic radiographs were obtained within 24 hours of an echocardiographic examination. The VLAS was measured on right and left lateral thoracic radiographs and compared with the left atrium-to-aortic root ratio acquired from short-axis (LA:AoSx) and long-axis (LA:AoLx) echocardiographic images. Left atrial enlargement was defined as an LA:AoLx \u2265 2.6 or LA:AoSx \u2265 1.6. Dogs were allocated to 4 groups on the basis of MMVD severity.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS<\/jats:bold>\n                    Of the 103 dogs, 15, 40, 26, and 22 were assigned to the control (no echocardiographic abnormalities), stage B1 (hemodynamically irrelevant MMVD), B2 (hemodynamically relevant MMVD), and C-D (MMVD with congestive heart failure) groups, respectively. Median VLAS, LA:AoSx, and LA:AoLx for the stage B2 and C-D groups were significantly greater than the corresponding medians for the control and stage B1 groups. There was a moderate positive correlation between VLAS and both LA:AoSx and LA:AoLx. Receiver operating characteristic analyses revealed that a VLAS \u2265 2.3 vertebrae was a useful predictor of LA enlargement. Intraobserver and interobserver agreements for VLAS measurements were high.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSIONS AND CLINICAL RELEVANCE<\/jats:bold>\n                    Results indicated VLAS was a repeatable and useful radiographic measurement for prediction of LA enlargement in dogs with MMVD.\n                  <\/jats:p>","DOI":"10.2460\/javma.253.8.1038","type":"journal-article","created":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T09:19:45Z","timestamp":1538385585000},"page":"1038-1045","source":"Crossref","is-referenced-by-count":101,"title":["Diagnostic value of vertebral left atrial size as determined from thoracic radiographs for assessment of left atrial size in dogs with myxomatous mitral valve disease"],"prefix":"10.2460","volume":"253","author":[{"given":"Elizabeth L.","family":"Malcolm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance C.","family":"Visser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn L.","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynelle R.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"Vet Clin North Am Small Anim Pract","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/j.cvsm.2010.03.008","article-title":"Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy","volume":"40","author":"Borgarelli","year":"2010"},{"key":"ref2","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1111\/j.1939-1676.2011.00860.x","article-title":"Survival characteristics and prognostic variables of dogs with preclinical chronic degenerative mitral valve disease attributable to myxomatous degeneration","volume":"26","author":"Borgarelli","year":"2012"},{"key":"ref3","series-title":"J Vet Cardiol","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.jvc.2012.01.008","article-title":"Prediction of first onset of congestive heart failure in dogs with degenerative mitral valve disease: the PREDICT cohort study","volume":"14","author":"Reynolds","year":"2012"},{"key":"ref4","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.2460\/javma.231.7.1061","article-title":"Results of the veterinary enalapril trial to prove reduction in onset of heart failure in dogs chronically treated with enalapril alone for compensated, naturally occurring mitral valve insufficiency","volume":"231","author":"Atkins","year":"2007"},{"key":"ref5","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1111\/jvim.14586","article-title":"Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: the EPIC study\u2014a randomized clinical trial","volume":"30","author":"Boswood","year":"2016"},{"key":"ref6","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1111\/j.1939-1676.2007.0008.x","article-title":"Survival characteristics and prognostic variables of dogs with mitral regurgitation attributable to myxomatous valve disease","volume":"22","author":"Borgarelli","year":"2008"},{"key":"ref7","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1111\/j.1939-1676.2008.0150.x","article-title":"Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study","volume":"22","author":"H\u00e4ggstr\u00f6m","year":"2008"},{"key":"ref8","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1111\/j.1939-1676.2009.0392.x","article-title":"Guidelines for the diagnosis and treatment of canine chronic valvular heart disease","volume":"23","author":"Atkins","year":"2009"},{"key":"ref9","series-title":"Vet Radiol Ultrasound","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1111\/j.1740-8261.2011.01871.x","article-title":"Value of tracheal bifurcation angle measurement as a radiographic sign of left atrial enlargement in dogs","volume":"53","author":"Le Roux","year":"2012"},{"key":"ref10","series-title":"J Vet Intern Med","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1111\/j.1939-1676.1993.tb01015.x","article-title":"Recommendations for standards in transthoracic two-dimensional echocardiography in the dog and cat. 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