{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T12:44:09Z","timestamp":1777293849997,"version":"3.51.4"},"reference-count":18,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Veterinary Sciences"],"abstract":"<jats:p>Myxomatous mitral valve disease (MMVD) is the most common chronic heart valve disease, leading to left-sided cardiomegaly in dogs. The leaflet\u2013annulus index (LAI) was originally used in humans as a predictor of mitral regurgitation (MR) after mitral valve repair surgery. This index represents the quantity and severity of MR since it is affected by annular dilation. Recently, LAI was adapted to veterinary medicine, and its usefulness as an indicator of annular dilation on 2D transthoracic echocardiography in MMVD dogs was suggested. For this study, 135 Maltese dogs were selected and divided into groups of control, B1, and B2, according to the American College of Veterinary Internal Medicine consensus statement. The following data were collected: radiographic indices including the vertebral heart score and vertebral left atrial size, echocardiographic indices including the left-atrium-to-aortic-root ratio (LA:Ao), left ventricular internal diameter at diastole, normalized for body weight, and anteroposterior length and LAI measured on right parasternal long-axis view. The results showed a significant difference in LAI between each group, becoming smaller as the disease progressed. Also, there was a significant correlation between LAI and each index, showing the strongest correlation with LA:Ao. LAI could be helpful as a new indicator used for the determination of severity and prognosis in Maltese dogs with MMVD.<\/jats:p>","DOI":"10.3390\/vetsci10080493","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T09:24:24Z","timestamp":1690881864000},"page":"493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Correlation between the Leaflet\u2013Annulus Index and Echocardiographic Indices in Maltese Dogs with Myxomatous Mitral Valve Disease"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-4095","authenticated-orcid":false,"given":"Han-Joon","family":"Lee","sequence":"first","affiliation":[{"name":"College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyung-Jin","family":"Park","sequence":"additional","affiliation":[{"name":"Sungsim Animal Medical Center, 131, Gyeryong-ro, Yuseong-gu, Daejeon 34134, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joong-Hyun","family":"Song","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-2035","authenticated-orcid":false,"given":"Kun-Ho","family":"Song","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/jvim.16073","article-title":"Radiographic quantification of left atrial size in dogs with myxomatous mitral valve disease","volume":"35","author":"Lam","year":"2021","journal-title":"J. Vet. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1016\/S0140-6736(09)60692-9","article-title":"Mitral regurgitation","volume":"373","author":"Akins","year":"2009","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jvc.2012.02.001","article-title":"Pathology of myxomatous mitral valve disease in the dog","volume":"14","author":"Fox","year":"2012","journal-title":"J. Vet. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0735-1097(99)00630-0","article-title":"Cardiac remodeling\u2014Concepts and clinical implications: A consensus paper from an international forum on cardiac remodeling","volume":"35","author":"Cohn","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/jvim.15488","article-title":"ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs","volume":"33","author":"Keene","year":"2019","journal-title":"J. Vet. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.2460\/javma.253.8.1038","article-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","volume":"253","author":"Malcolm","year":"2018","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ijcard.2018.01.049","article-title":"Prognostic impact of leaflet-to-annulus index in patients treated with transapical off-pump echo-guided mitral valve repair with NeoChord implantation","volume":"257","author":"Colli","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.rvsc.2022.08.004","article-title":"The leaflet-annulus index in canine myxomatous mitral valve disease","volume":"152","author":"Isaka","year":"2022","journal-title":"Res. Vet. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4142\/jvs.2019.20.1.63","article-title":"Genome-wide association study of degenerative mitral valve disease in Maltese dogs","volume":"20","author":"Lee","year":"2019","journal-title":"J. Vet. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"194","DOI":"10.2460\/javma.1995.206.02.194","article-title":"Vertebral scale system to measure canine heart size in radiographs","volume":"206","author":"Buchanan","year":"1995","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","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","volume":"7","author":"Thomas","year":"1993","journal-title":"J. Vet. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/j.1740-8261.2002.tb01051.x","article-title":"Left atrial to aortic root indices using two-dimesional and M-mode echocardiography in Cavalier King Charles Spaniels with and without left atrial enlargement","volume":"43","author":"Hansson","year":"2002","journal-title":"Vet. Radiol. Ultrasound"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/jvim.14885","article-title":"Longitudinal analysis of quality of life, clinical, radiographic, echocardiographic, and laboratory variables in dogs with preclinical myxomatous mitral valve disease receiving pimobendane or placebo: The EPIC study","volume":"32","author":"Boswood","year":"2018","journal-title":"J. Vet. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.1016\/j.jcin.2019.09.014","article-title":"Impact of the leaflet-to-annulus index on residual mitral regurgitation in patients undergoing edge-to-edge mitral repair","volume":"12","author":"Tabata","year":"2019","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.17555\/jvc.2020.02.37.1.9","article-title":"An assessment of vertebral left atrial size in relation to the progress of myxomatous mitral valve disease in dogs","volume":"37","author":"Kim","year":"2020","journal-title":"J. Vet. Clin."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1292\/jvms.20-0629","article-title":"Comparison of N-terminal pro-atrial natriuretic peptide and three cardiac biomarkers for discriminatory ability of clinical stage in dogs with myxomatous mitral valve disease","volume":"83","author":"Ogawa","year":"2021","journal-title":"J. Vet. Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.14202\/vetworld.2022.2072-2083","article-title":"Evaluation of the association between electrocardiogram parameters and left cardiac remodeling in dogs with myxomatous mitral valve disease","volume":"15","author":"Ogawa","year":"2022","journal-title":"Vet. World"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Menciotti, G., and Borgarelli, M. (2017). Review of diagnostic and therapeutic approach to canine myxomatous mitral valve disease. Vet. Sci., 4.","DOI":"10.3390\/vetsci4040047"}],"container-title":["Veterinary Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-7381\/10\/8\/493\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:23:38Z","timestamp":1760127818000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-7381\/10\/8\/493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["vetsci10080493"],"URL":"https:\/\/doi.org\/10.3390\/vetsci10080493","relation":{},"ISSN":["2306-7381"],"issn-type":[{"value":"2306-7381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}