Breed-specific values for vertebral heart score (VHS), vertebral left atrial size (VLAS), and radiographic left atrial dimension (RLAD) in pugs without cardiac disease, and their relationship to Brachycephalic Obstructive Airway Syndrome (BOAS)

Abstract

This prospective study aims to establish reference ranges for vertebral heart score (VHS), vertebral left atrial size (VLAS), and radiographic left atrial dimension (RLAD) in pugs. The impact of clinical severity of Brachycephalic Obstructive Airway Syndrome (BOAS), gender, body condition score, and body weight on VHS, VLAS, and RLAD were investigated. Intra- and interobserver correlation was determined. Correlation of radiographic scores to echocardiographic left atrial dimension was inspected. Additionally, for VLAS and RLAD, correlation to VHS was examined. Additionally, an assessment of thoracic and vertebral malformations was performed. Forty-seven privately owned pugs underwent physical examination, echocardiography, and thoracic radiography to determine cardiac health. Thirty-two pugs were eligible for establishing reference ranges for VHS in right lateral radiographs, which was 11.25 ± 0.62 (95% range, 10.1–12.8). Reference ranges for VHS in left lateral, and for VLAS and RLAD in right lateral radiograph were determined in 30 pugs. The VHS in left lateral radiograph was 11.01 ± 0.70 (95% range, 9.4–12.6), VLAS was 1.96 ± 0.38 (95% range, 1.1–2.8), and RLAD was 1.59 ± 0.34 (95% range, 0.7–2.4). Clinical severity of BOAS did not show any impact on radiographic measurements. For VLAS, a significant correlation to VHS was detected by all observers. No other variables had a consistent influence on the radiographic scores given by all observers. Interobserver agreement was almost perfect for VHS (0.89 on right lateral and 0.91 on left lateral image), moderate for VLAS (0.49), and fair for RLAD (0.22). More than one third of the entire study population (18 of 47 pugs) showed at least one thoracic cavity or spine abnormality, often leading to considerable changes in vertebral body shape and size.

Thoracic Vertebral Length-to-Height Ratio, a Promising Parameter to Predict the Vertebral Heart Score in Normal Welsh Corgi Pembroke Dogs

“…These methods were used to evaluate the heart size, focusing on the left atrial dimension, which is commonly enlarged secondary to degenerative mitral valve disease. It has been reported that Cavalier King Charles Spaniels [ 35 ], Chihuahuas [ 19 ], Maltese [ 11 ], and Pug-specific VLAS [ 7 ] have a lower value than the original value reported by Malcolm [ 9 ]. Therefore, the LA assessment using these two techniques should be warranted if there is a variation in the thoracic vertebral characteristics indicated by the T4L/H ratio.…”

“…Several objective methods, such as the cardiothoracic ratio (CTR), cardiac size-to-intercostal space, and vertebral heart score (VHS), have been proposed. In addition, the radiographic left atrial dimension (RLAD) [ 6 , 7 , 8 ] and vertebral left atrial size (VLAS) [ 7 , 8 , 9 , 10 , 11 ] were recently proposed to evaluate the left atrial size on the thoracic radiograph. The CTR was adapted from human medicine [ 12 ] for use in dogs.…”

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

“…Both VLAS and VHS were measured to the nearest 0.1 vertebra. "Increased VLAS" was defined using published breed-specific reference intervals, [14][15][16][17] if available. If unavailable, VLAS >2.2 vertebrae defined increased VLAS.…”

Diagnostic validation of vertebral heart score machine learning algorithm for canine lateral chest radiographs

“…Statistical analysis was done using R version 4.0.4. Graphical analyses and data cleaning were done using ggplot2 and tidyverse (Wickham & RStudio 2017). PB regression, bootstrap confidence intervals and medical decision point analysis were done using the mcr package (Ekaterina Manuilova et al 2014).…”

“…2021, Baisan & Vulpe 2022, Wiegel et al . 2022). The purpose of this study was to assess the performance of the use of a VHS algorithm utilising the simplified Sanchez method compared to manual VHS scoring on 1200 radiographs split between three board‐certified veterinary cardiologists using the Buchanan method.…”