Influence of Morphometry on Echocardiographic Measurements in Cavalier King Charles Spaniels: An Inverse Probability Weighting Analysis

Abstract

The development and progression of myxomatous mitral valve disease (MMVD) in Cavalier King Charles Spaniels (CKCS) are difficult to predict. Thus, the identification of dogs with a morphotype associated with more severe mitral disease at a young age is desirable. The aims of this study were to: (1) describe the physical, morphometric, and echocardiographic features of class B1 MMVD-affected Cavalier King Charles Spaniels (CKCS) according to the American College of Veterinary Internal Medicine (ACVIM) guidelines; (2) evaluate the influence of morphometric physical measurements on murmur intensity, mitral valve prolapse (MVP), regurgitant jet size, and indexed mitral valve and annulus measurements. Fifty-two MMVD-affected CKCS were included in the ACVIM class B1. This is a prospective clinical cross-sectional study. Morphometric measurements, which included the body, thorax, and head sizes of each dog, were investigated to establish the association with heart murmur intensity, valvular and annular echocardiographic measurements, MVP, and regurgitant jet size, using inverse probability weighting (IPW) analyses to adjust for confounding. The IPW analyses showed that when the head length and nose length decreased, dogs had a more severe regurgitant jet size. Furthermore, subjects with a more pronounced head stop angle had thicker anterior mitral valve leaflets. A brachycephalic morphotype, as seen in dogs similar to the King Charles Spaniel breed in terms of cephalic morphology, is associated with a more severe regurgitant jet size and with valvular characteristics that are related to the most severe forms of MMVD.

Preliminary prospective study on the predictive significance of plasma miR-30b-5p through the study of echocardiographic modifications in Cavalier King Charles Spaniels affected by different stages of myxomatous mitral valve disease: the PRIME study

“…A study published by Bagardi et al [7] conducted on the CKCS recently provided interesting results for miR-30b-5p in ACVIM class B1 CKCSs, demonstrating that miR-30b-5p can discriminate between B1 subjects and healthy dogs, and B1 CKCSs younger than 3 years of age and healthy dogs [7]. Since a heart murmur is uncommon to detect in young patients and echocardiographic changes can be misclassified as normal findings by inexperienced sonographers, miR-30b-5p can support the early diagnosis of MMVD-affected dogs [32]. The results reported in the present study may further strengthen the potential clinical utility of miR-30b-5p measurement in CKCSs affected by MMVD.…”

“…The Inverse Probability Weighting (IPW) method was performed to face confounding biases using “R” software [32] to estimate the association of the exposure variable (miR-30b-5p) with the outcome variables (clinical and echocardiographic variables) considering the time. The regressors were miR-30b-5p, time, and their interaction.…”

Prospective pilot study on the predictive significance of plasma miR-30b-5p through the study of echocardiographic modifications in Cavalier King Charles Spaniels affected by different stages of myxomatous mitral valve disease: The PRIME study

“…A study published by Bagardi et al [ 7 ] conducted on the CKCS recently provided interesting results for miR-30b-5p in ACVIM class B1 CKCSs, demonstrating that miR-30b-5p can discriminate between B1 subjects and healthy dogs, and B1 CKCSs younger than 3 years of age and healthy dogs [ 7 ]. Since a heart murmur is uncommon to detect in young patients and echocardiographic changes can be misclassified as normal findings by inexperienced sonographers, miR-30b-5p can support the early diagnosis of MMVD-affected dogs [ 34 ]. The results reported in the present pilot study may further strengthen the potential clinical utility of miR-30b-5p measurement in CKCSs affected by MMVD.…”

“…The Inverse Probability Weighting (IPW) method was performed to face confounding biases using “R” software [ 34 ] to estimate the association of the exposure variable (miR-30b-5p) with the outcome variables (clinical and echocardiographic variables) considering the time. The regressors were miR-30b-5p, time, and their interaction.…”

“…Obtained values were defined as statistically significant at a P value < 0.05, and all the significance values were adjusted according to the Bonferroni post hoc correction. The Inverse Probability Weighting (IPW) method was performed to face confounding biases using "R" software [34] to estimate the association of the exposure variable (miR-30b-5p) with the outcome variables (clinical and echocardiographic variables) considering the time. The regressors were miR-30b-5p, time, and their interaction.…”