Diagnostic value of peak transmitral flow velocity for left atrial enlargement in dogs with myxomatous mitral valve disease

초록

Objective To investigate factors influencing pulsed-wave Doppler transmitral flow profiles and evaluate their diagnostic value in dogs with myxomatous mitral valve disease (MMVD). Methods Dogs with MMVD underwent echocardiography; thoracic radiography; blood analysis, including N-terminal pro-B-type natriuretic peptide; and clinical staging. Dogs were divided into mitral E/A peak (E/A) reversal and no reversal groups. Correlations of E-wave velocity (E-vel) and peak velocity (P-vel; higher of E or A wave) with MMVD indices were analyzed, and receiver operating characteristic curves assessed diagnostic performance. Results Of 61 dogs, 25 dogs were assigned to the no reversal group and 36 to the reversal group. No significant differences were identified between the groups in most variables. E-wave velocity correlated strongly with left ventricular dila-tion indices (vertebral heart size, left ventricular end-diastolic diameter in diastole normalized for body weight), whereas P-vel correlated more with left atrial (LA) enlargement indices (vertebral LA size, LA-to-aorta ratio, LA fractional shortening) and N-terminal pro-B-type natriuretic peptide. Peak velocity also showed closer association with International Small Animal Cardiac Health Council class than E-vel. Receiver operating characteristic analysis demonstrated E-vel effectively identified LV dilation, whereas P-vel was superior for detecting LA enlargement. Conclusions E-vel may reflect LV dilation, whereas P-vel better may represent LA enlargement and functional burden, particu-larly in dogs with altered transmitral flow profiles. Clinical Relevance Incorporating both E-vel and P-vel provides a more comprehensive assessment of cardiac remodeling in MMVD, supporting improved staging and monitoring in clinical practice.

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