The Mitral INsufficiency Echocardiographic score: A severity classification of myxomatous mitral valve disease in dogs.
cardiac death
heart failure
mitral regurgitation
prognosis
survival
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
29
03
2021
received:
08
07
2020
accepted:
07
04
2021
pubmed:
6
5
2021
medline:
29
6
2021
entrez:
5
5
2021
Statut:
ppublish
Résumé
There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables. To propose an easy-to-use echocardiographic classification of severity of MMVD in dogs. Five hundred and sixty dogs with MMVD. This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium-to-aorta ratio, left ventricular end-diastolic diameter normalized for body weight, fractional shortening, and E-wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4-5), moderate (score: 6-7), severe (score: 8-12), late stage (score: 13-14). Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877-2810 days), moderate (1882 days, 95% CI 1341-2434 days), severe (623 days, 95% CI 432-710 days), and late stage (157 days, 95% CI 53-257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001). The MINE score is a new easy-to-use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.
Sections du résumé
BACKGROUND
BACKGROUND
There is no commonly shared severity score for myxomatous mitral valve disease (MMVD) based on routinely acquired echocardiographic variables.
HYPOTHESIS/OBJECTIVES
OBJECTIVE
To propose an easy-to-use echocardiographic classification of severity of MMVD in dogs.
ANIMALS
METHODS
Five hundred and sixty dogs with MMVD.
METHODS
METHODS
This was a retrospective, multicenter, observational study. The proposed Mitral INsufficiency Echocardiographic (MINE) score was based on 4 echocardiographic variables: left atrium-to-aorta ratio, left ventricular end-diastolic diameter normalized for body weight, fractional shortening, and E-wave transmitral peak velocity. Specific echocardiographic cutoffs were defined based on previous prognostic studies on MMVD, and severity scores were assigned as follows: mild (score: 4-5), moderate (score: 6-7), severe (score: 8-12), late stage (score: 13-14).
RESULTS
RESULTS
Median survival time was significantly different (P < .05) between the proposed severity classes: mild (2344 days, 95% confidence interval [CI] 1877-2810 days), moderate (1882 days, 95% CI 1341-2434 days), severe (623 days, 95% CI 432-710 days), and late stage (157 days, 95% CI 53-257 days). A MINE score >8 was predictive of cardiac death (area under the curve = 0.85; P < .0001; sensitivity 87%, specificity 73%). In the multivariable analysis, all the echocardiographic variables of the MINE score were independent predictors of death because of heart disease (P < .001).
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
The MINE score is a new easy-to-use echocardiographic classification of severity of MMVD, which has been proven to be clinically effective as it is associated with survival. This classification provides prognostic information and could be useful for an objective echocardiographic assessment of MMVD.
Identifiants
pubmed: 33951235
doi: 10.1111/jvim.16131
pmc: PMC8163114
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study, Veterinary
Langues
eng
Sous-ensembles de citation
IM
Pagination
1238-1244Informations de copyright
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Références
Vet Radiol Ultrasound. 2002 Nov-Dec;43(6):568-75
pubmed: 12502113
J Vet Intern Med. 2017 Jul;31(4):1008-1016
pubmed: 28573754
J Vet Intern Med. 2018 Nov;32(6):1803-1822
pubmed: 30353952
J Vet Cardiol. 2012 Mar;14(1):269-79
pubmed: 22366569
Adv Vet Sci Comp Med. 1977;21:75-106
pubmed: 146409
J Vet Intern Med. 2016 Nov;30(6):1765-1779
pubmed: 27678080
J Vet Cardiol. 2012 Mar;14(1):127-48
pubmed: 22366573
J Vet Intern Med. 2014 Sep-Oct;28(5):1527-33
pubmed: 25056960
J Vet Cardiol. 2015 Mar;17(1):1-12
pubmed: 25586168
J Vet Intern Med. 2015 Mar-Apr;29(2):569-74
pubmed: 25818210
J Vet Intern Med. 2019 Mar;33(2):489-498
pubmed: 30793808
J Vet Intern Med. 2004 May-Jun;18(3):311-21
pubmed: 15188817
J Vet Cardiol. 2012 Mar;14(1):193-202
pubmed: 22366568
J Vet Intern Med. 2016 May;30(3):697-705
pubmed: 27177623
J Small Anim Pract. 2009 Sep;50 Suppl 1:12-24
pubmed: 19765216
J Vet Intern Med. 2014 Jul-Aug;28(4):1206-13
pubmed: 24934609
J Vet Intern Med. 2003 Jan-Feb;17(1):84-8
pubmed: 12564731
JACC Cardiovasc Imaging. 2010 Mar;3(3):235-43
pubmed: 20223419
J Vet Intern Med. 2021 May;35(3):1238-1244
pubmed: 33951235
J Vet Intern Med. 2012 Jan-Feb;26(1):69-75
pubmed: 22211523
Vet Rec. 1999 Mar 20;144(12):315-20
pubmed: 10212505
J Vet Cardiol. 2016 Jun;18(2):137-45
pubmed: 27009978
Vet Radiol Ultrasound. 2000 Nov-Dec;41(6):543-9
pubmed: 11130798
J Vet Intern Med. 2008 Jan-Feb;22(1):120-8
pubmed: 18289298
J Vet Intern Med. 2019 May;33(3):1127-1140
pubmed: 30974015
J Small Anim Pract. 2010 Feb;51(2):84-96
pubmed: 20070494
J Small Anim Pract. 2015 Nov;56(11):641-50
pubmed: 26473746
J Vet Cardiol. 2017 Oct;19(5):433-440
pubmed: 28964709
J Am Vet Med Assoc. 2005 Sep 1;227(5):743-7
pubmed: 16178395
J Vet Intern Med. 2017 Mar;31(2):303-310
pubmed: 28109120
Can Vet J. 2011 Nov;52(11):1219-25
pubmed: 22547843
J Am Soc Echocardiogr. 2017 Apr;30(4):303-371
pubmed: 28314623
J Vet Intern Med. 2019 Sep;33(5):1909-1920
pubmed: 31313382
J Vet Cardiol. 2020 Feb;27:34-53
pubmed: 32032923
J Vet Cardiol. 2011 Dec;13(4):267-70
pubmed: 22036803
J Vet Intern Med. 2010 Nov-Dec;24(6):1358-68
pubmed: 20840304
J Vet Cardiol. 2003 Nov;5(2):33-8
pubmed: 19081363
J Vet Intern Med. 1993 Jul-Aug;7(4):247-52
pubmed: 8246215
J Am Vet Med Assoc. 2007 Aug 1;231(3):399-406
pubmed: 17669041
Eur Heart J Cardiovasc Imaging. 2013 Jul;14(7):611-44
pubmed: 23733442