# Evaluation of Cardiomegaly in Dogs Using the Manubrium Heart Score Method and Determination of Its Diagnostic Accuracy in Comparison with the Vertebral Heart Score

## TL;DR

This study compares two methods for measuring heart size in dogs and finds that the Manubrium Heart Score is not a reliable alternative to the Vertebral Heart Score.

## Contribution

The study evaluates the diagnostic accuracy of the Manubrium Heart Score as an alternative to the Vertebral Heart Score in dogs.

## Key findings

- A positive correlation between VHS and MHS was observed in most groups except medium-sized dogs with heart disease.
- MHS showed no correlation with left atrial dimensions.
- VHS showed statistically significant differences in dogs with heart disease, but MHS did not.

## Abstract

Vertebral heart size (VHS) is widely used in clinical practice as a useful objective method to assess the dimensions of the cardiac silhouette. However, this method has several limitations related to breed variations, morphotype, orthopedic conditions, anatomical anomalies and operator-dependent factors. The aim of this study was to evaluate the diagnostic utility of the Manubrium Heart Score (MHS) as an alternative to VHS in the evaluation of cardiac enlargement in dogs. A total of 490 dogs were classified and grouped according to body weight and cardiac health status. VHS and MHS were calculated for each dog. A positive correlation between VHS and MHS was observed in all groups except for medium sized dogs with heart disease. No correlations were observed between MHS and left atrial dimension. Statistically significant differences were observed between VHS and MHS in dogs with heart disease (p < 0.001), but not in all groups (p > 0.05). MHS may not be a valuable tool to use as an alternative to VHS for cardiac enlargement.

Vertebral Heart Score (VHS) is one of the commonly used methods for detecting cardiomegaly in dogs. However, this method has diagnostic limitations due to factors such as breed variations, orthopedic disorders, anatomical anomalies, and operator-dependent subjectivity. The aim of this study was to evaluate the diagnostic utility of the Manubrium Heart Score (MHS) as an alternative to VHS in the assessment of cardiomegaly in dogs. A total of 490 dogs were classified and grouped based on body weight and cardiac health status. On the right lateral thoracic radiographs, MHS was calculated as the ratio of manubrium length (ML) to the sum of the long-axis heart length (cLAL) and short-axis heart length (cSAL). Similarly, VHS was determined. A positive correlation between VHS and MHS, as well as between ML and cSAL/cLAL, were observed in all groups except for the group of medium sized dogs with heart diseases. No correlations were found between MHS and LA or the LA/Ao ratio. In pairwise comparisons of VHS and MHS between heart-diseased and healthy dogs, the mean VHS showed a statistically significant difference in heart-diseased dogs (p < 0.001), and not across all groups (p > 0.05). MHS may not consider a useful method as an alternative to VHS.