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How many dogs with mild left atrial enlargement, but without LV enlargement, might consequently be misclassified as having cardiomegaly remains unknown." The investigators recommend that such breeds as the CKCS "likely require breed-specific reference intervals for LVIDDN to correctly identify left ventricular enlargement." In a March 2024 article, French researchers studied the echocardiographic measurements of 155 cavaliers (128 diagnosed with mitral valve disease and 27 without MVD), comparing linear measurements of the left atrium (LA) with volumetric measurements, including monoplane and biplane Simpson's methods of discs (SMOD) and area-length methods (ALM)

Their selection for the study did not consider whether they had symptoms or a history of sleep apnea, according to Van Cauter

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