The LISTEN Study
Prospective Multicenter Evaluation of Murmur Localization and Stage-Dependent Grading in Various Canine Cardiac Diseases
The LISTEN STUDY: The world largest digital canine auscultation study
Study objective
The LISTEN Study was a prospective, multicenter observational study conducted across 50 internationally distributed centers.* Examinations were performed by experienced veterinarians with advanced training in cardiology, including board-certified specialists (ACVIM or ECVIM) as well as clinicians holding nationally recognized cardiology qualifications.
Dogs undergoing clinical cardiac evaluation were prospectively enrolled. Digital cardiac auscultation recordings and echocardiographic examinations were obtained during the same clinical visit.
The study aimed to:
- investigate the distribution of PMI recording sites and audibility of heart murmurs from various canine cardiac diseases by echocardiographic diagnosis
- investigate the association of MMVD stage with heart murmur intensity
Patient characteristics and sound samples used
Results
The LISTEN Study demonstrated a strong association between increasing heart murmur intensity and more advanced MMVD stages.
In the study population, over one‑third (38.3%) of dogs with MMVD and a moderate murmur were found to be in stages B2 or C/D.
MMVD murmur grade to disease stage
Results from the LISTEN Study are used within the report generated by the Eko Vet+™ App to provide insights regarding MMVD disease stage** likelihood, where applicable, to support further clinical assessment and owner discussions.
The Eko Vet+ App output does not provide a diagnosis and does not replace echocardiographic assessment. Results should be interpreted by professional veterinary judgement and are not a substitute for veterinary advice.
* The LISTEN study was conceived, developed, and financially supported by Boehringer Ingelheim. The LISTEN study is in the process of submission.
**Murmur intensity is used to estimate the likelihood of MMVD disease stage based on a large, epidemiological canine study.1 Disease stage classifications are based on ACVIM guidelines.2 Definitive staging requires confirmation by diagnostic imaging.
References: 1. The LISTEN Study. 2026. Publication in submission. 2. Keene BW, Atkins CE, Bonagura JD, et al. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 2019;33:1127–1140.
