Two-dimensional, long-axis echocardiographic ratios for assessment of left atrial and ventricular size in dogs

L. E. Strohm, Lance C Visser, E. H. Chapel, W. T. Drost, J. D. Bonagura

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Left ventricular (LV) and left atrial (LA) enlargement affect management and outcome of dogs with cardiac disease. Short-axis, two-dimensional echocardiographic (2DE) images, indexed to the aorta (Ao), are frequently used to identify cardiomegaly. Long-axis images offer complementary views of the left heart. Animals: Eighty healthy dogs and 25 dogs with MMVD. Methods: Healthy dogs were prospectively recruited to determine reference intervals (Clinical Laboratory Standards Institute methodology) for long-axis ratios. Measurement variability and repeatability were quantified by intraclass correlation coefficient and coefficient of variation. Mean long-axis ratios from dogs with MMVD were compared with healthy dogs (unpaired t-test). In addition, the proportion of MMVD dogs exceeding the 97.5 percentile by LV/Ao and a conventional, allometric method were compared (McNemar's test). Results: Two-dimensional echocardiographic long-axis reference intervals were as follows: left ventricular to aortic dimension (LV/Ao) 1.8–2.5; left atrial to aortic dimension (LA/Ao) 1.8–2.4, and left atrial to left ventricular dimension (LA/LV) 0.9–1.1. Intraobserver and interobserver measurement agreement was good-to-excellent (intraclass correlation coefficients ≥0.84), and day-to-day variability was low (coefficient of variations <4%). Left ventricular to aortic dimension, LA/Ao, and LA/LV were significantly greater in canine MMVD compared with healthy dogs (p<0.001). The percentages of MMVD dogs demonstrating LV dilatation by LV/Ao and conventional method were 68% and 36%, respectively (p=0.043, 95% confidence interval for difference 7.9%, 56.1%). Conclusions: Simple 2DE long-axis ratios of LV/Ao, LA/Ao, and LA/LV are repeatable and demonstrate clinical utility for identifying LV and LA enlargement in dogs with MMVD.

Original languageEnglish (US)
JournalJournal of Veterinary Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

aorta
Dogs
Aorta
dogs
Cardiomegaly
heart diseases
methodology
Canidae
Dilatation
repeatability
Heart Diseases
confidence interval
Confidence Intervals
heart
animals

Keywords

  • Canine
  • Cardiomegaly
  • Mitral regurgitation
  • Myxomatous mitral valve disease
  • Ultrasound

ASJC Scopus subject areas

  • Physiology
  • veterinary(all)

Cite this

Two-dimensional, long-axis echocardiographic ratios for assessment of left atrial and ventricular size in dogs. / Strohm, L. E.; Visser, Lance C; Chapel, E. H.; Drost, W. T.; Bonagura, J. D.

In: Journal of Veterinary Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

@article{473742d93b2f4bed960eac924332feb1,
title = "Two-dimensional, long-axis echocardiographic ratios for assessment of left atrial and ventricular size in dogs",
abstract = "Introduction: Left ventricular (LV) and left atrial (LA) enlargement affect management and outcome of dogs with cardiac disease. Short-axis, two-dimensional echocardiographic (2DE) images, indexed to the aorta (Ao), are frequently used to identify cardiomegaly. Long-axis images offer complementary views of the left heart. Animals: Eighty healthy dogs and 25 dogs with MMVD. Methods: Healthy dogs were prospectively recruited to determine reference intervals (Clinical Laboratory Standards Institute methodology) for long-axis ratios. Measurement variability and repeatability were quantified by intraclass correlation coefficient and coefficient of variation. Mean long-axis ratios from dogs with MMVD were compared with healthy dogs (unpaired t-test). In addition, the proportion of MMVD dogs exceeding the 97.5 percentile by LV/Ao and a conventional, allometric method were compared (McNemar's test). Results: Two-dimensional echocardiographic long-axis reference intervals were as follows: left ventricular to aortic dimension (LV/Ao) 1.8–2.5; left atrial to aortic dimension (LA/Ao) 1.8–2.4, and left atrial to left ventricular dimension (LA/LV) 0.9–1.1. Intraobserver and interobserver measurement agreement was good-to-excellent (intraclass correlation coefficients ≥0.84), and day-to-day variability was low (coefficient of variations <4{\%}). Left ventricular to aortic dimension, LA/Ao, and LA/LV were significantly greater in canine MMVD compared with healthy dogs (p<0.001). The percentages of MMVD dogs demonstrating LV dilatation by LV/Ao and conventional method were 68{\%} and 36{\%}, respectively (p=0.043, 95{\%} confidence interval for difference 7.9{\%}, 56.1{\%}). Conclusions: Simple 2DE long-axis ratios of LV/Ao, LA/Ao, and LA/LV are repeatable and demonstrate clinical utility for identifying LV and LA enlargement in dogs with MMVD.",
keywords = "Canine, Cardiomegaly, Mitral regurgitation, Myxomatous mitral valve disease, Ultrasound",
author = "Strohm, {L. E.} and Visser, {Lance C} and Chapel, {E. H.} and Drost, {W. T.} and Bonagura, {J. D.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jvc.2018.07.008",
language = "English (US)",
journal = "Journal of Veterinary Cardiology",
issn = "1760-2734",
publisher = "Elsevier",

}

TY - JOUR

T1 - Two-dimensional, long-axis echocardiographic ratios for assessment of left atrial and ventricular size in dogs

AU - Strohm, L. E.

AU - Visser, Lance C

AU - Chapel, E. H.

AU - Drost, W. T.

AU - Bonagura, J. D.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Left ventricular (LV) and left atrial (LA) enlargement affect management and outcome of dogs with cardiac disease. Short-axis, two-dimensional echocardiographic (2DE) images, indexed to the aorta (Ao), are frequently used to identify cardiomegaly. Long-axis images offer complementary views of the left heart. Animals: Eighty healthy dogs and 25 dogs with MMVD. Methods: Healthy dogs were prospectively recruited to determine reference intervals (Clinical Laboratory Standards Institute methodology) for long-axis ratios. Measurement variability and repeatability were quantified by intraclass correlation coefficient and coefficient of variation. Mean long-axis ratios from dogs with MMVD were compared with healthy dogs (unpaired t-test). In addition, the proportion of MMVD dogs exceeding the 97.5 percentile by LV/Ao and a conventional, allometric method were compared (McNemar's test). Results: Two-dimensional echocardiographic long-axis reference intervals were as follows: left ventricular to aortic dimension (LV/Ao) 1.8–2.5; left atrial to aortic dimension (LA/Ao) 1.8–2.4, and left atrial to left ventricular dimension (LA/LV) 0.9–1.1. Intraobserver and interobserver measurement agreement was good-to-excellent (intraclass correlation coefficients ≥0.84), and day-to-day variability was low (coefficient of variations <4%). Left ventricular to aortic dimension, LA/Ao, and LA/LV were significantly greater in canine MMVD compared with healthy dogs (p<0.001). The percentages of MMVD dogs demonstrating LV dilatation by LV/Ao and conventional method were 68% and 36%, respectively (p=0.043, 95% confidence interval for difference 7.9%, 56.1%). Conclusions: Simple 2DE long-axis ratios of LV/Ao, LA/Ao, and LA/LV are repeatable and demonstrate clinical utility for identifying LV and LA enlargement in dogs with MMVD.

AB - Introduction: Left ventricular (LV) and left atrial (LA) enlargement affect management and outcome of dogs with cardiac disease. Short-axis, two-dimensional echocardiographic (2DE) images, indexed to the aorta (Ao), are frequently used to identify cardiomegaly. Long-axis images offer complementary views of the left heart. Animals: Eighty healthy dogs and 25 dogs with MMVD. Methods: Healthy dogs were prospectively recruited to determine reference intervals (Clinical Laboratory Standards Institute methodology) for long-axis ratios. Measurement variability and repeatability were quantified by intraclass correlation coefficient and coefficient of variation. Mean long-axis ratios from dogs with MMVD were compared with healthy dogs (unpaired t-test). In addition, the proportion of MMVD dogs exceeding the 97.5 percentile by LV/Ao and a conventional, allometric method were compared (McNemar's test). Results: Two-dimensional echocardiographic long-axis reference intervals were as follows: left ventricular to aortic dimension (LV/Ao) 1.8–2.5; left atrial to aortic dimension (LA/Ao) 1.8–2.4, and left atrial to left ventricular dimension (LA/LV) 0.9–1.1. Intraobserver and interobserver measurement agreement was good-to-excellent (intraclass correlation coefficients ≥0.84), and day-to-day variability was low (coefficient of variations <4%). Left ventricular to aortic dimension, LA/Ao, and LA/LV were significantly greater in canine MMVD compared with healthy dogs (p<0.001). The percentages of MMVD dogs demonstrating LV dilatation by LV/Ao and conventional method were 68% and 36%, respectively (p=0.043, 95% confidence interval for difference 7.9%, 56.1%). Conclusions: Simple 2DE long-axis ratios of LV/Ao, LA/Ao, and LA/LV are repeatable and demonstrate clinical utility for identifying LV and LA enlargement in dogs with MMVD.

KW - Canine

KW - Cardiomegaly

KW - Mitral regurgitation

KW - Myxomatous mitral valve disease

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=85051750048&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051750048&partnerID=8YFLogxK

U2 - 10.1016/j.jvc.2018.07.008

DO - 10.1016/j.jvc.2018.07.008

M3 - Article

JO - Journal of Veterinary Cardiology

JF - Journal of Veterinary Cardiology

SN - 1760-2734

ER -