Two-dimensional echocardiographic left- atrial-to-aortic ratio in healthy adult dogs: a reexamination of reference intervals

Section: Methodsmentioning

confidence: 99%

Utility of tricuspid annular plane systolic excursion normalized by right ventricular size indices in dogs with postcapillary pulmonary hypertension

Yuchi

Suzuki

Teshima

et al. 2020

“…LVIDD was normalized to body size (LVIDDN) as previously described 10 . Left atrial and aortic root dimensions were measured by the 2‐D right parasternal short axis view as previously described 11 and normalized to body weight by the following formula: normalized LAD (LADN) = LAD (cm)/BW (kg)^.355 12 . Normalized AoD (AoDN) = AoD (cm)/BW (kg)^.341 10 .…”

Section: Methodsmentioning

confidence: 99%

Utility of radiographic measurements to predict echocardiographic left heart enlargement in dogs with preclinical myxomatous mitral valve disease

Poad

Manzi

Oyama

et al. 2020

Background: Evaluation of left heart size helps determine disease severity in dogs with myxomatous mitral valve disease (MMVD). Hypothesis/Objectives: Determine the ability of radiographic vertebral heart size (VHS) and vertebral left atrial size (VLAS) to predict LHE ECHO in dogs with preclinical MMVD. Animals: Seventy client-owned dogs with MMVD and no historical or present clinical or radiographic evidence of congestive heart failure (CHF). Methods: Retrospective cross-sectional study of dogs with same-day echocardiography and thoracic radiography. Receiver-operating characteristic (ROC) curves were used to assess the ability of VHS, VLAS, and VHS + VLAS to discern dogs with and without LHE ECHO , and clinically relevant cutpoints for these radiographic measurements were selected. Results: The ability of VHS and VHS + VLAS to predict LHE ECHO was moderate (area under the curve [AUC] VHS = 0.851; 95% CI, 0.762-0.941; AUC VHS + VLAS = 0.865; 0.783-0.947), and performance of VLAS and VHS + VLAS was not different from that of VHS alone. A VHS cutpoint of >10.8 had sensitivity = 91.1% (76.3%-98.1%) and specificity = 69.4% (51.9%-83.7%) for predicting LHE ECHO. A cutpoint of >11.7 had sensitivity = 32.4% (17.4%-50.5%) and specificity = 97.2% (85.5%-99.9%) for predicting LHE ECHO. Thirty (43%) of the 70 dogs had a VHS value of 10.9 to 11.7. Conclusions and Clinical Importance: Vertebral heart size >11.7 identified dogs with LHE ECHO and VHS ≤ 10.8 excluded dogs with LHE ECHO. A large percentage of dogs had VHS values intermediate to these cutpoints.

“…It provides a convenient body size-independent measurement of LA size and is typically the representative echocardiographic index of LA size reported in studies of dogs with MMVD. [4][5][6]8 However, potential limitations of this method include incorporating a pulmonary vein in the LA measurement, 23 lack of consistency of timing of the measurements within the cardiac cycle, 24,25 and defining the path of aortic root measurement relative to valve sinuses.…”

Section: Introductionmentioning

confidence: 99%

“…One alternative linear measurement of LA size is the left atrial diameter/dimension (LAD) acquired from a standard right parasternal long-axis 4-chamber image. It can be normalized to body size using an allometric equation 21,25,26 or indexed to the aortic valve diameter (AoD) acquired from a separate standard right parasternal long-axis image of the left ventricular outflow view. 21,27 Doing so avoids incorporating a pulmonary vein, avoids measuring a sinus of Valsalva, and standardizes timing of the measurements for LAD (just before opening of the mitral valve) and AoD (during early to midsystole between the hinge points of the maximally opened aortic valve cusps).…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of echocardiographic indices of left atrial size in dogs with subclinical myxomatous mitral valve disease

Hsue

Visser

2020

Background: Reliability of echocardiographic measurements of left atrial (LA) size, an important marker of disease severity, has not been reported in dogs with myxomatous mitral valve disease (MMVD). Objectives: To define and compare reliability of left atrial dimension/diameter (LAD), LAD indexed to aortic valve diameter (LAD/AoD), left atrium-to-aortic root ratio (LA/Ao), left atrial volume acquired from a right parasternal long-axis (LAV RPLx), and left apical view (LAV LAP) in dogs with subclinical MMVD. Animals: Nine dogs with subclinical MMVD. Methods: Prospective reproducibility study. Dogs underwent 12 echocardiographic examinations by 2 operators on the mornings and afternoons of 3 nonconsecutive days within 1 week. Reliability (measurement variability) was quantified using coefficients of variation (CV) and 95% repeatability/reproducibility coefficients (95% RC). A mixed-model analysis of variance (ANOVA) was used to determine if time of day, day, and operator were significant sources of variability for each index. Results: Linear measurements (LAD, LAD/AoD, and LA/Ao) exhibited less within-day, between-day, and interoperator variability (CVs, 3.9%-12.5%) than did volume estimate measurements (LAV RPLx and LAV LAP ; CVs, 11.8%-17.9%). Of the linear measurements, LA/Ao exhibited greater variability (CVs, 9.9%-12.5%) compared to LAD and LAD/AoD (CVs, 3.9%-4.9%). Operator was a significant (P = .005) source of variability for LA/Ao. Conclusions and Clinical Importance: Compared to other linear measurements, LA/Ao was the least reproducible and most dependent on operator. The 95% RC for each LA size index are provided to help identify clinically relevant changes (beyond intraoperator or interoperator variability) during serial echocardiographic examinations of dogs with subclinical MMVD.