D Dickson1, D Caivano2, M Patteson3, M Rishniw4. 1. HeartVets, The Animal Hospital, Dursley, Gloucestershire, GL11 6AJ, UK. Electronic address: dave@heartvets.co.uk. 2. Department of Clinical Sciences, School of Veterinary Medicine, University of Perugia, Perugia, Italy. 3. HeartVets, The Animal Hospital, Dursley, Gloucestershire, GL11 6AJ, UK. 4. Department of Clinical Sciences, Cornell University, Ithaca, NY, USA.
Abstract
INTRODUCTION: Diastolic aortic valve measurements are used to obtain weight-independent cardiac ratiometric indices. However, whether clinically important variations in valve measurements occur during diastole remains undetermined. ANIMALS: One hundred sixty-three dogs and 40 cats; a mixture of healthy animals and patients with heart disease. MATERIALS AND METHODS: Aortic valve diameter and area were measured at three time-points: early diastole {AoMAX}, during the P-wave {AoP} and at end-diastole {AoMIN}. Measurement beat-to-beat variability was determined. Difference plots were generated for each measurement pair. Aortic measurements were compared by repeated measures analysis of variance. RESULTS: In dogs, normalised aortic diameters showed a fixed bias of approximately 14% for AoMAX-AoMIN, 6% for AoMAX-AoP and 8% for AoP-AoMIN. In cats, the aortic diameter and area biases were all less than 2.5% and less than 7% respectively. AoMAX was the largest measurement in 78% patients and AoMIN was the smallest measurement in 73% patients. In dogs, AoMAX > AoP > AoMIN (p < 0.0001). Median within-patient measurement variability was 5% for linear dimensions and 8% for area measurements in dogs and 4.5% for linear and 10.4% for area in cats. DISCUSSION: Aortic measurements in dogs differ significantly throughout diastole, with Ao(A)MAX > Ao(A)P > Ao(A)MIN. These differences could clinically impact cardiac ratiometric indices. The difference in cats is less than the within-patient measurement variability and unlikely to be of clinical significance. CONCLUSIONS: Operators should adopt a single diastolic time-point for measurement of the aorta to ensure consistency in measuring and reporting in echocardiography.
INTRODUCTION: Diastolic aortic valve measurements are used to obtain weight-independent cardiac ratiometric indices. However, whether clinically important variations in valve measurements occur during diastole remains undetermined. ANIMALS: One hundred sixty-three dogs and 40 cats; a mixture of healthy animals and patients with heart disease. MATERIALS AND METHODS: Aortic valve diameter and area were measured at three time-points: early diastole {AoMAX}, during the P-wave {AoP} and at end-diastole {AoMIN}. Measurement beat-to-beat variability was determined. Difference plots were generated for each measurement pair. Aortic measurements were compared by repeated measures analysis of variance. RESULTS: In dogs, normalised aortic diameters showed a fixed bias of approximately 14% for AoMAX-AoMIN, 6% for AoMAX-AoP and 8% for AoP-AoMIN. In cats, the aortic diameter and area biases were all less than 2.5% and less than 7% respectively. AoMAX was the largest measurement in 78% patients and AoMIN was the smallest measurement in 73% patients. In dogs, AoMAX > AoP > AoMIN (p < 0.0001). Median within-patient measurement variability was 5% for linear dimensions and 8% for area measurements in dogs and 4.5% for linear and 10.4% for area in cats. DISCUSSION: Aortic measurements in dogs differ significantly throughout diastole, with Ao(A)MAX > Ao(A)P > Ao(A)MIN. These differences could clinically impact cardiac ratiometric indices. The difference in cats is less than the within-patient measurement variability and unlikely to be of clinical significance. CONCLUSIONS: Operators should adopt a single diastolic time-point for measurement of the aorta to ensure consistency in measuring and reporting in echocardiography.
Authors: K Nakamura; S Kawamoto; T Osuga; T Morita; N Sasaki; K Morishita; H Ohta; M Takiguchi Journal: J Vet Intern Med Date: 2017-02-01 Impact factor: 3.333
Authors: Domenico Caivano; Andrea Corda; Mark Rishniw; Maria Elena Giorgi; Maria Luisa Pinna Parpaglia; Maria Beatrice Conti; Francesco Porciello; Francesco Birettoni Journal: PLoS One Date: 2019-08-14 Impact factor: 3.240