RESUMO
INTRODUCTION/OBJECTIVES: In clinical practice, dogs are screened for subaortic stenosis (SAS) using two-dimensional (2DE) and Doppler echocardiography. There is no accepted antemortem diagnostic criterion to distinguish between mild SAS and unaffected, therefore additional means of evaluating the left ventricular outflow tract (LVOT) and aorta may be desirable. This study sought to determine and compare LVOT and aortic orifice areas using 2DE and three-dimensional echocardiography (3DE) in apparently healthy dogs of various breeds and somatotypes. ANIMALS, MATERIALS, AND METHODS: Sixty-nine healthy, privately-owned dogs. The LVOT and aortic orifice areas were determined using 2DE aortic valve (AV) diameter-derived area; the continuity equation (CE); and 3DE planimetry of the LVOT, AV, sinus of Valsalva, and sinotubular junction. Orifice areas were indexed to body surface area (BSA). RESULTS: Obtaining 3DE images and performing planimetry were feasible in all dogs. The mean indexed area measured using the 2DE AV diameter (2.85 cm2/m2) was significantly lower than that derived from 3DE AV planimetry (3.85 cm2/m2; mean difference, 1.00 cm2/m2; P<0.001). There was poor agreement between the effective area calculated using the CE and the anatomic areas calculated using 2DE AV diameter and 3DE planimetry. The area calculated using the CE was less than all other calculations of area. Interobserver and intraobserver repeatability and reproducibility for 3DE planimetry were excellent. CONCLUSIONS: Methods for determining aortic orifice areas in dogs are not interchangeable, and this must be taken into account if these methods are investigated in the evaluation of dogs with SAS in the future.
Assuntos
Ecocardiografia Tridimensional , Cães/anatomia & histologia , Animais , Ecocardiografia Tridimensional/veterinária , Ecocardiografia Tridimensional/métodos , Masculino , Feminino , Doenças do Cão/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ecocardiografia/veterinária , Valva Aórtica/diagnóstico por imagem , Aorta/diagnóstico por imagemRESUMO
Transcatheter pulmonary valve implantation (TPVI) is indicated for use in the management of failing pulmonary valves in humans. We report here the long-term follow-up of the first documented transcatheter pulmonary valve implanted in a client-owned dog. A one-year-old Beagle dog with severe congenital type A valvular pulmonic stenosis first underwent percutaneous balloon pulmonary valvuloplasty, leading two years later to severe pulmonary regurgitation. A TPVI using a Melody™ bioprosthetic valve was then successfully performed, with normalization of the right heart cavities. Repeated two- and three-dimensional transthoracic echocardiographic examinations combined with Doppler modes confirmed the appropriate position and function of the valve for four years. Mitral myxomatous valvular degeneration led to refractory left-sided congestive heart failure, and the dog was humanely euthanized. After postmortem examination, X-ray imaging and histopathological evaluation of the stent and the valve were performed. Ex-vivo imaging of the implanted valve using a Faxitron® Path radiography system and microscopic evaluation of the implanted stent and bioprosthetic leaflets did not show any relevant leaflet or stent alterations. This case provides a proof of concept in interventional veterinary cardiology, showing that TPVI can be performed in dogs with subsequent long-term maintaining normal pulmonary valve function.
Assuntos
Doenças do Cão , Implante de Prótese de Valva Cardíaca , Estenose da Valva Pulmonar , Valva Pulmonar , Animais , Cães , Doenças do Cão/cirurgia , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/patologia , Estenose da Valva Pulmonar/veterinária , Estenose da Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/cirurgia , Valva Pulmonar/cirurgia , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/patologia , Implante de Prótese de Valva Cardíaca/veterinária , Implante de Prótese de Valva Cardíaca/instrumentação , Ecocardiografia Tridimensional/veterinária , Insuficiência da Valva Pulmonar/veterinária , Insuficiência da Valva Pulmonar/cirurgia , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Ecocardiografia/veterinária , Bioprótese/veterinária , Masculino , Próteses Valvulares Cardíacas/veterinária , FemininoRESUMO
BACKGROUND: Many canine cardiac diseases are associated with left atrial (LA) remodeling and decreased function. For accurate assessment of LA indices, large-scale and prospectively determined reference intervals are necessary. OBJECTIVES: To generate reference intervals of LA size and function using two-dimensional and three-dimensional echocardiography. ANIMALS: Two hundred and one healthy adult dogs. METHODS: Left atrial volume was assessed in right parasternal long-axis, left apical four-chamber and two-chamber views using monoplane Simpson's method, two-dimensional and three-dimensional speckle tracking. Additionally, LA diameter was measured in right parasternal short-axis and long-axis views. Furthermore, LA function was determined by measuring strain and calculating LA fractional shortening and ejection fraction. All variables were tested for correlation to heart rate, age, and body weight. For LA diameter and volume, scaling exponents and prediction intervals were generated using allometric scaling. Reference intervals for LA function parameters were calculated using nonparametric methods. RESULTS: Left atrial diameter and volume showed a strong correlation with body weight. The scaling exponent for LA diameter was approximately 1/3 (0.34-0.40) and approximately one for volume measurements (0.97-1.26). Parameters of LA function showed no clinically relevant correlation with body weight, except for two variables, which showed a mild negative correlation. No clinically relevant correlations with age or heart rate were found. CONCLUSIONS: Reference intervals for linear, two-dimensional and three-dimensional measurements of LA size and function were established. The wide range of measurement methods offers the opportunity to select the appropriate reference values for LA evaluation depending on the available technical possibilities.
Assuntos
Função do Átrio Esquerdo , Ecocardiografia Tridimensional , Ecocardiografia , Átrios do Coração , Animais , Cães/anatomia & histologia , Valores de Referência , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/anatomia & histologia , Feminino , Ecocardiografia Tridimensional/veterinária , Ecocardiografia Tridimensional/métodos , Masculino , Ecocardiografia/veterinária , Função do Átrio Esquerdo/fisiologiaRESUMO
The unique imaging capabilities of transesophageal echocardiography (TEE) make it a valuable tool for characterizing the structure and function of the heart and for providing procedural monitoring. With the creation of new devices and expansion of procedural options with increased applications, multiplanar and three-dimensional imaging with TEE can be essential for clinical decision making. A description of the indications and clinical application of TEE in animals while highlighting probe characteristics, limitations and patient safety are the focus of this review. The increased availability of three-dimensional imaging in smaller probes, advanced applications including photorealistic and fusion imaging, and the development of recommended standards for performing a comprehensive TEE imaging study including training guidelines may facilitate the use of TEE in the veterinary field.
Assuntos
Ecocardiografia Tridimensional , Ecocardiografia Transesofagiana , Animais , Ecocardiografia Transesofagiana/veterinária , Ecocardiografia Transesofagiana/métodos , Coração , Ecocardiografia Tridimensional/veterináriaRESUMO
Real-time three-dimensional echocardiography (RT3DE) is increasingly available in the veterinary field due to continuous reduction in costs and improvement of equipment. Much like its motion-mode and bi-dimensional counterparts, acquisition and analysis of RT3DE images and datasets is greatly improved by a thorough understanding of the technological aspects, basic physic principles, and knowledge of available modalities with their advantages and drawbacks. In this review, the authors aim to describe how the currently available RT3DE technology has evolved, explain technical aspects of the equipment, and illustrate the most commonly available modalities for image acquisition and visualization.
Assuntos
Ecocardiografia Tridimensional , Animais , Ecocardiografia Tridimensional/veterinária , Reprodutibilidade dos TestesRESUMO
Transseptal puncture is necessary to access the left atrium and mitral valve from a transvenous approach but is poorly described in veterinary medicine. The procedure is generally regarded as difficult and dangerous, particularly given the size of most small animal patients. Precise imaging is paramount to the procedure to ensure that puncture occurs within the desired location and to monitor for potential complications. Transesophageal echocardiography, including biplanar two-dimensional and particularly three-dimensional modalities, has great potential to improve the success and safety of transseptal puncture due to superior visualization of the fossa ovalis and other intracardiac structures. Here, we describe the use of transesophageal echocardiography to guide transseptal puncture based on our experience in 159 dogs, with an emphasis on three-dimensional echocardiography. We also detail how to perform transseptal puncture from a jugular approach, which we consider preferable in most patients. Complications from transseptal puncture are discussed, along with ways to limit those complications.
Assuntos
Ablação por Cateter , Ecocardiografia Tridimensional , Humanos , Cães , Animais , Ecocardiografia Transesofagiana/veterinária , Cateterismo Cardíaco/métodos , Cateterismo Cardíaco/veterinária , Átrios do Coração/diagnóstico por imagem , Ecocardiografia Tridimensional/veterinária , Punções/veterinária , Punções/métodos , Ablação por Cateter/veterináriaRESUMO
This review includes 36 studies of transthoracic real-time three-dimensional echocardiography (RT3DE) in animals. Most of these studies concern cardiac chamber quantification of the left atrium and left ventricle, in dogs. Comparisons of RT3DE and different two-dimensional echocardiographic (2DE) methods have been reported in dogs with myxomatous mitral valve disease (MMVD), dilated cardiomyopathy, and in healthy control dogs. Comparisons of RT3DE and standard reference methods have been reported in healthy control dogs. In dogs with MMVD, volumetric RT3DE measurements of left atrium do not appear to provide superior prognostic value compared with 2DE methods using Simpson's method of discs in dogs with MMVD. The major advantages of RT3DE compared to 2DE include improvements in visualization of the complex morphology of the mitral valve, the estimation of mitral valve regurgitation, and improved visualization of complex congenital cardiac abnormalities.
Assuntos
Doenças do Cão , Ecocardiografia Tridimensional , Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Animais , Cães , Ecocardiografia Tridimensional/veterinária , Ecocardiografia/veterinária , Ecocardiografia/métodos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/veterinária , Valva Mitral/diagnóstico por imagem , Doenças das Valvas Cardíacas/veterinária , Doenças do Cão/diagnóstico por imagemRESUMO
BACKGROUND: Left atrial size predicts cardiac morbidity and mortality in humans and dogs. Real-time three-dimensional echocardiography (3DE) may be reliable for assessing left atrial volume (LAV) in horses. OBJECTIVES: To determine intra- and interobserver variability estimates of 3DE-LAV and compare it to that of 2DE-LAV estimates. STUDY DESIGN: Method comparison. METHODS: 3DE datasets were obtained from 40 horses, then graded for quality, creating a final study population of 22 horses. The 3DE and 2DE maximum LAV (LAVmax ) and minimum LAV (LAVmin ) were measured, and left atrial emptying volume (LA EV) and left atrial ejection fraction (LA EF) were calculated, from the same 3D dataset on four occasions using (a) a semi-automatic surface recognition algorithm and (b) a modified Simpson's method of discs. 3DE LAV measurements were repeated by a second observer. RESULTS: For 3DE, median LAVmax was 596cm3 for observer one, and 852 cm3 for observer two, LAVmin was 373 cm3 for observer one and 533 cm3 for observer two. Low intraobserver measurement variation was observed for LAVmax and LAVmin , with horse-level intraclass correlation coefficients (ICChorse ) for both observers between 76% and 85% (horse added as random effect). The interobserver ICC was 58% for LAVmax and 50% for LAVmin on averaged measurements (with observer added as random effect), indicating consistent differences between observers. While intraobserver variation was similar for 2DE LAVmax measurements, it was greater for LAVmin (ICChorse = 67%). The intermethod ICC for 3DE vs 2DE was low at 14% for LAVmax and ~0% for LAVmin , indicating less-consistent differences with method. MAIN LIMITATIONS: Small study population, low observer number, use of different imaging modalities (fundamental frequency and octave harmonics). CONCLUSIONS: 3DE assessment of LAV was reliable, suggesting suitability for longitudinal evaluation of clinical cases. Clinicians should be aware of differences in LAV measurements between observers. More defined measurement guidelines may improve repeatability.
Assuntos
Ecocardiografia Tridimensional , Cavalos , Animais , Ecocardiografia/veterinária , Ecocardiografia Tridimensional/veterinária , Átrios do Coração/diagnóstico por imagem , Variações Dependentes do Observador , Reprodutibilidade dos TestesRESUMO
INTRODUCTION: Mitral valve area (MVA) planimetry is used to diagnose and classify mitral stenosis (MS) in humans using two-dimensional and three-dimensional echocardiography (MVA2D and MVA3D). This study aimed to evaluate agreement, feasibility, and observer variability between MVA2D and MVA3D in English Bull Terriers (BT). Our hypotheses were (1) that the MVA of BT is generally smaller than that of breeds with similar body weight and (2) that these techniques could be used to diagnose MS in BTs. ANIMALS: Twenty healthy BTs, 15 healthy Boxers, and 49 BTs with heart disease. MATERIALS AND METHODS: A prospective diagnostic agreement study was conducted. All dogs underwent a thorough clinical examination, conventional transthoracic echocardiography, and three-dimensional echocardiography. RESULTS: Bland-Altman plots (limits of agreement: 0.12-1.5) showed consistent bias and poor agreement between MVA2D and MVA3D. For the 69 BTs, MVA3D (2.1 ± 0.50 cm2) measurements were significantly lower than MVA2D measurements (2.9 ± 0.60 cm2), and healthy BTs had significantly lower MVA parameters than healthy Boxers (p < 0.001). Intraobserver and interobserver variability were excellent for both MVA2D and MVA3D (intraclass correlation coefficient >0.9). Six BTs were diagnosed with MS, with MVA3D less than 1.8 cm2 and a mean transmitral gradient (MTG) of more than 5 mmHg. CONCLUSIONS: Both MVA2D and MVA3D are feasible, have low observer variability and can be used to diagnose MS in BTs. For assessing the narrowest orifice area, the preferred method is MVA3D. The smaller MVA in BTs compared to Boxers may indicate some degree of MS.
Assuntos
Doenças do Cão , Ecocardiografia Tridimensional , Estenose da Valva Mitral , Animais , Doenças do Cão/diagnóstico por imagem , Cães , Ecocardiografia Tridimensional/veterinária , Ecocardiografia Transesofagiana , Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/veterinária , Estudos ProspectivosRESUMO
Information about antemortem cardiac evaluation in sea otters (Enhydra lutris) is limited, despite well-established clinical care and rehabilitation procedures and a reported elevated risk of cardiac disease for this species. Serum cardiac troponin I (cTnI) concentration and echocardiographic assessment are two ways of screening for and diagnosing cardiac disease. However, no baseline data or reference intervals for either evaluation are published for sea otters. The objectives of this prospective study were to establish serum cTnI concentrations and echocardiographic technique and quantitative measurements in anesthetized healthy female southern sea otters (Enhydra lutris nereis) (n=15). Serum cTnI values were assessed by a high-sensitivity assay. Serum cTnI concentration ranged from <0.006 to 0.038 ng/ml. A complete echocardiogram, including two-dimensional and M-mode modalities, was performed. Echocardiographic measurements for left atrial size, aorta size, left ventricular structure, and left ventricular function were reported. The median left atrial size to aorta ratio was 1.22 (range 0.80-1.59) in short-axis and 1.70 (range 1.39-2.15) in long-axis. The median left ventricular internal dimension was 3.53 cm (range 2.87-4.92 cm) when assessed in two dimensions and 3.58 cm (range 2.80-4.48 cm) by M-mode. Serum concentrations of cTnI and transthoracic echocardiography may represent valuable tools for the antemortem diagnosis of cardiac disease in sea otters.
Assuntos
Anestesia/veterinária , Ecocardiografia Tridimensional/veterinária , Lontras , Troponina/sangue , Envelhecimento , Animais , Estudos Transversais , Ecocardiografia Tridimensional/métodos , Feminino , Estudos ProspectivosRESUMO
INTRODUCTION: Information about real-time three-dimensional (3D) transesophageal echocardiography (TEE) for the evaluation of canine mitral valve morphology is lacking in veterinary medicine. OBJECTIVES: To evaluate the feasibility of 3D TEE for the evaluation of canine mitral valves and whether there was a difference in mitral valve morphology between American College of Veterinary Internal Medicine (ACVIM) stages. ANIMALS: Thirty-one dogs were evaluated, including nine dogs classified as ACVIM stage B2, 15 as stage C, and seven as stage D. MATERIALS AND METHODS: Three-dimensional TEE was performed after anesthetic induction for mitral valve surgery, and the 3D geometry of the mitral valve apparatus was measured. RESULTS: The intraclass correlation coefficient was good in both inter- and intraobserver analyses of the 3D measurements of mitral valve annulus geometry and excellent in both inter- and intraobserver analyses in the 3D measurements of mitral valve annular and leaflet sizes. Annulus height to commissural width ratio of stage D dogs showed significantly lower values than B2 dogs (B2: 14.2% [9.1-20.5%]; C: 10.6% [6.5-24.1%]; D: 9.5% [4.7-13.8%]). The aortic-mitral angle of stages C and D were significantly flatter than stage B2 (B2: 122.32 ± 9.39; C: 133.66 ± 8.43; D: 140.70 ± 10.70). CONCLUSIONS: Real-time 3D echocardiography using TEE is a feasible method to evaluate the morphology of the mitral valve in dogs. The saddle shape of the mitral annulus and aortic-mitral angle were flatter in stage D. Further studies are required to understand the pathology of mitral valve disease in dogs.
Assuntos
Doenças do Cão , Ecocardiografia Tridimensional , Insuficiência da Valva Mitral , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Ecocardiografia Tridimensional/veterinária , Ecocardiografia Transesofagiana/veterinária , Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/veterinária , Índice de Gravidade de DoençaRESUMO
BACKGROUND: The left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats. Its size is currently measured in one-dimensional methods, while human medicine considers two- and three-dimensional echocardiography as standard. The objectives of this study were to compare monoplane, biplane, triplane and real-time three dimensional echocardiography for volumetric measurement of the left atrium in healthy cats and establish a reference interval for further studies on cats with heart disease. Additionally, the influence of age, sex and weight on left atrial volume (LAV) was tested. RESULTS: One dimensional monoplane Simpson method of discs (SMOD) in the right parasternal four chamber view (r4) and the left apical 2 chamber view (l2) as well as biplane SMOD had no significant difference for left atrial maximum volume (LAMax). They can be used as equivalent in future studies and one common reference range was set up (1.96 ± 0.54 ml). Those three methods produced significantly higher volumes than triplane echocardiography (RTTPE) and real time three dimensional echocardiography (RT3DE) using TomTec® software. LA volumetry with RTTPE and RT3DE-TomTec™ was more feasible than expected, but low RT3DE image quality was the main reason for excluding patients. Neither age nor weight had an influence on LA volume in healthy cats. Male LAV results were only slightly, but in 2D and RTTPE significantly higher than those of female cats with a range of + 10.46% to + 19.58%. CONCLUSIONS: Monoplane, biplane, triplane and real-time three dimensional echocardiography were feasible for LA volumetry in healthy cats and showed acceptable intra- and interobserver variability. One common LAMax reference range for monoplane r4, l2 and biplane SMOD was set up. Raw data can be used for LA volumes and does not need to be correlated with the cat's weight or age. Male cats have only slightly but significantly larger atria than females in 2D and RTTPE. Therefore, under reservation, also sex related limit values were defined.
Assuntos
Gatos/anatomia & histologia , Ecocardiografia/veterinária , Átrios do Coração/diagnóstico por imagem , Fatores Etários , Animais , Peso Corporal , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Ecocardiografia Tridimensional/veterinária , Feminino , Átrios do Coração/anatomia & histologia , Masculino , Variações Dependentes do Observador , Valores de Referência , Fatores SexuaisRESUMO
Atrial septal defects have been well reported in humans and dogs and the principles of intervention have been well established. In contrast, there is very little information published about these congenital anomalies in horses. True ASDs are regarded as rare and little is known about the clinical significance of these defects in horses. An 11-year-old Thoroughbred gelding with a history of poor performance was diagnosed with an atrial septal defect, measuring approximately 2 cm in diameter, on 2D transthoracic echocardiography. Real-time three-dimensional (3D) echocardiography was used to map the structure of the defect and was useful in fully characterising the ASD in this case.
Assuntos
Ecocardiografia Tridimensional/veterinária , Comunicação Interatrial/veterinária , Cavalos/anormalidades , Animais , Comunicação Interatrial/diagnóstico por imagem , MasculinoRESUMO
A 7-year-old Golden Retriever was presented for a second opinion regarding a cardiac mass. Two-dimensional transthoracic echocardiography demonstrated presence of a mass in the area of the right atrium. The mass appeared adherent and possibly infiltrative to the external wall of the right atrium. Three-dimensional transthoracic echocardiography allowed better visualization of the neoplasia, suggesting that it was not infiltrative and contributed significantly to the decision to carry out the surgical resection of the cardiac tumor. This case report demonstrates the use of three-dimensional transthoracic echocardiography in the diagnostic evaluation of cardiac masses in dogs without the need for general anesthesia.
Assuntos
Doenças do Cão/diagnóstico por imagem , Ecocardiografia Tridimensional/veterinária , Neoplasias Cardíacas/veterinária , Hemangiossarcoma/veterinária , Animais , Doenças do Cão/cirurgia , Cães , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: To compare left atrial volume (LAV) and right atrial volume (RAV) determined by 2-D and 3-D echocardiographic methods with the LAV and RAV determined by ECG-gated multidetector CT (MDCT) for healthy dogs. ANIMALS: 11 healthy purpose-bred young adult hound-type dogs. PROCEDURES: Each dog was anesthetized and underwent MDCT and a complete echocardiographic examination. Modality-specific software was used to measure the respective atrial volumes at ventricular end systole, and LAV and RAV measurements were subsequently indexed to body weight and compared among imaging modalities. RESULTS: The LAV determined by echocardiographic methods did not differ significantly from the LAV determined by MDCT. However, the RAV determined by 3-D echocardiography and 2-D echocardiography via the left apical and left cranial windows differed significantly from the RAV determined by MDCT. Bland-Altman analyses indicated that the indexed LAV and RAV determined by echocardiographic methods were systematically underestimated, compared with MDCT measurements, but the bias was much smaller for LAV than for RAV. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that, for dogs, echocardiography might be an acceptable alternative to MDCT for measurement of LAV but not for measurement of RAV. However, the study population was small and homogenous in terms of breed, age, and weight. These findings need to be validated in a larger, more varied population of dogs with and without cardiac disease.
Assuntos
Ecocardiografia Tridimensional/veterinária , Átrios do Coração/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/veterinária , Animais , Volume Cardíaco , Cães , Ecocardiografia Tridimensional/normas , Feminino , Masculino , Tomografia Computadorizada Multidetectores/normasRESUMO
INTRODUCTION: We hypothesized that real-time three-dimensional echocardiography (RT-3DE) was superior to two-dimensional echocardiography for the estimation of left atrial volume (LAV), using electrocardiographic (ECG)-gated multidetector computed tomography angiography (MDCTA) as a volumetric gold standard. The aim was to compare maximum LAV (LAVmax) and minimum LAV (LAVmin) measured by biplane area-length method (ALM), biplane method of disk (MOD) and RT-3DE with 64-slice ECG-gated MDCTA in dogs ANIMALS: The study included twenty dogs, anaesthetized for various diagnostic purposes and without evidence of cardiovascular disease. METHODS: Left atrial volume was estimated by ALM, MOD and RT-3DE following ECG-gated MDCTA. The results were compared with LAV from MDCTA and correlations were performed. The limits of agreement (LoA) between methods were evaluated using Bland-Altman analysis and intraclass correlations. Coefficients of variation were calculated. RESULTS: Area-length method (r = 0.79 and 0.72), MOD (r = 0.81 and 0.70) and RT-3DE (r = 0.94 and 0.82) correlated with MDCTA for LAVmax and LAVmin, respectively (all p < 0.05). Biases for LAVmax (-0.96 mL, 95% LoA: -5.6 to 3.7) and LAVmin (-0.67 mL, 95% LoA: -5.4 - 4.1) were minimal with RT-3DE, reflecting a slight underestimation. Conversely, MOD (LAVmaxbias = 3.19 mL, 95% LoA: -5.7 - 12.1; LAVminbias = 1.96 mL, 95% LoA: -4.6 - 8.5) and ALM (LAVmaxbias = 4.05, 95% LoA: -5.7 - 13.8; LAVminbias = 2.80 mL, 95% LoA: -3.9 - 9.5) suggested LAV overestimation. Intraobserver and interobserver variability were adequate. CONCLUSIONS: Real-time three-dimensional echocardiography is a non-invasive, accurate and feasible method with superior accuracy to two-dimensional methods.
Assuntos
Cães/anatomia & histologia , Átrios do Coração/anatomia & histologia , Animais , Ecocardiografia/veterinária , Ecocardiografia Tridimensional/veterinária , Feminino , Átrios do Coração/diagnóstico por imagem , Masculino , Tomografia Computadorizada Multidetectores/veterinária , Estudos Prospectivos , Valores de ReferênciaRESUMO
INTRODUCTION: The objective of the study was to evaluate the accuracy of two- and three-dimensional (2D, 3D) transthoracic echocardiography (TTE), 2D transesophageal echocardiography, and computed tomography angiography (CTA) compared with cardiac magnetic resonance imaging (CMR) in normal dogs and to assess repeatability of 2D and 3D TTE for the assessment of left ventricular (LV) and left atrial (LA) dimensions. ANIMALS: The study was performed on six healthy dogs. MATERIALS AND METHODS: Transthoracic echocardiography, transesophageal echocardiography, CTA, and CMR were performed on each dog. Right ventricular (RV) and LV volumes (in systole and diastole), ejection fraction (EF), and LA and right atrial (RA) volumes were assessed. Repeatability and intrarater and interrater measurements of variability were quantified by average coefficient of variation (CV) for 2D and 3D TTE. RESULTS: No clinically relevant differences in LV volume were detected between CMR and all modalities. Importantly, 3D TTE had the lowest CV (6.45%), correlated with (rs = 0.62, p = 0.01), and had the highest overlap in distribution with CMR (OVL >80%). Left ventricular EF and LA size via CTA compared best with CMR and RV and RA volumes were best estimated by 3D TTE. Assessment of LV and LA volumes via 3D TTE had moderate repeatability (15-21%) compared with LV M-mode measurements and 2D LA-to-aortic ratio (<10%), respectively. For LV size, interrater CV for 3D TTE (19.4%) was lower than 2D TTE (23.1%). CONCLUSIONS: Measurements of LV, RV, and RA volumes via 3D TTE and LA volume and LV EF assessed by CTA compared best with CMR. Three-dimensional echocardiography had lower interrater and intrarater CV compared with 2D TTE.
Assuntos
Cães/anatomia & histologia , Ecocardiografia Tridimensional/veterinária , Ecocardiografia Transesofagiana/veterinária , Ecocardiografia/veterinária , Coração/diagnóstico por imagem , Imageamento por Ressonância Magnética/veterinária , Tomografia Computadorizada por Raios X/veterinária , Animais , Feminino , Átrios do Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Myxomatous mitral valve disease (MMVD) is more prevalent in Cavalier King Charles Spaniels (CKCSs) compared to dogs of other breeds at a given age. Abnormal valvular stress is thought to contribute to the development and progression of MMVD, and a relationship exists between mitral valve (MV) morphology and stress acting on the valve. OBJECTIVES: To determine whether the MV morphology of healthy adult CKCSs differs from the morphology of healthy adult dogs of other breeds determined by RT-3DTTE. ANIMALS: Thirty-five healthy CKCSs and 41 healthy dogs of other breeds. METHODS: Prospective cross-sectional study. Dogs underwent physical examination, conventional echocardiography, and RT-3DTTE. RT-3DTTE datasets were analyzed using dedicated software for MV morphologic analysis. Morphologic variables were compared between CKCSs and dogs of other breeds. RESULTS: The MV of healthy CKCSs had a smaller annulus height (0.46 ± 0.11 vs. 0.56 ± 0.17; P = .0021), tenting height (0.26 ± 0.12 vs. 0.42 ± 0.18; P < .001), tenting area (0.42 ± 0.15 vs. 0.79 ± 0.34; P < .001), normalized tenting volume (0.09 [0.05-0.13] vs. 0.14 [0.10-0.20]; P < .001), and normalized area of the posterior leaflet (0.57 ± 0.15 vs. 0.66 ± 0.18; P = .016) compared to healthy dogs of other breeds; this results in CKCSs having a flatter MV with reduced tenting, compared to the MV of other breeds. CONCLUSIONS AND CLINICAL IMPORTANCE: These morphologic features could confer a mechanical disadvantage and play a role in the predisposition of CKCSs to the early development of MMVD.
Assuntos
Ecocardiografia Tridimensional/veterinária , Valva Mitral/anatomia & histologia , Animais , Estudos Transversais , Cães , Feminino , Predisposição Genética para Doença , Masculino , Insuficiência da Valva Mitral/genéticaRESUMO
OBJECTIVE To evaluate accuracy of quantification of right ventricle volume (RVV) by use of 3-D echocardiography (3DE) and ECG-gated multidetector CT (MDCT). ANIMALS 6 healthy hound-cross dogs. PROCEDURES ECG-gated MDCT and complete 3DE examinations were performed on each dog. Right ventricular end-diastolic volumes (EDVs), end-systolic volumes (ESVs), stroke volume (SV), and ejection fraction (EF) were measured for 3DE and MDCT data sets by use of software specific for RVV quantification. Correlation and level of agreement between methods were determined. Intraobserver and interobserver variability were assessed for 3DE. RESULTS No significant differences were detected between SV and EF obtained with MDCT and 3DE. Significant differences were detected between right ventricular EDV and ESV obtained with MDCT and 3DE. No significant difference in heart rate was detected between methods. The correlation between MDCT and 3DE was very good (r = 0.87) for EDV and ESV, moderate (r = 0.60) for EF, and poor (r = 0.31) for SV. Bland-Altman analysis revealed a systematic underestimation of RVV derived by use of 3DE, compared with the RVV derived by use of MDCT (mean bias, 15 and 10.3 mL for EDV and ESV, respectively). Intraobserver (EDV, 12%; ESV, 18%) and interobserver (EDV, 14%; ESV, 11%) variability were acceptable for 3DE. CONCLUSIONS AND CLINICAL RELEVANCE There was substantial variance for RVV measured by use of 3DE in healthy dogs and a significant underestimation of volumes, compared with results for MDCT, despite the fact there were no significant differences in SV and EF.
Assuntos
Cães/fisiologia , Ecocardiografia Tridimensional/veterinária , Ventrículos do Coração/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/veterinária , Volume Sistólico , Animais , Feminino , Frequência Cardíaca , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , SoftwareRESUMO
BACKGROUND: Accurately assessing the morphology and shape of the patent ductus arteriosus (PDA) and obtaining measurements are important to avoid procedural complications. OBJECTIVES: To characterize and compare PDA morphology, shape, and dimensions with angiography and echocardiography. ANIMALS: 25 client-owned dogs with echocardiographically confirmed PDA. METHODS: Prospective case series. Imaging consisted of single plane angiography, transthoracic echocardiography from the right (TTE-R) and left (TTE-L), and two-dimensional, biplane, and three-dimensional transesophageal echocardiography (TEE-2D and TEE-3D). Measurements included angiographic minimal ductal diameter (MDD), echocardiographic pulmonary ostium in a single dimension (TTE-R, TTE-L, and TEE-2D) and in perpendicular dimensions (TEE-3D) with similar measurements of the ampulla 3 mm above the MDD or pulmonary ostium. The morphology and shape of the PDA were characterized. RESULTS: Catheter-based occlusion (N = 20) and surgical ligation (N = 5) were performed without complication. Angiographic morphology was classified as type II (N = 19), type III (N = 1), and other (N = 1). Angiographic MDD and TEE-2D pulmonary ostium measurements were significantly (P = .008) but weakly correlated (r = .56); similar relationships were found for ampulla diameter measurements (P < .0001; r = .75). In general, TEE-2D did not correlate with other imaging modalities measurements. Based on TEE-3D measurements, the majority of pulmonary ostium (17/24; 71%) and ampulla (19/24; 79%) were oval. CONCLUSIONS AND CLINICAL IMPORTANCE: Measurements using different imaging modalities are not interchangeable. TEE-3D provided an en face view of the PDA that cannot be replicated with other echocardiographic techniques and demonstrated an oval shape in the majority of dogs. We propose an update to the current classification system to include additional PDA morphologies.