Assessment of the left atrial (LA) size is crucial in cats with cardiomyopathies because LA dilation, which results from an increased diastolic filling pressure, predisposes towards the development of congestive heart failure and arterial thromboembolism. In addition, LA dilation has been shown to be a negative prognostic factor in cats affected by hypertrophic cardiomyopathy. The aim of this study was to evaluate the agreement between M-mode and two-dimensional (2D) echocardiography in the assessment of LA size in cats. The study was retrospective and observational. Cats with and without heart diseases were included. The LA and aorta (AO) were measured in M-mode and 2D using a standard right parasternal short axis view at the aortic valve level. A left atrium to aorta ratio (LA/AO) >1.5 was considered indicative of LA enlargement. Cohen’s kappa agreement was calculated and Bland- Altman plots were obtained. A total of 188 client-owned cats were included: 104 with heart disease and 84 without heart disease. LA and AO dimensions in M-mode were 13.9 +/- 3.7 mm and 8.7 +/- 1.5 mm, respectively, and in 2D were 14.1 +/- 3.5 mm and 8.8 +/- 1.4 mm, respectively. Bland-Altman plots showed that the mean difference for the evaluation of AO dimensions between 2D and M-mode was 0.1 +/- 1.0 mm and that of LA was 0.1 +/- 1.4 mm. LA/AO measured in 2D and M-mode was 1.6 +/- 0.5 and 1.6 +/- 0.5, respectively, with a median difference between the two methods of 0.0 0.2. Cohen’s kappa yielded a good agreement between the two methods in the interpretation of LA/AO ratio (kappa = 0.760; 95% CI: 0.54–0.99), with 184 agreements out of 188 (97.6%). In conclusion, 2D echocardiography resulted in a slightly higher estimation of the LA and AO diameters in comparison to Mmode, but not for the LA/AO. Because a good agreement was documented between M-mode and 2D evaluation of the LA/AO, the two methods can be used interchangeably to measure this echocardiographic index in cats.
Comparison of M-mode and two-dimensional echocardiography in evaluating the left atrium to aorta ratio in cats
VEZZOSI, TOMMASOSecondo
;
2017-01-01
Abstract
Assessment of the left atrial (LA) size is crucial in cats with cardiomyopathies because LA dilation, which results from an increased diastolic filling pressure, predisposes towards the development of congestive heart failure and arterial thromboembolism. In addition, LA dilation has been shown to be a negative prognostic factor in cats affected by hypertrophic cardiomyopathy. The aim of this study was to evaluate the agreement between M-mode and two-dimensional (2D) echocardiography in the assessment of LA size in cats. The study was retrospective and observational. Cats with and without heart diseases were included. The LA and aorta (AO) were measured in M-mode and 2D using a standard right parasternal short axis view at the aortic valve level. A left atrium to aorta ratio (LA/AO) >1.5 was considered indicative of LA enlargement. Cohen’s kappa agreement was calculated and Bland- Altman plots were obtained. A total of 188 client-owned cats were included: 104 with heart disease and 84 without heart disease. LA and AO dimensions in M-mode were 13.9 +/- 3.7 mm and 8.7 +/- 1.5 mm, respectively, and in 2D were 14.1 +/- 3.5 mm and 8.8 +/- 1.4 mm, respectively. Bland-Altman plots showed that the mean difference for the evaluation of AO dimensions between 2D and M-mode was 0.1 +/- 1.0 mm and that of LA was 0.1 +/- 1.4 mm. LA/AO measured in 2D and M-mode was 1.6 +/- 0.5 and 1.6 +/- 0.5, respectively, with a median difference between the two methods of 0.0 0.2. Cohen’s kappa yielded a good agreement between the two methods in the interpretation of LA/AO ratio (kappa = 0.760; 95% CI: 0.54–0.99), with 184 agreements out of 188 (97.6%). In conclusion, 2D echocardiography resulted in a slightly higher estimation of the LA and AO diameters in comparison to Mmode, but not for the LA/AO. Because a good agreement was documented between M-mode and 2D evaluation of the LA/AO, the two methods can be used interchangeably to measure this echocardiographic index in cats.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
