M-MODE ECHOCARDIOGRAPHIC PARAMETERS AND INDICES IN THE NORMAL GERMAN SHEPHERD DOG

M-mode echocardiographic measurements were made from 50 healthy German Shepherd dogs (30 males and 20 females). The dogs were awake and unsedated, in right lateral recumbent position. The following parameters were measured on the echocardiographic images: interventricular septal thickness at end-diastole (IVSd), interventricular septal thickness at end-systole (IVSs), left ventricular internal dimension at end-diastole (LVIDd), left ventricular internal dimension at end-systole (LVIDs), left ventricular posterior wall thickness at end-diastole (LVPWd), left ventricular posterior wall thickness at end-systole (LVPWs), left atrial dimension (LAD), aortic root dimension (AOD), left atrial to aortic root ratio (LAD/AOD), right ventricular internal dimension at end-diastole (RVID), amplitude of mitral valve excursion (DE amplitude), velocity of mitral valve opening (D-E slope), and velocity of mitral valve closure (E-F slope). Fractional shortening (FS) was also calculated. The effect of gender and age on each echocardiographic parameter was analyzed and the relationship between body weight (BW) and each parameter was also investigated. There was a significant relationship between gender and LVPW in systole and diastole and FS. Significant association was also found between BW and IVS, LVID, and LVPW in systole and diastole, FS, LAD, AOD, RVID, DE amplitude, and D-E slope of the mitral valve.     

Measurement of M-mode echocardiographic parameters in healthy adult Maine Coon cats

OBJECTIVE: To determine reference values for M-mode echocardiographic parameters in nonsedated healthy adult Maine Coon cats and compare those values with data reported for nonsedated healthy adult domestic cats. DESIGN: Prospective study. ANIMALS: 105 healthy adult Maine Coon cats. PROCEDURE: Over a 3-year period, M-mode echocardiographic examinations (involving a standard right parasternal transthoracic technique) were performed on Maine Coon cats as part of prebreeding evaluations; values of M-mode parameters in healthy individuals were collected, and mean values were calculated for comparison with those reported for healthy adult domestic cats. RESULTS: The mean +/- SD weight of Maine Coon cats was significantly greater than that of domestic cats. Mean values of left ventricular internal dimension at end diastole and end systole (LVIDd and LVIDs, respectively), interventricular septal thickness at end systole (IVSs), left ventricular posterior wall thickness at end systole (LVPWs), left atrial dimension at end systole (LADs), and aortic root dimension (Ao) in Maine Coon cats differed significantly from values in healthy domestic cats. The greatest differences detected between the 2 groups involved values of LVIDd, LADs, and Ao. Linear regression analysis revealed a weak but significant correlation between weight and each of LVIDd, LVPWs, IVSs, Ao, LADs, and left ventricular posterior wall thickness at end diastole. CONCLUSIONS AND CLINICAL RELEVANCE: Values of several M-mode echocardiographic parameters in Maine Coon cats differ from those reported for domestic cats; these differences should be considered during interpretation of echocardiographic findings to distinguish between cardiac health and disease in this breed.     

M-MODE ECHOCARDIOGRAPHIC REFERENCE VALUES IN CATS IN THE FIRST THREE MONTHS OF LIFE

Thirty-five young cats were studied by echocardiography from the 2nd to 12th weeks of life to analyze correlation between body weight, body surface area, age and heart rate with fourteen echocardiographic parameters. There was a positive linear correlation (r = 0.49-0.78) between the independent variables (body weight, body surface area, age) and left ventricular wall thickness and diameter, aortic diameter and left atrial diameter, whereas there was a negative correlation (r = -0.39 and r = -0.43) between the heart rate and left ventricular diameter during systole and diastole. No linear dependence of the fractional shortening, ejection fraction, percentage thickening of the interventricular septum and left ventricular posterior wall, LA/AO ratio, and the ratio IVSED/LVWED to the independent variables was observed.     

Transthoracic echocardiography in Estrela Mountain dogs: reference values for the breed

Of 100 Estrela Mountain dogs, 74 were examined to obtain echocardiographic reference values for the breed. The influence of bodyweight, age and sex on different echocardiographic parameters was studied using either analysis of variance or regression analysis. Statistically significant differences were found between sex and heart rate as well as interventricular septal thickness at end-systole and left ventricular internal dimension at end-diastole. A statistically significant linear correlation was also found between several parameters and (1) age (mean arterial pressure, left ventricular internal dimension at end-systole, fractional shortening, circularity index in systole, aortic valve velocity time integral, pulmonic valve velocity time integral and mitral valve E wave peak velocity), (2) weight (left ventricular posterior wall thickness at end-diastole and end-systole, end-diastolic volume index, left atrium diameter, aortic valve peak velocity and mitral valve E wave deceleration time), (3) sex and age (left ventricle end-diastolic volume), and (4) sex and weight (aortic root diameter and pulmonic valve peak velocity). Reference values for the breed are presented, as well as dispersion graphics for selected parameters, based on a regression equation.     

Allometric scaling of echocardiographic measurements in healthy Spanish foals with different body weight

Scaling in biology is usually allometric, and therefore, the size of the heart may be expressed as a power function of body weight (BW). The present research analyses the echocardiographic measurements in 68 healthy Spanish foals weighed between 70 and 347 kg in order to determine the correct scaling exponent for the allometric equation. The echocardiographic parameters measured were: left ventricular internal dimensions (LVID), free wall thickness (LVFWT), interventricular septum thickness (IVST) at systole (s) and diastole (d), EPSS (distance between the point E of the mitral valve and the interventricular septum), and aorta diameters at the level of the aortic valve (AOD), base of valve leaflets (ABS), sinus of Valsalva (ASV) and sino-tubular junction (AJT). Indices of left ventricular performance were calculated. It was found that LVIDd, IVSTs, AOD, and ASV have a relationship to BW raised to 0.300-0.368 power, whereas left ventricular end-diastolic volume and stroke volume scaled to BW raised to 0.731-0.712 power. With these data, appropriate values can be calculated for normal Spanish foals.     

Comparison of echocardiographic and autopsy measurements of cardiac dimensions in the horse

This study was initiated to determine the accuracy of M-mode echocardiography in measuring left ventricular dimensions and estimating heart weights in horses. Left ventricular free wall and interventricular septal thickness and left ventricular external and internal diameters were measured and heart weights estimated from the echocardiograms of 47 horses. Autopsy measurements of the same parameters were then recorded. Statistical comparison of the data demonstrated: (1) Systolic measurements of wall thickness more closely resembled the heart in death than the diastolic measurements; (2) good correlations existed between parameters measured echocardiographically and at autopsy, especially wall thicknesses and left ventricular external diameter (maximum r = 0.82); (3) heart weight was readily predicted from echocardiographic wall thickness regressions (maximum R-squared = 68 per cent). M-mode echocardiography demonstrated the potential for direct and accurate measurements of cardiac mass and some ventricular dimensions in the horse. The data suggested that intense rigor and exsanguination may render the autopsied heart unsatisfactory for comparative measurements when assessing techniques such as echocardiography.     

ECHOCARDIOGRAPHIC REFERENCE VALUES IN WHIPPETS

The aim of the study was to establish reference echocardiographic values for whippets, to compare these values with previously published reference values for the general dog population, and to determine whether there is an influence of gender and breeding lines on echocardiographic measurements. Echocardiographic parameters from 105 apparently healthy whippets without cardiac symptoms were used to establish reference values for the breed and to compare these values with two previously reported reference ranges. The coefficients of the allometric equation Y= aM(b), useful to reconstruct normal M-mode and two-dimensional average values for whippets of varying weights, were calculated, as well as the lower and upper limits of the 95% prediction interval. First, we found that whippets have a significantly larger left ventricular diameter, increased left ventricular wall, and interventricular septum thickness than expected, in diastole as well as in systole. Fractional shortening was significantly lower than the reference value. Second, comparing males and females, taking body weight differences into account, females had a significantly larger left ventricular diameter in diastole and systole. Minor differences were found between racing and show pedigree dogs. In conclusion, the results of this study confirm that breed-specific reference values are needed in echocardiography. In whippets, the values found in this study can be used as references in order to avoid overinterpretation of cardiac dilation, hypertrophy, and/or decreased contractility in these dogs.     

Repeatability of the M-mode echocardiogram and the effects of acute changes in heart rate, cardiac contractility, and preload in healthy cats sedated with ketamine hydrochloride and acepromazine

In healthy cats sedated with a combination of ketamine hydrochloride and acepromazine, the reproducibility of sequential echocardiographic examinations was studied. The effects of experimental alteration in heart rate, contractility, and preload on the echocardiogram also were studied. Ten cats had M-mode echocardiograms recorded once weekly for 5 weeks. There were no statistically significant differences in echocardiographic measurements over time, although measurements of certain cardiac structures of an individual cat did vary from time to time. The cardiovascular system was altered by a constant infusion of isoproterenol, followed by a rapid intravenous infusion of isotonic fluid equal to 25% of the calculated blood volume, and then by a rapid withdrawal of blood equal to the amount of fluid previously given. Cardiac output using indocyanine green dilution curves were determined for each treatment and compared to the cardiac output calculated from the echocardiogram. The correlation coefficient was 0.90 for all treatments. During the infusion of isoproterenol a significant increase in the percent fractional shortening and left ventricular wall amplitude occurred compared to the control echocardiogram. After the rapid infusion of fluid, none of the mean echocardiographic measurements significantly changed from control values although the left ventricular chamber diameter at systole significantly increased, and the percent fractional shortening significantly decreased, when compared to values obtained during isoproterenol infusion. Significant changes recorded between echocardiographic measurements made after blood withdrawal compared to those made after fluid loading included an increase in left ventricular wall thickness at diastole, a decrease in left ventricular diameter at diastole, and a decrease in the present left ventricular wall thickening. Cats were terminated and the average of measurements made during the repeatability study of the septal and left ventricular wall thickness during systole, rather than during diastole, more closely approximated the postmortem measurements.     

Observer-dependent variability of quantitative clinical endpoints: the example of canine echocardiography

The objective of this study was to determine the intra- and inter-observer variability of echocardiographic measurements in dogs. Four observers with different levels of experience in echocardiography performed 192 echocardiographic examinations of six dogs on four different days. The lowest within- and between-day coefficients of variation (CV) (%) were 13.8 and 5.2 for the right ventricle in diastole, 8.9 and 4.5 for the interventricular septal thickness in diastole (6.3 and 7.0 in systole), 7.7 and 9.4 for the left ventricular free-wall thickness in diastole (8.1 and 5.2 in systole), 3.1 and 5.0 for the left ventricular end-diastolic diameter (6.2 and 7.0 for end-systolic diameter), 10.2 and 10.8 for the left ventricular shortening fraction, and 8.2 and 9.8 for the left atrium/aorta ratio, respectively. Most of these lowest CVs were observed by the two most experienced observers. Conversely, all maximum values were obtained with the two less experienced observers. These differences in observer-dependent variability may considerably influence the minimum number of animals required to detect a treatment-associated change in echocardiographic variables.     

A COMPARISON OF ECHOCARDIOGRAPHIC INDICES OF THE NONRACING, HEALTHY GREYHOUND TO REFERENCE VALUES FROM OTHER BREEDS

Echocardiographic evaluation of healthy, nonexercising, awake greyhounds revealed substantial differences in left ventricular cavity dimensions, wall thickness, systolic time intervals and fractional shortening as compared to previously reported normal echocardiographic values obtained from mongrels and various other dog breeds. Despite corrections for body surface area and body weight, these differences remained, suggesting that breed and body conformation should be considered when interpreting echocardiographic studies in the dog.     

Effects of isoflurane on echocardiographic parameters in healthy dogs

Objective To study the echocardiographic effects of isoflurane at an end‐tidal concentration approximating 1.0 times the minimum alveolar concentration (MAC) in healthy unpremedicated dogs. Study design Prospective experimental trial. Animals Sixteen mature mongrel dogs of either sex weighing 11.06 ± 2.72 kg. Methods After performing a baseline echocardiogram in the awake animal, anesthesia was induced with increasing inspired concentrations of isoflurane via a face mask until tracheal intubation was possible. Following intubation, the end‐tidal concentration was decreased to 1.4% for the rest of the anesthetic period. Serial echocardiograms were recorded at 25, 40, and 55 minutes after the end‐tidal concentration was reached. Results No changes were observed in heart rate. However, significant decreases were seen in left ventricular end‐diastolic diameter (Mean maximal change: 13.8%), interventricular septal thickness during systole (15.2%), interventricular septal thickening fraction (72.2%), left ventricular free wall thickening fraction (63.5%), ejection fraction (39.9%), and fractional shortening (46.7%). In addition, peak flow velocities across mitral, pulmonic, and aortic valves were significantly lower than baseline values. Decreases were also observed in end‐diastolic left ventricular volume index (approximately 32.1% from the awake value), stroke index (58.2%), and cardiac index (55.3%) when compared with awake measurements. Conclusions and clinical relevance Our results indicate that 1 × MAC isoflurane caused significant myocardial depression in healthy dogs. These changes in myocardial function need to be considered carefully when isoflurane is to be used in dogs with poor cardiovascular reserve.     

Echocardiographic reference values in healthy cats sedated with ketamine hydrochloride

An M-mode echocardiographic examination was performed in a consistent manner in 30 clinically healthy cats under light ketamine hydrochloride sedation. There was a significant linear relationship between increasing body size and increasing cardiac dimensions for several echocardiographic values. Positive correlation existed between body weight and body surface area with aortic root, left ventricular caudal wall thickness (LVCW), interventricular septal thickness (IVS), IVS/LVCW, and mean velocity of circumferential fiber shortening (Vcf); there was a negative correlation between body weight and body surface area with left ventricular ejection time (LVET). Body surface area also correlated positively with percentage of ventricular minor axis dimensional change (% delta D). Positive correlations were recorded between left ventricular end-diastolic dimension (LVEDD) and left ventricular endsystolic dimension (LVESD), LVESD and LVET, LVCW and IVS, LVET (calculated by LVCW motion) and LVET (calculated by aortic valve motion), % delta D and Vcf, heart rate and Vcf, and Vcf (calculated using aortic valve motion to compute LVET) and Vcf (using LVCW motion to compute LVET). There were negative correlations between LVEDD and % delta D, LVEDD and Vcf, LVESD and Vcf, LVET and Vcf, LVET and heart rate, LVET and % delta D. Significant differences were recorded between means of echocardiographic reference values generated in this and other studies, except for LVESD.     

Changes in linear dimensions of the heart, relative to body weight, as measured by M-mode echocardiography in growing dogs.

The growth of the heart, relative to body weight, was measured by M-mode echocardiography in dogs during the first year of life. Echocardiographic measurements were obtained from 16 English Pointers at 1, 2, 4, and 8 weeks of age and at 3, 6, 9, and 12 months of age. Left atrial (LA), aortic (AO), left and right ventricular internal dimensions, interventricular septal and left ventricular wall thickness measurements increased in curvilinear fashion relative to increasing body weight. Least-squares regression analysis, performed on logarithmically transformed data, was used to develop power-law equations describing the relationship of echocardiographic measurements to body weight. Linear dimensions of the LA, AO, left and right ventricular internal dimensions and interventricular septal and left ventricular wall thickness changed proportionally to slightly differing exponential powers of body weight (BW), varying from 0.31 to 0.45 (BW0.31 to BW0.45). Fractional shortening and the LA to AO ratio decreased slightly, but significantly, as body weight increased. Indexing echocardiographic measurements to BW1/3 was more appropriate than indexing such measures linearly to body weight, offering a practical method for developing accurate normative graphs or tables for M-mode echocardiographic dimensions in growing dogs.     

Effect of lactation on functional and morphological echocardiographic variables in adult dairy cows

ObjectivesTo study the effect of pregnancy and lactation on echocardiographic parameters in Holstein dairy cows.AnimalsNine multiparous high milk producing (HMP) dairy cows (producing more than 40 kg of milk per day in peak production) and 9 low milk producing (LMP) cows (producing less than 30 kg or milk per day in peak production).MethodsEchocardiography was performed twice; one month before calving and two months after calving.ResultsThe heart rate of HMP cows in the early lactation period was significantly higher than in the dry period. In LMP cows, there was a significant increase in left ventricular dimension in the early lactation period as compared to the dry period, and the interventricular septum in systole (IVSs) in the dry period was significantly thicker than early lactation period. In HMP cows, there was an increase in the right ventricular diameter in systole in the early lactation period as compared to the dry period. Left ventricular and aortic dimensions in the dry period of HMP were significantly higher than those of LMP cows. When the data were corrected for body weight, comparison of values of the dry period of HMP and LMP cows showed that left ventricular volume in systole in HMP was significantly higher and that IVSs, left ventricular fractional shortening and ejection fraction were significantly lower than in LMP cows.ConclusionsThis study demonstrated that lactation influences the intracardiac dimensions. The amount of milk production can influence echocardiographic parameters in dairy cows.     

Reference Values and Repeatability of B-Mode and M-Mode Echocardiographic Parameters in Healthy Donkey (Equus asinus)—The Guide to Assess Healthy Heart

Donkey (Equus asinus), the cheapest form of agricultural power in Egypt, is used principally as draught or pack animals and may also be ridden, or used for threshing, raising water, milling, and other work. The aim of the present study was to provide B-mode and M-mode echocardiographic reference ranges from a sample of population of donkeys (E. asinus) based on the probability theory and statistics. In the present study, B-mode and 2-dimensional guided M-mode echocardiography were performed on 44 clinically healthy donkeys (E. asinus) (22 males and 22 females), without any neither clinical nor echocardiographic evidence of cardiovascular diseases, aged 2–25 year old, and weighed 150–350 kg. The echocardiographic dimensions, including interventricular septum thickness at end diastole, interventricular septum thickness at end systole, left ventricular internal diameter at end diastole, left ventricular internal diameter at end systole, left ventricular posterior wall thickness at end diastole, and left ventricular posterior wall thickness at end systole were assessed. The cardiac function indices, including end diastolic volume, end systolic volume, stroke volume, ejection fraction, and fractional shortening were also measured. B-mode and guided M-mode echocardiographic examination of healthy donkeys revealed that both the interventricular septum thickness and the left ventricular posterior free wall were greater during systole than diastole. However, the left ventricular dimension during diastole was greater than systole. Furthermore, the recorded data of cardiac function indices, including end diastolic volume, end systolic volume, stroke volume, ejection fraction, and fractional shortening using B-mode echocardiography were closer to those recorded by guided M-mode echocardiography. To our knowledge, this is the first Egyptian study to report the echocardiographic reference ranges of donkeys (E. asinus) based on the probability theory and statistics, the coefficient of variation. The results of the present study can be used as standard and reference values for further echocardiographic studies in donkeys and represent a step in the identification, interpretation, and evaluation of cardiovascular disorders in such animals.     

Reproducibility and repeatability of M-mode echocardiographic measurements collected from 25 normal horses

Three different operators with varying levels of experience made repeated echocardiographic measurements of the aortic root diameter, interventricular septal thickness, left ventricular internal diameter, and left ventricular free wall thickness of 25 horses using a 3.5 MHz transducer. Each operator followed specific guidelines in order to determine the reproducibility (inter-operator variation) and repeatability (intra-operator variation) of their measurements. Variations due to horse differences, operator differences, and horse by operator interactions were determined. The largest variation was due to differences between horses. Inter-operator-based variability was only significant with respect to interventricular septal and aortic root measurements. All other measurements were reproducible and repeatable when obtained by well-trained operators. The experience of operators affects reproducibility and repeatability, however. It was concluded that different operators could apply equine M-mode echocardiography to obtain measurements of ventricular chamber and free wall dimensions that can be legitimately compared to measurements obtained by others if operators are adequately trained and landmarks are clearly standardized.     

Effect of Breed and Body Weight on Echocardiographic Values in Four Breeds of Dogs of Differing Somatotype

Eighty normal dogs of four morphologically disparate breeds (Pembroke Welsh Corgi, Miniature Poodle, Afghan Hound, Golden Retriever) (twenty of each breed), were studied by echocardiography to determine the importance of breed and weight in establishing normal echocardiographic reference ranges. Echocardiographic measurements included left-ventricular chamber dimension at systole and end-diastole, right-ventricular chamber dimension at end-diastole, interventricular septal thickness at systole and end-diastole, left-ventricular free wall thickness at systole and end-diastole, E-point septal separation, aortic root dimension at end-diastole, left atrial dimension, and fractional shortening. Analyses of covariance indicated that for all measurements except right-ventricular chamber dimension, the means were significantly different among breeds, after the differences in weight were taken into account. Echocardiographic measurements are variable even within the same breed. Breed must be considered in establishing echocardiographic measurement reference ranges. Echocardiographic values for each breed are presented.     

Effects of animal position and number of repeated measurements on selected two-dimensional and M-mode echocardiographic variables in healthy dogs

OBJECTIVE: To evaluate the effects of positioning and number of repeated measurements on intra- and interobserver variability of echocardiographic measurements in dogs. DESIGN: Prospective study. ANIMALS: 4 healthy dogs. PROCEDURE: Each observer performed 24 examinations, separately assessing each dog 6 nonconsecutive times (3 times with the dog in lateral recumbency and 3 with the dog in a standing position). Variables evaluated included M-mode measurements of left ventricular end-diastolic and left ventricular end-systolic diameters, left ventricular free-wall thickness in diastole and systole, interventricular septal thickness in diastole and systole, left ventricular shortening fraction, and 2-dimensional measurements of the left atrial diameter-to-aortic diameter ratio. RESULTS: All coefficients of variation (range, 3.4% to 26.6%) were similar between operators and positions and were < 15% for 27 of 32 values. For both operators, repeatability of the measurements was better for left ventricular end-systolic diameter, left ventricular free-wall thickness in diastole, left ventricular free-wall thickness in systole, and the left atrial diameter-to-aortic diameter in the standing position, and similar for both positions for shortening fraction and left ventricular end-diastolic diameter. No effect of cardiac cycle was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Within-day variability of conventional echocardiography performed with the dog in the standing position was at least as good as that obtained with the dog in lateral recumbency for most measured variables. Single measurements of each variable may be sufficient for trained observers examining dogs that do not have an arrhythmia. The standing position should be used, particularly for stressed or dyspneic dogs.     

Normal values of the canine M-mode echocardiogram

M-mode echocardiograms were recorded from 40 healthy dogs, awake and unsedated, in left lateral recumbent position. Fifteen echocardiographic measurements were taken and correlated with body weights using linear regression equations. The left ventricular internal dimension in systole and diastole, the left ventricular wall thickness, the aortic root dimension, and the left atrial dimension had high correlation coefficients (r2), ranging from 0.756 to 0.619. The fractional shortening of the left ventricle in systole (39% +/- 6%) and the left atrial to aortic root ratio (0.99 +/- 0.10) were not linearly related to body weights and had constant values.     

Heterogeneity of Hypertrophy in Feline Hypertrophic Heart Disease

Eighty-six cats with non-dilated left ventricular myocardial hypertrophy were studied retrospectively. Cats were categorized by two-dimensional echocardiography as having symmetric ventricular hypertrophy (Type I), asymmetric with predominant septal thickening hypertrophy (Type II), and asymmetric hypertrophy with predominant free-wall thickening (Type III). The distribution of hypertrophy was judged subjectively and objectively. Subjective and objective results were similar (P= 0.03) although overlap existed between groups. Morphologic patterns (Types I, II, and III) were compared with breed, age, sex, heart rate, percent fractional shortening, left atrial size, serum creatinine concentration, and the presence (yes/no) of pleural effusion, pulmonary edema, pericardial effusion, heart murmur, dyspnea, thromboembolism, hyperthyroidism, and being alive at the time of study. Interventricular septal thickness, left ventricular free wall thickness, percent fractional shortening, and left atrial size additionally were compared to 3-month survival. Cats with Type HI hypertrophy were more likely to experience thromboembolism than cats with Type II hypertrophy (P= 0.05) and cats with Type I hypertrophy were more likely to have heart murmurs than cats with Type III (P= 0.02). No other significant associations were found in comparison to pattern of hypertrophy. Both left atrial size and percent fractional shortening significantly correlated with 3-month survival (P < 0.001 for each). The degree of interventricular septal wall thickness was associated with 3-month survival (P= 0.02) when known hyperthyroid cats were excluded from the study group, while left ventricular free wall thickness consistently was not associated with survival. This study demonstrates the heterogeneity of hypertrophy in cats with hyper-trophic heart disease and provides predictors of survival (left atrial size, percent fractional shortening, and interventricular septal wall thickness when compared with euthanasia/spontaneous death data).