Meta-analysis of normal canine echocardiographic dimensional data using ratio indices

ObjectivesTo investigate the dependence of echocardiographic ratio indices (ERIs) on age, body weight (BW) and breed/study group using individually contributed and published summarized data in dogs.BackgroundERIs allow for narrow prediction intervals of M-mode echocardiographic measurements in generic adult dogs. Breed and age-specific differences have not been examined systematically using ERI methods.Animals, materials and methodsIndividual M-mode measurements were contributed by 15 published investigators from 661 dogs, allowing direct calculation of ERIs and summary statistics for each of these breed/study groups. M-mode ERI summary statistics were estimated from published summaries of 22 additional groups that included 527 adult and 36 growing dogs. Individual two-dimensional (2DE) left atrial (LA) and aortic root (Ao) measurements were contributed from 36 dogs. ERIs were analyzed for dependence on BW, breed/study group and age.ResultsThe majority of variation among ERIs was due to differences in the breed or study technique with comparatively little dependence on BW. Age dependence of ERIs was seen in the early growth phases of young dogs, but expected values for each ERI became static long before maturity, roughly at 10–12 weeks of age. ERIs derived from individual 2DE LA and Ao measurements showed no significant dependence on BW.ConclusionsERIs are well normalized for body size and may be useful for clinical evaluation of individuals, prediction of expected M-mode and 2DE cardiac dimensions, and investigation of age or breed-specific cardiac shape changes.     

Linear,logarithmic, and polynomial models of M-mode echocardiographic measurements in dogs

OBJECTIVE: To determine whether logarithmic and polynomial models are superior to simple linear models for predicting reference values for M-mode echocardiographic variables in dogs with a wide range of body weights. ANIMALS: 69 apparently healthy adult male and female dogs of various breeds, ages (range, 1 to 12 years; median, 3.5 years), and body weights (range, 3.9 to 977 kg; median, 25.4 kg). PROCEDURE: Echocardiographic M-mode measurements of the interventricular septum, left ventricular dimension (LVD), left ventricular wall, aorta, and left atrium were obtained. Simple linear, second-order polynomial, third-order polynomial, and logarithmic regression models were determined by use of the least-squares method to describe the relationship between M-mode measurements and body weight. Differences in adjusted R2 values of logarithmic and polynomial models were tested for significance of contribution, compared with the simple linear model. RESULTS: Significant differences in adjusted R2 were found when comparing simple linear with logarithmic or polynomial models for LVD-diastole, LVD-systole, aorta, and left atrium. Differences in adjusted R2 between second-order polynomial, third-order polynomial, and logarithmic models were not significant for any M-mode measurement. CONCLUSIONS AND CLINICAL RELEVANCE: In this study, logarithmic or second-order polynomial models predicted reference values of M-mode measurements for size of the cardiac chambers better than simple linear models for dogs with a wide range of body weights. Logarithmic and polynomial models were not superior to simple linear models for M-mode measurements of cardiac wall thickness.     

LEFT ATRIAL TO AORTIC ROOT INDICES USING TWO-DIMENSIONAL AND M-MODE ECHOCARDIOGRAPHY IN CAVALIER KING CHARLES SPANIELS WITH AND WITHOUT LEFT ATRIAL ENLARGEMENT

Two-dimensional (2-D) echocardiographic measurement of the left atrium (LA) has the potential to be more accurate than the standard M-mode method, because the LA body can be measured. We evaluated a 2-D method for measuring LA and aorta (AO) in a right parasternal short-axis view and compared it to the M-mode method. An index for LA size (LA/AO) was calculated in 166 cavalier King Charles spaniels, 56 normal and 110 dogs with mitral regurgitation (MR) of varying degrees secondary to chronic valvular disease. In normal dogs, the AO-2-D and LA/AO-2-D did not correlate to body weight (BW) or BW2; whereas, all M-mode values and the LA-2-D were significantly (p < .05) related to both BW parameters. In normal dogs, there was no difference between M-mode and 2-D indices. For all dogs (normal and dogs with MR) there was an 11% bias between the M-mode and 2-D index with the LA/AO-2-D being higher than the LA/AO-M. The association between the mean and the difference of the indices demonstrated a quadratic relationship. Dogs with a mean LA/AO of 2.0-2.5 showed the largest difference between the two indices. Small values for the 2-D coefficients of variation for respiration and stage of diastole were found; 3.4 and 3.1%, respectively. The 2-D index is more sensitive to LA enlargement than the M-mode index.     

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.     

Relationship Between Echocardiographic Measurements and Body Size in Horses

The objectives of this study were to evaluate the optimal body size variable, and to determine mathematical model that best fits echocardiographic measurements to body size in the equine species. One hundred fifty horses of various breeds, aged 1 week to 17 years, body weight (BW) 38-890 kg, and free from cardiac disease were used in this study. Based on their age (ie, younger or older than 2 years), animals were separated into two groups. In each horse, the BW, height at withers (HT), thoracic circumference (TC), and the body length were measured; the body surface area was calculated; and a standard two-dimensional and M-mode echocardiography was performed allowing classic cardiac measurements to be taken. Correlations between each echocardiographic measurement and each of the anthropometric variables were assessed via a Pearson's product-moment analysis and using linear, logarithmic, and power regression analysis in all animals and within the two groups. The dimensional, but not functional, echocardiographic measurements showed a close correlation with all body size variables, especially during growth. The relationship between cardiac measurements and body size was best described using power regression models with TC as the anthropometric variable, but the relationship was also very accurately described using BW, body surface area, or body length. In the equine species, dimensional echocardiographic reference values should be established using power regression equations on TC. Such a correction for body size could increase the diagnostic value of echocardiography in equine cardiology.     

Use of Body Surface Area (BSA)-Based Dosages to Calculate Chemotherapeutic Drug Dose in Dogs: I. Potential Problems with Current BSA Formulae

The dose of most cancer chemotherapeutic drugs administered to dogs is calculated on the basis of estimated body surface area (BSA); however, results of some chemotherapy trials have revealed that this dosing method increases toxicosis in small dogs. The current formula used to estimate BSA in dogs may be inaccurate or the assumption that BSA correlates with chemotherapeutic drug exposure may be unfounded. Results presented in this review suggest that canine BSA estimates may be inaccurate because the values for the constant (K) and exponent (a) in the formulae (BSA = K.W^a) are incorrect or because a linear parameter such as body length is lacking from the formulae. Results that suggest the relationship between BSA and the physiologic/pharmacologic factors that influence drug exposure may not be closely correlated are also presented. Studies are warranted to determine whether there are dosing methods that normalize chemotherapeutic drug toxicity in dogs.     

Evaluation of four 2-dimensional echocardiographic methods of assessing left atrial size in dogs

Two-dimensional (2D) echocardiography is the cornerstone of noninvasive evaluation of the cardiac patient, and often involves estimating left atrial (LA) size. However, 2D echocardiographic methods of estimating LA size have been inadequately described, and most reference intervals are based on M-mode echocardiographic measurements. We determined reference intervals for 4 different 2D echocardiographic methods of estimating LA size in adult (> or =9-month-old) dogs without cardiovascular disease. Thirty-six dogs, placed in right lateral recumbency, were examined by 2D echocardiography. The left atrium was measured at specific time points in the cardiac cycle. Measurement methods were LA diameter in short axis, LA diameter in long axis, LA circumference in short axis, and LA cross-sectional area in short axis. Comparisons of these LA dimensions to appropriate aortic dimensions provided body weight-independent estimates of LA size. We found strong associations of LA dimensions with body weight (r2 = .76-.88). Comparable body weight-independent 2D echocardiographic estimates of LA size in short axis exceeded historical M-mode reference intervals. These data provide echocardiographers with reference intervals for 2D echocardiographic estimates of LA size in adult dogs.     

Echocardiography and conventional Doppler examination in clinically healthy adult Cavalier King Charles Spaniels: Effect of body weight,age, and gender,and establishment of reference intervals

ObjectivesThe objectives of this study were (1) to assess the potential effect of body weight (BW), age, and gender on the most commonly used echocardiographic and conventional Doppler variables in a large population of healthy Cavalier King Charles Spaniels (CKCS), and (2) to establish the corresponding reference intervals (RI).Animals134 healthy adult CKCS.MethodsUltrasound examinations were performed by trained observers in awake dogs. M-mode variables included left ventricular (LV) end-diastolic and end-systolic diameters, LV free wall and interventricular septal thicknesses at end-diastole and end-systole, and LV fractional shortening (FS%). The left atrium (LA) and aortic (Ao) diameters were measured using a 2D method, and the LA/Ao was calculated. Pulsed-wave Doppler variables included peak systolic aortic and pulmonary flow velocities, mitral E and A waves, and E/A ratio. Effects of BW, age, and gender on these 15 variables were tested using a general linear model, and RIs were determined by applying the statistical procedures recommended by the Clinical and Laboratory Standards Institute.ResultsA significant BW effect was observed for all variables, except LA/Ao, FS%, and mitral E/A ratio. A significant but negligible effect of gender and age was also observed for 5/15 and 4/15 of the tested variables, respectively. Only the BW effect on M-mode variables was considered as clinically relevant and the corresponding regression-based RIs were calculated.ConclusionsBody weight should be taken into account when interpreting echocardiographic values in CKCS, except for LA/Ao, FS%, and mitral E/A ratio.     

Reference values of two-dimensional and M-mode echocardiographic measurements as a function of body size in various equine breeds and in ponies

Introduction

The aim of this study was to establish echocardiographic reference values for the equine species using allometric regression equations based on body weight (BW) and thoracic circumference (TC).

Echocardiographic measurements in greyhounds, whippets and Italian greyhounds--dogs with a similar conformation but different size

OBJECTIVE: To determine the effect of body size on various echocardiographic measurements in dogs of widely differing size, but identical body conformation. DESIGN: A randomised echocardiographic study of healthy sighthounds. ANIMALS: 60 dogs comprising an equal number (20) of racing Greyhounds, Whippets and Italian Greyhounds. PROCEDURE: Following sedation with acepromazine and morphine, and acclimatization, a thorough echocardiographic examination was performed on each dog using standard methods. RESULTS: Dimensions measured echocardiographically were highly correlated with body size. These data were subsequently examined using analyses of variance and regression. Body surface area was the best overall predictor of dimensional measurements. In comparison to previous studies using dogs of differing size and conformation, the spread of values for measurements plotted against body surface area showed substantially narrower ranges. Thus, the relationship between echocardiographic measurements and body surface area was much closer for dogs with an identical somatotype than for dogs of differing size and conformation. Commonly used ejection phase indices (fractional shortening, ejection fraction and velocity of circumferential fibre shortening) were negatively correlated with body size. In contrast, the thickening fraction of the left ventricular posterior wall, another ejection phase index, was independent of body weight and body surface area for all three breeds and when the data were pooled. CONCLUSION: Taken in consideration with previous work, this study demonstrates that body conformation and body size both influence canine echocardiographic measurements. Commonly used ejection phase indices are significantly affected by body size, with larger sighthounds having lower values. A more appropriate method of quantitating left ventricular function may be the determination of the thickening fraction of the left ventricular posterior wall.     

IOHEXOL PLASMA CLEARANCE IN HEALTHY DOGS AND CATS

Iohexol plasma clearance as a measure of glomerular filtration was determined in 31 dogs and 19 cats after an intravenous (i.v.) bolus injection. All animals were healthy and privately owned. Serial blood samples were taken before and up to 4 h after tracer injection. Iohexol plasma concentration was determined using X-ray fluorescence. A plasma tracer elimination curve was generated and clearance was calculated by dividing the injected dose by the area under the curve estimated using a two-compartment pharmacological model. Clearance was normalized to body weight (BW), body surface area (BSA), and extracellular fluid volume (ECFV). Mean, SD, and coefficient of variation of plasma clearance, before and after normalization, were calculated. Linear regression analyses were performed between body size and normalized plasma clearances. No significant linear relation was found between BSA and clearance normalized to BSA in dogs, and between BSA, BW, ECFV and clearance normalized to BSA, BW, and ECFV in cats. The optimal method for normalization of iohexol plasma clearance in dogs was by using BSA. In cats, all three methods tested were considered satisfactory. Normalization to BSA appears to be superior to normalization to BW and ECFV in dogs, and can be recommended for clinical use.     

Relationships of Body Weight,Body Size,Subject Velocity,and Vertical Ground Reaction Forces in Trotting Dogs

Objective: To evaluate the relationship of body weight (BW) and size, dog velocity, and vertical ground reaction forces (GRF) from a large number of dogs of various sizes. Study Design: Clinical research. Animals: Orthopedically healthy dogs (n=129) Methods: BW and dog size, represented as height at the withers (WH), were obtained. Stance times (ST), vertical impulses (VI), and peak vertical forces (PVF) of thoracic and pelvic limbs were measured on a force plate at controlled trotting speed. They were evaluated against BW and WH using linear regression analysis in absolute (nonnormalized) values, and when normalized to BW and/or body size according to the theory of dynamic similarity. Relative velocities were calculated for each dog. Results: Absolute ST, VI, and PVF showed strong positive correlations with BW and/or body size. When GRFs were normalized to BW, correlations with body size were markedly reduced, but remained positive for VI, and turned negative for PVF. Normalizing the time‐dependent variables (ST and VI) also to WH eliminated most size influence. A small dependency of fully normalized GRF on body size remained that was because of differences in relative velocity between dogs of different sizes. Reference values for the fully normalized data are given. Conclusions: The inherent relationship between BW, body size, dog velocity, and vertical GRF was demonstrated. Clinical Relevance: BW, body size, and relative dog velocity must be accounted for when wanting to obtain GRF variables that are comparable between different dogs.     

Evaluation of the distance between Schwalbe’s line and the anterior lens capsule as a parameter for the correction of ultrasound biomicroscopic values of the canine iridocorneal angle

Objective To determine whether the distance between Schwalbe’s line (the peripheral termination of Descemet’s membrane, i.e., the borderline between the cornea and sclera) and the anterior lens capsule (SLD) is an applicable parameter for correcting raw ultrasound biomicroscopic values of the canine iridocorneal angle (ICA) and to establish a comparative system for the ICA values in different canine breeds with varied body sizes/weights. Animal studied The dogs were divided into four groups based on body weight (BW): <4 kg, 4–8 kg, 8–20 kg, and >20 kg, and 180 normotensive eyes were studied. Procedures The ICA microstructure was examined by ultrasound biomicroscopy (UBM) using 40‐MHz probes in dogs with or without anesthesia/sedation. Linear regression analysis and correlation coefficients were evaluated between SLD or SLD² and UBM measurements; subsequently, noncorrected and SLD‐corrected UBM values were statistically assessed. Results Significant linear correlations were detected between SLD and the ciliary cleft width, the minimum distance between the angle recess and the scleral venous plexus, and the scleral thickness. Positive linear correlations were also demonstrated between SLD² and the ciliary cleft area as well as the scleral venous plexus area. Raw UBM measurements were corrected by using a ratio with SLD on the distance or SLD² on the area. Although noncorrected UBM measurements increased with canine BW, SLD‐corrected UBM values remained similar with no significant statistical differences in any of the dogs. Conclusions Correction with SLD would be clinically useful for comparing UBM measurements of the ICA in dogs with different body sizes/weights.     

Echocardiographic ratio indices in overtly healthy Boxer dogs screened for heart disease

BACKGROUND: Boxer dogs are routinely screened by echocardiography to exclude congenital and acquired heart disease. Individuals of a given breed may span a large range of body sizes, potentially invalidating linear regression of M-mode measurements against body weight. Echocardiographic ratio indices (ERIs) provide a novel method of characterizing echocardiographic differences between Boxers and other dog breeds. HYPOTHESIS: ERIs obtained from overtly healthy Boxer dogs presented for cardiac screening will be different from ERIs established for normal non-Boxer dogs, and those differences will be unrelated to aortic velocity or systolic blood pressure. ANIMALS: Eighty-one Boxers with no outward clinical signs of heart disease were studied. METHODS: All dogs were examined by 2-dimensional, M-mode, and Doppler echocardiography. M-mode measurements were used to perform ERI calculations, and the indices in Boxers were compared between Boxers with varying severity of arrhythmia and those of normal non-Boxer dogs. RESULTS: Differences in weight-based ERIs, which reflect increased thickness of the left ventricular free wall (LVW) and interventricular septum (IVS) and smaller aortic size, were found in overtly healthy Boxer dogs compared with normal non-Boxer dogs. ERIs of left atrial and LV cavity size in overtly healthy Boxers were not significantly different from those of non-Boxer dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Boxer dogs may have an increased relative thickness of the LVW and IVS that is independent of aortic size, aortic velocity, or arterial blood pressure, and this morphology should be taken into consideration when screening Boxers by echocardiography.     

Comparison of two-dimensional echocardiographic measurements of the left atrium in healthy dogs

The aim of the study was to establish normal echocardiographic values of the left atrium just above the mitral annulus (LAama) in healthy dogs. In the first part of the study 20 dogs of various breeds were examined. The diameter of the left atrium just above the mitral annulus (LAama) was compared to the linear (left to right) dimension of the left atrium (LAr-l) as published earlier. There was a linear relationship between LAr-l and the body weight (LAr-l = 0.5061 BW (kg) + 22.206; R2 = 0.81), but the proportion of LAr-l/LAama was independent of the body weight (LAr-l/LAama = 0.0004 BW (kg) + 1.0833; R2 = 0.01). In the second part of the study the left atrial diameter just above the mitral annulus (LAama) was measured in 121 dogs of various breeds. There was a positive linear relationship (R2 = 0.697; p < 0.001) between body weight and LAama (LAama = 0.54 BW (kg) + 18.502+/-4.76), but there were no significant correlations between the age of animals and LAama (p = 0.45) as well as between the gender of animals and LAama (p = 0.78). Two-dimensional echocardiographic (2DE) determination of LAama as described in the present study can be recommended for use in those dogs where measurement of LAr-l encounters technical difficulties. In these cases LAr-l can be calculated from LAama using the formula LAr-l/LAama = 0.0004 BW (kg) + 1.0833, worked out in the first experiment.     

Breed‐associated variability in serum biochemical analytes in four large‐breed dogs

Background: Genetic background can influence the expected values of hematologic and serum biochemical analytes in domestic animal species. Objective: The purpose of this study was to determine if there are breed‐related differences in serum biochemical variables in healthy purebred dogs of 4 breeds and to develop appropriate reference intervals. Methods: Alaskan Malamutes (n=59), Siberian Huskies (n=78), Golden Retrievers (n=90), and English Setters (n=77) were included in the study. The dogs had a median age of 42 months (range 10–112 months) and each breed included a mix of intact and neutered dogs of both sexes. Serum biochemical profiles (Olympus AU400e) were performed along with physical examinations, CBCs, and urinalyses to ensure dogs were clinically healthy. Differences in the values of biochemical analytes were assessed nonparametrically and reference intervals for all breeds combined were calculated as the central 95% percentile. Results: Significant differences were observed between breeds for all serum biochemical analytes except alkaline phosphatase, glucose, and chloride. The analyte ranges had a large degree of overlap between the different breeds. Conclusions: Although many statistically significant breed‐related differences in serum biochemical values were observed, the differences were small and unlikely to have clinical relevance or impact medical decision making.     

Echocardiographic variables in healthy North American Salukis

Introduction

To report normal echocardiographic variables from a population of healthy Salukis in North America.

The canine T wave: a retrospective analysis on qualitative and quantitative T wave variables obtained in 129 healthy dogs and proposed reference intervals

Introduction/objectiveThe T wave is a poorly characterized electrocardiographic variable in small animals. Therefore, this study aimed to describe T wave features in a large population of healthy dogs.Animals, materials, and methodsMedical records were reviewed to identify healthy dogs ≥one-year-olds that underwent an electrocardiogram. T wave qualitative (morphology, polarity, and concordance between R and T waves) and quantitative (duration, amplitude, mean electrical axis, ratio between T and R waves amplitudes, interval from the peak to the end of the T wave, and ratio between the duration of the latter interval and that of the QT) variables were evaluated. Continuous and categorical variables were compared between dogs of distinct sex, body weight (BW), age and somatotype using the Mann–Whitney U test and χ² test, respectively. Spearman's correlation coefficients between quantitative variables and age and BW were calculated. Reference intervals of quantitative variables were determined in the overall population.ResultsOne hundred and twenty-nine dogs were enrolled. Concerning morphology, the asymmetrical (slow/fast) pattern occurred more frequently than the symmetrical and biphasic ones. Concerning polarity, positive T waves occurred more frequently than negative and neutral ones. T and R waves were predominantly concordant. No meaningful differences were found when comparing qualitative and quantitative variables between dogs of distinct sex, BW, age and somatotype. No significant correlations were found between quantitative variables and age and BW. Reference intervals of quantitative variables are provided.ConclusionsCanine T wave features were addressed and statistically reliable reference intervals made available for clinical use.     

M-mode echocardiographic ratio indices in normal dogs, cats, and horses: a novel quantitative method

A novel method for quantitative echocardiographic interpretations is introduced based on the calculation of ratio indices in which each raw M-mode measurement is divided by the aortic root dimension (Ao). "Aorta-based" indices were calculated with the animal's measured aortic root dimension (Ao(m)) as the length standard. Conversely, "weight-based" indices employed an idealized estimate of aortic dimension (Ao(w)) with a weighted least squares linear regression against the cube root of body weight (Ao(w) = kW(1/3)). Use of these indices circumvented undesirable statistical characteristics inherent in linear regression of echocardiographic dimensions against body weight and, to a lesser extent, body surface area. Compared with the regressions, ratio indices resulted in substantial refinement of the predictive range for each M-mode measurement in dogs, particularly with decreasing body size. Weight-based indices outperformed aorta-based indices in this regard. To refine the predictive range, neither type of index was clearly advantageous in cats compared with the simple average method typically employed for that species. Several of the raw M-mode measurements, however, were correlated with body weight in cats and horses, indicating the need for an appropriate correction for body size in these species. The ratio index method was suitable for this purpose. Summary statistics derived from normal dogs (n = 53), cats (n = 32), and horses (n = 17) are presented for each index, including novel clinical indices calculated from area ratios. The latter were designed to represent body size-adjusted lett ventricular stroke area (ie, volume overload) and myocardial wall area (ie, hypertrophy).