Chetboul Valerie, Tidholm Anna, Nicolle Audrey, Sampedrano Carolina Carlos, Gouni Vassiliki, Pouchelon Jean-Louis, Lefebvre Herve P, Concordet Didier
Unité de Cardiologie, and INSERM U660, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort cedex, France.
J Am Vet Med Assoc. 2005 Sep 1;227(5):743-7. doi: 10.2460/javma.2005.227.743.
To evaluate the effects of positioning and number of repeated measurements on intra- and interobserver variability of echocardiographic measurements in dogs.
Prospective study.
4 healthy dogs.
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.
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.
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.
评估体位和重复测量次数对犬超声心动图测量中观察者内和观察者间变异性的影响。
前瞻性研究。
4只健康犬。
每位观察者进行24次检查,分别对每只犬进行6次非连续测量(犬侧卧时测量3次,站立时测量3次)。评估的变量包括左心室舒张末期和收缩末期直径的M型测量、舒张期和收缩期左心室游离壁厚度、舒张期和收缩期室间隔厚度、左心室缩短分数,以及左心房直径与主动脉直径比值的二维测量。
所有变异系数(范围为3.4%至26.6%)在操作者和体位之间相似,32个值中有27个<15%。对于两位操作者,站立位时左心室收缩末期直径、舒张期左心室游离壁厚度、收缩期左心室游离壁厚度以及左心房直径与主动脉直径比值的测量重复性更好,缩短分数和左心室舒张末期直径在两个体位的重复性相似。未观察到心动周期的影响。
对于大多数测量变量,犬站立位时进行的常规超声心动图日内变异性至少与犬侧卧时相当。对于检查无心律失常犬的训练有素的观察者,每个变量的单次测量可能就足够了。应采用站立位,特别是对于应激或呼吸困难的犬。