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使用线性测量、基于面积的指标和容积估计对温血马左心室大小和收缩功能进行超声心动图评估:一项回顾性数据库分析。

Echocardiographic assessment of left ventricular size and systolic function in Warmblood horses using linear measurements, area-based indices, and volume estimates: A retrospective database analysis.

作者信息

Berthoud Djamila, Schwarzwald Colin C

机构信息

Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

出版信息

J Vet Intern Med. 2021 Jan;35(1):504-520. doi: 10.1111/jvim.15968. Epub 2020 Nov 28.

Abstract

BACKGROUND

Echocardiographic assessment of left ventricular (LV) size and function using area-based indices and volumetric estimates is not well established in horses.

OBJECTIVE

To report reference intervals and measurement variability for uni-, 2-, and 3-dimensional echocardiographic indices of LV size and systolic function in Warmblood horses and to provide proof of concept for allometric scaling of variables to body weight. Unidimensional indices were to be compared to area-based indices and LV volume estimates to establish their clinical use.

ANIMALS

Thirty healthy Warmblood horses and 70 Warmblood horses with a primary diagnosis of mitral regurgitation or aortic regurgitation.

METHODS

Echocardiographic indices of LV size and systolic function were measured using an existing echocardiography database. Weight-related variables were scaled to body weight (BWT). Reference intervals and measurement variability were calculated, the influence of valvular regurgitation on LV size and function was investigated and agreement between different variables for detection of reduced, normal, and increased LV size and systolic function was assessed.

RESULTS

Reference values for healthy Warmblood horses were reported. Measurement variability was sufficiently low for clinical use of all variables. Allometric scaling was effective to correct diastolic LV dimensions and cardiac output for differences in BWT. Various echocardiographic indices resulted in different conclusions regarding identification of LV enlargement and systolic dysfunction in healthy horses and horses with valvular regurgitation.

CONCLUSIONS AND CLINICAL IMPORTANCE

Echocardiographic assessment of LV size and systolic function should include joint assessment of multiple uni- and multidimensional indices. Area-based or volumetric indices that reflect LV long-axis motion should be included.

摘要

背景

在马匹中,使用基于面积的指标和容积估计值对左心室(LV)大小和功能进行超声心动图评估尚未得到充分确立。

目的

报告温血马左心室大小和收缩功能的一维、二维和三维超声心动图指标的参考区间和测量变异性,并为变量与体重的异速生长缩放提供概念验证。将一维指标与基于面积的指标和左心室容积估计值进行比较,以确定其临床用途。

动物

30匹健康温血马和70匹初步诊断为二尖瓣反流或主动脉瓣反流的温血马。

方法

使用现有的超声心动图数据库测量左心室大小和收缩功能的超声心动图指标。将与体重相关的变量缩放到体重(BWT)。计算参考区间和测量变异性,研究瓣膜反流对左心室大小和功能的影响,并评估不同变量在检测左心室大小和收缩功能降低、正常和增加方面的一致性。

结果

报告了健康温血马的参考值。所有变量的测量变异性均足够低,可用于临床。异速生长缩放有效地校正了舒张期左心室尺寸和心输出量因体重差异而产生的影响。各种超声心动图指标在识别健康马匹和瓣膜反流马匹的左心室扩大和收缩功能障碍方面得出了不同的结论。

结论及临床意义

超声心动图评估左心室大小和收缩功能应包括对多个一维和多维指标的联合评估。应包括反映左心室长轴运动的基于面积或容积的指标。

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