Graziano Nicolas, Gommeren Kris, Valcke Annelies, Burnotte Priscilla, Beeston Dave, Walker Tom, Gele Rebecca, Lekane Marine, Merveille Anne Christine
Department of Small Animal Clinical Science, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
Willows Veterinary Centre and Referral Services, Solihull, United Kingdom.
Front Vet Sci. 2025 May 21;12:1548417. doi: 10.3389/fvets.2025.1548417. eCollection 2025.
To determine interobserver variability of left ventricular eccentricity indices measurements in systole (EIs), diastole (EId) and at maximum flattening (EIm) by emergency and critical care residents on prerecorded cineloops in dogs with or without pulmonary hypertension. To assess whether these EI measurements allow to identify dogs with right heart changes compatible with moderate to severe pulmonary hypertension (PAH).
Multicenter, retrospective, case-control study from 2017 to 2021. Medical records of dogs with stage B1 myxomatous mitral valve disease (MMVD) and dogs diagnosed with precapillary pulmonary hypertension (PCPH) via echocardiograms were reviewed. Dogs were categorized by a cardiologist into five groups (normal, B1 MMVD, mild, moderate, and severe PCPH) based on Doppler pulmonary pressure gradients and right heart morphology. Four blinded emergency and critical care residents measured EIs, EId and EIm.
One hundred and forty-five client-owned dogs were included. Interobserver agreement was strong, with an intraclass correlation coefficient (ICC) of 0.737 (95% CI: 0.621-0.852) across all eccentricity indices for the full study population and 0.768 (0.642-0.856) for the PAH group specifically. EIs, EId, and EIm were significantly higher in the PAH group compared to control and MMVD groups ( < 0.0001). The differentiation between moderate-to-severe and mild/absent PAH by EIs, EId, and EIm resulted in AUCs of 0.738, 0.834, and 0.766, with cut-off values of 1.40, 1.34, and 1.28, respectively. A gray zone approach identified 90% sensitivity for EIs (1.12), EId (1.15), and EIm (1.23), and specificity for EIs (2.27), EId (1.32), and EIm (2.1) to rule out or diagnose moderate-to-severe PAH.
This study showed good inter-observer agreement of EIs, EIm, and EId measurement by ECC residents on prerecorded loops. EI allowed good identification of dogs with moderate to severe PAH by ECC residents.
确定急诊和重症监护住院医师对患有或不患有肺动脉高压的犬类预先录制的电影环路中左心室收缩期（EIs）、舒张期（EId）和最大扁平期（EIm）偏心指数测量的观察者间变异性。评估这些EI测量是否能够识别出右心变化与中度至重度肺动脉高压（PAH）相符的犬类。
2017年至2021年的多中心、回顾性、病例对照研究。回顾了患有B1期黏液瘤性二尖瓣疾病（MMVD）的犬类以及通过超声心动图诊断为毛细血管前肺动脉高压（PCPH）的犬类的病历。心脏病专家根据多普勒肺动脉压力梯度和右心形态将犬类分为五组（正常、B1 MMVD、轻度、中度和重度PCPH）。四名不知情的急诊和重症监护住院医师测量了EIs、EId和EIm。
纳入了145只客户拥有的犬类。观察者间一致性很强，整个研究人群所有偏心指数的组内相关系数（ICC）为0.737（95% CI：0.621 - 0.852），PAH组特异性为0.768（0.642 - 0.856）。与对照组和MMVD组相比，PAH组的EIs、EId和EIm显著更高（<0.0001）。EIs、EId和EIm区分中度至重度和轻度/无PAH的曲线下面积（AUC）分别为0.738、0.834和0.766，截断值分别为1.40、1.34和1.28。一种灰色区域方法确定EIs（1.12）、EId（1.15）和EIm（1.23）的敏感性为90%，EIs（2.27）、EId（1.32）和EIm（2.1）排除或诊断中度至重度PAH的特异性。
本研究表明，急诊和重症监护住院医师对预先录制环路中EIs、EIm和EId测量具有良好的观察者间一致性。EI能够使急诊和重症监护住院医师很好地识别出患有中度至重度PAH的犬类。
