Feasibility of transoesophageal echocardiography for evaluation of left ventricular performance in anaesthetised horses.

Transoesophageal Doppler echocardiography was performed in 7 Thoroughbred horses anaesthetised with halothane. The procedure was performed on 4 occasions under standard conditions. On one occasion dobutamine hydrochloride was infused at 4 micrograms/kg/min for 20 min. Recordings of aortic blood velocity, obtained using high pulsed repetition frequency Doppler echocardiography (HPRF), were used to derive maximum acceleration (dv/dtmax), maximum velocity (Vmax), left ventricular ejection time (ET), pre-ejection period (PEP), velocity time integral (VTI) and cardiac output (CO). The coefficient of variation and 95% confidence intervals were narrower for the Doppler variables than for those obtained from cardiac catheterisation. For each horse the anaesthetic to anaesthetic repeatability of the Doppler indices of left ventricular function, exceeded that of maximum rate of rise of left ventricular pressure (LVdp/dtmax). The horse to horse variability was significant for heart rates Vmax, dv/dtmax, and VTI. After dobutamine infusion there were significant changes in all measured variables except heart rate, VTI and CO. The % change that occurred exceeded the predicted 95% confidence intervals for single measurements in all significantly affected variables. This suggests Doppler indices of cardiac performance may be useful to assess changes in haemodynamic function. Passage of the probe into the oesophagus was not associated with serious adverse effects. Mild serous nasal discharge was visible for up to 24 h after the horses recovered from anaesthesia. Mild nasal haemorrhage occurred on 5 occasions during probe insertion. It is concluded that transoesophageal Doppler echocardiography provides a minimally invasive, continuous method for monitoring left ventricular systolic performance in anaesthetised horses.