Assessing aortic regurgitation severity from 2D, M-mode and pulsed wave Doppler echocardiographic measurements in horses.
Abstract: Aortic regurgitation (AR) in horses can lead to left ventricular (LV) eccentric hypertrophy, ventricular arrhythmia and heart failure. Objective quantification of the severity of regurgitation is difficult. The aim of this study was to evaluate dimensional measurements, systolic time intervals and blood flow velocities, acquired by standard 2D, M-mode and pulsed wave Doppler echocardiography, for quantification of AR. Echocardiography was performed in 32 healthy horses and 35 horses with AR that were subdivided in three groups (mild, moderate or severe AR). From the recorded images LV, left atrial and aortic dimensions, systolic time intervals and aortic blood flow velocities were measured. Diastolic run-off in the aorta (AoDiastDecr) was calculated as the difference in aortic diameter between early diastole and late diastole. Stroke volume (SV) was calculated from pulsed wave Doppler measurements, by the bullet method (SVbullet) and by the area-length method. Pre-ejection period (PEP) and ejection time (LVET) were determined from the M-mode images. Horses with AR showed enlargement of the LV, left atrium and aorta compared to the control group. The SV, the AoDiastDecr and the rate of AoDiastDecr were significantly larger than controls. PEP decreased significantly in horses with AR, whereas LVET did not change. PEP and the newly defined variable AoDiastDecr proved to be easy to measure parameters that provided a good indication of AR severity. There was increased SV in horses with AR using all three methods, but SVbullet was superior for the detection of increased AR severity.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Publication Date: 2016-01-18 PubMed ID: 26900009DOI: 10.1016/j.tvjl.2016.01.011Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research study is aimed at evaluating the effectiveness of various dimensional measurements from echocardiography in the quantification of aortic regurgitation (AR) severity in horses.
Echocardiographic Measurements and Assessment Methods
- The research involved echocardiography performed on 32 healthy horses and 35 horses with AR. The AR-affected horses were further subdivided into three groups based on the severity of their condition – mild, moderate, or severe.
- Different parameters like left ventricular (LV), left atrial and aortic dimensions, systolic time intervals, and aortic blood flow velocities were measured from the recorded echocardiographic images.
- Additional calculations like diastolic run-off in the aorta (calculated as the difference in aortic diameter between early and late diastole, abbreviated as AoDiastDecr), stroke volume (calculated from pulsed wave Doppler measurements, as well as by the bullet method and the area-length method), pre-ejection period (PEP), and ejection time (LVET) were also determined to evaluate AR severity.
Findings and Analysis
- It was observed that horses with AR had enlargement of the left ventricle, left atrium, and aorta compared to the control group of healthy horses.
- Parameters like stroke volume (SV), the AoDiastDecr, and the rate of AoDiastDecr were significantly larger in horses with AR in contrast to the control group.
- The pre-ejection period (PEP) was observed to have decreased significantly in horses with AR, whereas the ejection time (LVET) showed no significant change.
- It was found that PEP and the newly defined variable AoDiastDecr served as effective and easy to measure parameters, providing a good indication of AR severity.
- An increased stroke volume was observed in horses with AR using all three methods of calculation, but the bullet method (SVbullet) was found to be superior in detecting increased AR severity.
Conclusion
- This research highlights the effective utilization of various echocardiographic measurements and calculations to better classify and quantify the severity of aortic regurgitation in horses.
- The identified parameters and methods could potentially assist in improving the clinical management and treatment of equine aortic regurgitation.
Cite This Article
APA
Ven S, Decloedt A, Van Der Vekens N, De Clercq D, van Loon G.
(2016).
Assessing aortic regurgitation severity from 2D, M-mode and pulsed wave Doppler echocardiographic measurements in horses.
Vet J, 210, 34-38.
https://doi.org/10.1016/j.tvjl.2016.01.011 Publication
Researcher Affiliations
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Ghent B-9820, Belgium. Electronic address: sofie.ven@ugent.be.
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Ghent B-9820, Belgium.
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Ghent B-9820, Belgium.
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Ghent B-9820, Belgium.
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Ghent B-9820, Belgium.
MeSH Terms
- Animals
- Aortic Valve Insufficiency / diagnosis
- Aortic Valve Insufficiency / physiopathology
- Aortic Valve Insufficiency / veterinary
- Echocardiography, Doppler, Pulsed / veterinary
- Female
- Horse Diseases / diagnosis
- Horses
- Male
Citations
This article has been cited 5 times.- Vernemmen I, Van Steenkiste G, Dufourni A, Decloedt A, van Loon G. Transvenous electrical cardioversion of atrial fibrillation in horses: Horse and procedural factors correlated with success and recurrence.. J Vet Intern Med 2022 Mar;36(2):758-769.
- Vitale V, Laurberg M, van Galen G. Transthoracic echocardiography and its limitations in the diagnosis of congenital supernumerary aortic valve in a Thoroughbred.. Vet Med Sci 2023 Mar;9(2):712-716.
- Decloedt A, Ven S, De Clercq D, Rademakers F, van Loon G. Assessment of left ventricular function in horses with aortic regurgitation by 2D speckle tracking.. BMC Vet Res 2020 Mar 20;16(1):93.
- Vera L, De Clercq D, Van Steenkiste G, Decloedt A, Chiers K, van Loon G. Differences in ultrasound-derived arterial wall stiffness parameters and noninvasive blood pressure between Friesian horses and Warmblood horses.. J Vet Intern Med 2020 Mar;34(2):893-901.
- Boegli J, Schwarzwald CC, Mitchell KJ. Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation.. J Vet Intern Med 2019 May;33(3):1446-1455.
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