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Pulsed wave tissue Doppler imaging of the left ventricle in foals: Feasibility, inter- and intra-observer variability and wave pattern over the first days of life.
Abstract: Tissue Doppler imaging (TDI) may improve the assessment of myocardial function in neonatal foals. Objective: To document the feasibility of left ventricular pulsed wave (PW) TDI, inter- and intra-observer variability and wave pattern over the first 5 days of life. Methods: Prospective observational study. Methods: Transthoracic echocardiography was performed in 25 healthy Standardbred foals within the first 24 h after birth (T1), between 60-84 h (T2), and 108-132 h (T3) after birth using right parasternal short-axis (R-LV SAX) and subcostal long-axis views at the mitral annulus, both at the interventricular septum (SC-MV IVS) and free wall (SC-MV FW). Systolic (S, S) and diastolic (E, E, A) peak velocities were measured at each site. Intra- and inter-observer variability was assessed using intraclass correlation coefficients (ICC). Longitudinal changes were analysed using Friedman's test with Sidak-adjusted pairwise comparisons. E and A were compared using the paired Wilcoxon test. Results: Pulsed wave tissue Doppler imaging was feasible in all foals. S and E were frequently indistinguishable. ICCs showed excellent agreement for most variables; measurement variability was low. S (R-LV SAX: T1 = 9.3 [8.2-11.0] cm/s; T3 = 12 [11.1-12.7] cm/s; p < 0.01), E (R-LV SAX: T1 = 15.8 [14.1-20.1] cm/s; T3 = 22.1 [20.2-25.5] cm/s; p = 0.003; SC-MV FW: T1 = 16.9 [15.2-20.6] cm/s; T3 = 21.0 [18.1-22.3] cm/s; p = 0.019) and R-LV SAX E/A (T1 = 1.5 [1.3-1.9] cm/s; T3 = 1.9 [1.7-2.6] cm/s; p = 0.003) increased over time. E was higher than A in the R-LV SAX view at all time points. Conclusions: Effective sample size varied across analyses. Conclusions: Pulsed wave tissue Doppler imaging was feasible. S and E increased over time, while A remained stable, indicating early ventricular adaptation to extra-uterine life. PW TDI may be a useful tool in myocardial function monitoring of neonatal foals.
© 2026 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2026-08-04 PubMed ID: 42552265DOI: 10.1002/evj.70304Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
Pulsed wave tissue Doppler imaging (PW TDI) of the left ventricle was tested in newborn foals to see if it is practical to use, how consistent the measurements are between and within observers, and how heart muscle motion patterns change during the first days after birth.
Study Objective and Design
- Investigate the feasibility of using PW TDI to assess left ventricular myocardial function in neonatal foals.
- Evaluate inter-observer (between different examiners) and intra-observer (same examiner at different times) variability of PW TDI measurements.
- Characterize changes in Doppler wave patterns at specific left ventricular sites during the first 5 days of life.
- Conducted as a prospective observational study involving 25 healthy Standardbred foals.
Methods
- Transthoracic echocardiography with PW TDI was performed at three time points:
- T1: Within the first 24 hours after birth.
- T2: 60-84 hours (approximately days 3-4).
- T3: 108-132 hours (approximately days 4.5-5.5).
- Imaging used two echocardiographic views to assess the mitral annulus motion:
- Right parasternal short-axis view of the left ventricle (R-LV SAX).
- Subcostal long-axis view at the mitral valve, focusing separately on:
- Interventricular septum (SC-MV IVS)
- Free wall (SC-MV FW)
- Measured peak velocities of myocardial tissue motion at each site:
- Systolic peak velocity (S or S’).
- Early diastolic peak velocities (E or E’).
- Late diastolic peak velocity (A), reflecting atrial contraction.
- Statistical analysis included:
- Intraclass correlation coefficients (ICC) to assess measurement reliability between and within observers.
- Friedman’s test with Sidak adjustments for comparing values across time points.
- Paired Wilcoxon test to compare early (E) and late (A) diastolic velocities.
Key Findings: Feasibility and Measurement Reliability
- PW TDI was feasible in all 25 foals at all time points.
- Systolic (S) and early diastolic (E) waveforms often overlapped or were difficult to distinguish separately.
- Measurement variability was low, supported by excellent agreement indicated by ICC values for most velocity variables.
Longitudinal Changes in Doppler Velocities
- Systolic velocity (S) measured in the right parasternal short-axis view increased significantly from T1 to T3:
- T1 median: 9.3 cm/s (range 8.2-11.0 cm/s)
- T3 median: 12 cm/s (11.1-12.7 cm/s)
- Statistically significant (p < 0.01)
- Early diastolic velocity (E) increased in the R-LV SAX and SC-MV FW locations between T1 and T3:
- R-LV SAX: From 15.8 to 22.1 cm/s (p = 0.003)
- SC-MV FW: From 16.9 to 21.0 cm/s (p = 0.019)
- The E/A ratio (early to late diastolic velocity ratio) in R-LV SAX view increased, indicating that early diastolic filling velocity became more dominant over the first days:
- From 1.5 at T1 to 1.9 at T3 (p = 0.003)
- At all time points, E velocities exceeded A velocities in the R-LV SAX view, reflecting physiologic diastolic filling patterns.
- The A wave velocity remained relatively stable over time.
Conclusions and Clinical Implications
- PW TDI is a practical and reproducible method for assessing left ventricular myocardial velocities in healthy neonatal foals.
- Increasing systolic and early diastolic velocities during the first 5 days suggest early functional adaptation of the left ventricle to extra-uterine life.
- The stability of the late diastolic (A) velocity suggests consistent atrial contribution to ventricular filling shortly after birth.
- Given the low variability and feasibility, PW TDI may be a valuable tool for monitoring myocardial function and detecting subtle cardiac dysfunction in neonatal foals.
- The study found some limitations due to variable effective sample sizes in specific analyses.
Cite This Article
APA
D'el Rey Dantas FT, Hallowell G, Castagnetti C, Romito G, Menchetti L, Mannini A, Lanci A, Mariella J, Freccero F.
(2026).
Pulsed wave tissue Doppler imaging of the left ventricle in foals: Feasibility, inter- and intra-observer variability and wave pattern over the first days of life.
Equine Vet J.
https://doi.org/10.1002/evj.70304 Publication
Researcher Affiliations
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
- Medicine Vet Equine Referrals, Upper Broughton, Leicestershire, UK.
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy.
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy.
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