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Home / Equine Research Bank / Equine Vet J / Real-time three-dimensional echocardiography for left atrial...
Equine veterinary journal2021; 54(1); 176-190; doi: 10.1111/evj.13408

Real-time three-dimensional echocardiography for left atrial volume assessment in Thoroughbred racehorses: Observer variability and comparison with two-dimensional echocardiography.

Abstract: Left atrial size predicts cardiac morbidity and mortality in humans and dogs. Real-time three-dimensional echocardiography (3DE) may be reliable for assessing left atrial volume (LAV) in horses. Objective: To determine intra- and interobserver variability estimates of 3DE-LAV and compare it to that of 2DE-LAV estimates. Methods: Method comparison. Methods: 3DE datasets were obtained from 40 horses, then graded for quality, creating a final study population of 22 horses. The 3DE and 2DE maximum LAV (LAV ) and minimum LAV (LAV ) were measured, and left atrial emptying volume (LA EV) and left atrial ejection fraction (LA EF) were calculated, from the same 3D dataset on four occasions using (a) a semi-automatic surface recognition algorithm and (b) a modified Simpson's method of discs. 3DE LAV measurements were repeated by a second observer. Results: For 3DE, median LAV was 596cm for observer one, and 852 cm for observer two, LAV was 373 cm for observer one and 533 cm for observer two. Low intraobserver measurement variation was observed for LAV and LAV , with horse-level intraclass correlation coefficients (ICC ) for both observers between 76% and 85% (horse added as random effect). The interobserver ICC was 58% for LAV and 50% for LAV on averaged measurements (with observer added as random effect), indicating consistent differences between observers. While intraobserver variation was similar for 2DE LAV measurements, it was greater for LAV (ICC  = 67%). The intermethod ICC for 3DE vs 2DE was low at 14% for LAV and ~0% for LAV , indicating less-consistent differences with method. Conclusions: Small study population, low observer number, use of different imaging modalities (fundamental frequency and octave harmonics). Conclusions: 3DE assessment of LAV was reliable, suggesting suitability for longitudinal evaluation of clinical cases. Clinicians should be aware of differences in LAV measurements between observers. More defined measurement guidelines may improve repeatability.
© 2020 EVJ Ltd.
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Publication Date: 2021-02-15 PubMed ID: 33345356DOI: 10.1111/evj.13408Google Scholar: Lookup
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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.

The research article investigates the reliability of real-time three-dimensional echocardiography (3DE) for assessing left atrial volume (LAV) in horses. The study also compares the observer variability between 3DE and traditional two-dimensional echocardiography (2DE).

Research Methodology

  • The method comparison was conducted using 3DE datasets collected from 40 Thoroughbred racehorses. Due to quality grading, only datasets from 22 horses were used in the final study.
  • Maximum and minimum LAV were measured using a semi-automatic surface recognition algorithm and a modified Simpson’s method of discs. The measurements were performed from the same 3D dataset on four separate occasions.
  • The 3DE LAV measurements were subjected to a repetition by a second observer to establish any variability.

Research Findings

  • The initial 3DE measurements suggested that the median LAV was 596cm for the first observer and 852cm for the second observer.
  • Minimal variation was noted in the intraobserver measurements for LAV with intraclass correlation coefficients (ICC) for both observers ranging between 76% and 85%. This suggests high reliability and consistency between the same observer’s measurements.
  • However, the study found lower consistency in measurements between the two different observers. The interobserver ICC was 58% for maximum LAV and 50% for minimum LAV.
  • When comparing the intraobserver variation between 2DE and 3DE measurements, similar results were found for maximum LAV, but there was greater variability for minimum LAV.
  • The comparison between 3DE and 2DE measurements showed a low ICC of 14% for maximum LAV and approximately 0% for minimum LAV. This suggests significant differences arose when using the two different methods.

Research Conclusions

  • The study confirmed that real-time 3DE is reliable for assessing LAV in horses, making it a suitable tool for longitudinal analysis of clinical cases.
  • Despite the overall consistency, some discrepancy in LAV measurements between the two observers was noted. This underlines the necessity for trained clinicians to be aware of potential differences in measurements.
  • The research emphasizes the need for more detailed measurement guidelines to enhance repeatability and allow for better cross-comparability between observations.

Cite This Article

APA
Worsman FCF, Miller ZJ, Shaw DJ, Blissitt KJ, Keen JA. (2021). Real-time three-dimensional echocardiography for left atrial volume assessment in Thoroughbred racehorses: Observer variability and comparison with two-dimensional echocardiography. Equine Vet J, 54(1), 176-190. https://doi.org/10.1111/evj.13408

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 1
Pages: 176-190

Researcher Affiliations

Worsman, Francesca C F
  • The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK.
Miller, Zack J
  • Companion Care Vets Gloucester, Gloucester, Gloucestershire, UK.
Shaw, Darren J
  • The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK.
Blissitt, Karen J
  • The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK.
Keen, John A
  • The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, UK.

MeSH Terms

  • Animals
  • Echocardiography / veterinary
  • Echocardiography, Three-Dimensional / veterinary
  • Heart Atria / diagnostic imaging
  • Horses
  • Observer Variation
  • Reproducibility of Results

Grant Funding

  • VET/CS/026 / Horserace Betting Levy Board

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Citations

This article has been cited 4 times.
  1. Ghilardi S, Pradelli D, Rizzi R, Polli M, Bagardi M, Santilli RA, Brambilla PG, Bussadori CM. A study of the inter- and intra-operator variability on selected echocardiographic measurements in dogs. Vet Res Commun 2023 Jun 23;.
    doi: 10.1007/s11259-023-10154-6pubmed: 37351815google scholar: lookup
  2. Vernemmen I, Paulussen E, Dauvillier J, Decloedt A, van Loon G. Three-dimensional and catheter-based intracardiac echocardiographic characterization of the interatrial septum in 2 horses with suspicion of a patent foramen ovale. J Vet Intern Med 2022 Jul;36(4):1535-1542.
    doi: 10.1111/jvim.16451pubmed: 35635303google scholar: lookup
  3. 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.
    doi: 10.1002/vms3.472pubmed: 33713550google scholar: lookup
  4. Vernemmen I, Buschmann E, Demeyere M, Verhaeghe LM, Van Steenkiste G, Decloedt A, van Loon G. Feasibility of transthoracic echocardiographic guidance for multicatheter electrophysiological mapping studies in horses. J Vet Intern Med 2024 Sep-Oct;38(5):2686-2697.
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