Repeatability and reliability of left ventricular focused cardiac ultrasound parameters in dogs obtained and measured by two non-cardiologist clinicians

TL;DR

This study assesses how consistently non-cardiologists can measure heart parameters in dogs using focused cardiac ultrasound.

Contribution

The study evaluates repeatability and reliability of LV FCU parameters measured by non-cardiologists compared to a cardiologist.

Findings

LVEDD in short-axis B-mode showed excellent repeatability and reliability.

EPSS measurements were neither repeatable nor reliable.

M-mode and long-axis B-mode LVEDD showed good repeatability and reliability.

Abstract

Focused cardiac ultrasound (FCU) of the left ventricle (LV) is performed by non-cardiologists in critical care settings. Validity of measurements relies on accurate acquisition and measurement techniques.

Investigate the acquisition and measurement repeatability of selected LV parameters and report reliability compared with measurements made by a board-certified cardiologist, with the goal of identifying parameters that might warrant further investigation in FCU.

Thirty hemodynamically stable dogs with sinus cardiac rhythms.

Right-sided FCU was performed by 2 critical care clinicians and a cardiologist. Left ventricular (LV) diameters, fractional shortening, and E-point septal separation (EPSS) were recorded. Intra-operator acquisition repeatability was quantified by coefficients of variation (CVacquisition); inter-operator reliability (compared with the cardiologist) was described by intraclass correlation coefficients (ICCinter-operator) and CVinter-operator; intra-operator measurement repeatability was described by ICCmeasurement.

Left ventricular end-diastolic diameter (LVEDD) in short-axis B-mode had excellent repeatability and reliability for both critical care clinicians (CVacquisition < 10%; CVinter-operator < 10%, ICCinter-operator > 0.9; ICCmeasurement > 0.9). Left ventricular end-diastolic diameter in short axis M-mode and long axis B- and M-mode showed good repeatability and reliability. E-point septal separation was neither repeatable nor reliable.

The LVEDD measurements were repeatable and reliable when obtained and measured by 2 non-cardiologists in hemodynamically stable dogs with normal sinus rhythms. Further study of LVEDD measurements is recommended in FCU. The EPSS cannot be recommended based on these data.

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