Accuracy of visually estimated left heart size by echocardiography in dogs with myxomatous mitral valve disease
The aim of this study was to assess the correlation between visual estimation of left heart size and conventional echocardiographic measurements in dogs with myxomatous mitral valve disease (MMVD). Seventy dogs with various stages of MMVD were retrospectively enrolled. Five investigators (two cardio...
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| Published in: | Journal of veterinary cardiology Vol. 61; pp. 1 - 9 |
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01.10.2025
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| Abstract | The aim of this study was to assess the correlation between visual estimation of left heart size and conventional echocardiographic measurements in dogs with myxomatous mitral valve disease (MMVD).
Seventy dogs with various stages of MMVD were retrospectively enrolled. Five investigators (two cardiologists and three non-cardiologists) received brief training before visually evaluating the left atrium-to-aortic ratio (LA:AO) and the presence of left ventricular enlargement using right parasternal long-axis five-chamber and basal short-axis echocardiographic videos. Correlations between visually estimated and conventionally measured LA:AOs were assessed using linear regression and Spearman's rank correlation. Interobserver agreement was evaluated using the intraclass correlation coefficient. Agreement in identifying left ventricular enlargement was assessed using the Fleiss Kappa coefficient.
A strong correlation was found between visual estimation and conventional measurements of LA:AO (r = 0.89; ρ = 0.90; P<0.001). Interobserver agreement for LA:AO visual estimation was good (intraclass correlation coefficient = 0.76; 95% confidence interval: 0.65–0.84). Agreement between visual and conventional evaluation of left ventricular size was moderate (Fleiss Kappa = 0.50).
Limitations include the use of high-quality images obtained by a cardiologist, the predominance of small-breed dogs, and the use of a non-standard imaging view for left ventricular internal dimension at end-diastole normalized to body weight calculation.
Visual estimation demonstrated strong correlation with quantitative LA:AO measurements and moderate agreement for left ventricular size. It may be a useful tool in emergency or primary care settings when conventional echocardiography is not feasible. |
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| AbstractList | The aim of this study was to assess the correlation between visual estimation of left heart size and conventional echocardiographic measurements in dogs with myxomatous mitral valve disease (MMVD).INTRODUCTION/OBJECTIVESThe aim of this study was to assess the correlation between visual estimation of left heart size and conventional echocardiographic measurements in dogs with myxomatous mitral valve disease (MMVD).Seventy dogs with various stages of myxomatous mitral valve disease were retrospectively enrolled. Five investigators (two cardiologists and three non-cardiologists) received brief training before visually evaluating the left atrium-to-aortic ratio (LA:AO) and the presence of left ventricular enlargement using right parasternal long-axis five-chamber and basal short-axis echocardiographic videos. Correlations between visually estimated and conventionally measured LA:AOs were assessed using linear regression and Spearman's rank correlation. Interobserver agreement was evaluated using the intraclass correlation coefficient. Agreement in identifying left ventricular enlargement was assessed using the Fleiss Kappa coefficient.ANIMALS, MATERIALS AND METHODSSeventy dogs with various stages of myxomatous mitral valve disease were retrospectively enrolled. Five investigators (two cardiologists and three non-cardiologists) received brief training before visually evaluating the left atrium-to-aortic ratio (LA:AO) and the presence of left ventricular enlargement using right parasternal long-axis five-chamber and basal short-axis echocardiographic videos. Correlations between visually estimated and conventionally measured LA:AOs were assessed using linear regression and Spearman's rank correlation. Interobserver agreement was evaluated using the intraclass correlation coefficient. Agreement in identifying left ventricular enlargement was assessed using the Fleiss Kappa coefficient.A strong correlation was found between visual estimation and conventional measurements of LA:AO (r = 0.89; ρ = 0.90; P<0.001). Interobserver agreement for LA:AO visual estimation was good (intraclass correlation coefficient = 0.76; 95% confidence interval: 0.65-0.84). Agreement between visual and conventional evaluation of left ventricular size was moderate (Fleiss Kappa = 0.50).RESULTSA strong correlation was found between visual estimation and conventional measurements of LA:AO (r = 0.89; ρ = 0.90; P<0.001). Interobserver agreement for LA:AO visual estimation was good (intraclass correlation coefficient = 0.76; 95% confidence interval: 0.65-0.84). Agreement between visual and conventional evaluation of left ventricular size was moderate (Fleiss Kappa = 0.50).Limitations include the use of high-quality images obtained by a cardiologist, the predominance of small-breed dogs, and the use of a non-standard imaging view for left ventricular internal dimension at end-diastole normalized to body weight calculation.STUDY LIMITATIONSLimitations include the use of high-quality images obtained by a cardiologist, the predominance of small-breed dogs, and the use of a non-standard imaging view for left ventricular internal dimension at end-diastole normalized to body weight calculation.Visual estimation demonstrated strong correlation with quantitative LA:AO measurements and moderate agreement for left ventricular size. It may be a useful tool in emergency or primary care settings when conventional echocardiography is not feasible.CONCLUSIONSVisual estimation demonstrated strong correlation with quantitative LA:AO measurements and moderate agreement for left ventricular size. It may be a useful tool in emergency or primary care settings when conventional echocardiography is not feasible. The aim of this study was to assess the correlation between visual estimation of left heart size and conventional echocardiographic measurements in dogs with myxomatous mitral valve disease (MMVD). Seventy dogs with various stages of MMVD were retrospectively enrolled. Five investigators (two cardiologists and three non-cardiologists) received brief training before visually evaluating the left atrium-to-aortic ratio (LA:AO) and the presence of left ventricular enlargement using right parasternal long-axis five-chamber and basal short-axis echocardiographic videos. Correlations between visually estimated and conventionally measured LA:AOs were assessed using linear regression and Spearman's rank correlation. Interobserver agreement was evaluated using the intraclass correlation coefficient. Agreement in identifying left ventricular enlargement was assessed using the Fleiss Kappa coefficient. A strong correlation was found between visual estimation and conventional measurements of LA:AO (r = 0.89; ρ = 0.90; P<0.001). Interobserver agreement for LA:AO visual estimation was good (intraclass correlation coefficient = 0.76; 95% confidence interval: 0.65-0.84). Agreement between visual and conventional evaluation of left ventricular size was moderate (Fleiss Kappa = 0.50). Limitations include the use of high-quality images obtained by a cardiologist, the predominance of small-breed dogs, and the use of a non-standard imaging view for left ventricular internal dimension at end-diastole normalized to body weight calculation. Visual estimation demonstrated strong correlation with quantitative LA:AO measurements and moderate agreement for left ventricular size. It may be a useful tool in emergency or primary care settings when conventional echocardiography is not feasible. The aim of this study was to assess the correlation between visual estimation of left heart size and conventional echocardiographic measurements in dogs with myxomatous mitral valve disease (MMVD). Seventy dogs with various stages of myxomatous mitral valve disease were retrospectively enrolled. Five investigators (two cardiologists and three non-cardiologists) received brief training before visually evaluating the left atrium-to-aortic ratio (LA:AO) and the presence of left ventricular enlargement using right parasternal long-axis five-chamber and basal short-axis echocardiographic videos. Correlations between visually estimated and conventionally measured LA:AOs were assessed using linear regression and Spearman's rank correlation. Interobserver agreement was evaluated using the intraclass correlation coefficient. Agreement in identifying left ventricular enlargement was assessed using the Fleiss Kappa coefficient. A strong correlation was found between visual estimation and conventional measurements of LA:AO (r = 0.89; ρ = 0.90; P<0.001). Interobserver agreement for LA:AO visual estimation was good (intraclass correlation coefficient = 0.76; 95% confidence interval: 0.65–0.84). Agreement between visual and conventional evaluation of left ventricular size was moderate (Fleiss Kappa = 0.50). Limitations include the use of high-quality images obtained by a cardiologist, the predominance of small-breed dogs, and the use of a non-standard imaging view for left ventricular internal dimension at end-diastole normalized to body weight calculation. Visual estimation demonstrated strong correlation with quantitative LA:AO measurements and moderate agreement for left ventricular size. It may be a useful tool in emergency or primary care settings when conventional echocardiography is not feasible. |
| Author | Ito, D. Toyofuku, T. Arizuka, N. Ichihashi, H. Baba, R. Okada, M. |
| Author_xml | – sequence: 1 givenname: R. surname: Baba fullname: Baba, R. email: r.baba.dvm@gmail.com organization: Fujita Animal Hospital, 53-2-1, Kasuga, Ageo City, Saitama 362-0074, Japan – sequence: 2 givenname: D. surname: Ito fullname: Ito, D. organization: Vets Heart, 18-13, Nishiarai-cho, Tokorozawa, Saitama 359-0035, Japan – sequence: 3 givenname: T. surname: Toyofuku fullname: Toyofuku, T. organization: Nishigahara Rose Animal Hospital, 1-27-36, Nishigahara, Kita-ku, Tokyo 114-0024, Japan – sequence: 4 givenname: H. surname: Ichihashi fullname: Ichihashi, H. organization: Fujita Animal Hospital, 53-2-1, Kasuga, Ageo City, Saitama 362-0074, Japan – sequence: 5 givenname: N. surname: Arizuka fullname: Arizuka, N. organization: Fujita Animal Hospital, 53-2-1, Kasuga, Ageo City, Saitama 362-0074, Japan – sequence: 6 givenname: M. orcidid: 0000-0002-0746-206X surname: Okada fullname: Okada, M. organization: Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Towada, Aomori 034-8628, Japan |
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| Cites_doi | 10.3389/fvets.2022.830275 10.1111/jvim.15549 10.1111/j.1740-8261.2002.tb01051.x 10.1016/j.cvsm.2021.07.005 10.1016/j.ijcard.2004.03.027 10.1016/j.jvc.2011.11.005 10.1111/jvim.15488 10.1111/jvim.14586 10.5811/westjem.2013.9.16185 10.1111/jvim.15246 10.1186/1476-7120-7-41 10.1111/jvim.16539 10.1016/j.jvc.2023.04.003 10.1111/vec.12056 |
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| SubjectTerms | Animals body weight confidence interval Dog Diseases - diagnostic imaging Dog Diseases - pathology Dogs echocardiography Echocardiography - veterinary Eyeball Female Focused cardiac ultrasonography heart Heart Ventricles - diagnostic imaging Left heart enlargement Male Mitral Valve - diagnostic imaging Mitral Valve - pathology regression analysis Retrospective Studies |
| Title | Accuracy of visually estimated left heart size by echocardiography in dogs with myxomatous mitral valve disease |
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