How reliable is left heart ultrasound by non-cardiologist vets in dogs

Abstract

BACKGROUND: 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. HYPOTHESIS/OBJECTIVES: 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. ANIMALS: Thirty hemodynamically stable dogs with sinus cardiac rhythms. METHODS: 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. RESULTS: Left ventricular end-diastolic diameter (LVEDD) in short-axis B-mode had excellent repeatability and reliability for both critical care clinicians (CVacquisition&#xa0;<&#xa0;10%; CVinter-operator&#xa0;<&#xa0;10%, ICCinter-operator&#xa0;>&#xa0;0.9; ICCmeasurement&#xa0;>&#xa0;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. CONCLUSIONS AND CLINICAL IMPORTANCE: 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.