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Research article2019Peer reviewedOpen access

Comparison between real-time 3-dimensional and 2-dimensional biplane echocardiographic assessment of left atrial volumes in dogs with myxomatous mitral valve disease

Tidholm, Anna; Bodegard-Westling, Anna; Hoglund, Katja; Haggstrom, Jens; Ljungvall, Ingrid


Background: Assessment of left atrial (LA) size is important in medical decision making and prognostication in dogs with myxomatous mitral valve disease (MMVD). Real-time 3-dimensional (RT3DE) and 2-dimensional echocardiographic (2DE) methods may be used to assess LA size.Objectives: To compare measured LA volumes obtained by RT3DE with those calculated by biplane Simpson's modified method of discs (SMOD) and the area-length method (ALM) using the same RT3DE acquisition with the same timing.Animals: One hundred twenty-one privately owned dogs with naturally occurring MMVD.Methods: Prospective observational study comparing LA volumes indexed to body weight using RT3DE and 2DE-based biplane SMOD and ALM. Agreement between methods was evaluated using Bland-Altman plots and linear regression analyses.Results: Estimations of LA volume using SMOD or ALM did not show good agreement with RT3DE-derived measurements. Absolute differences between methods increased with increasing LA volume, but SMOD underestimated whereas ALM overestimated calculated volumes compared to RT3DE-derived measurements. The difference in LA volume between RT3DE and the biplane methods showed a systematic underestimation of 7% for SMOD and a systematic overestimation of 24% for ALM. Comparison of LA volumes obtained by SMOD and ALM did not show good agreement. The ALM yielded 30% larger LA volumes compared to SMOD.Conclusion and Clinical Importance: In comparison with RT3DE, SMOD systematically underestimated whereas ALM systematically overestimated LA volumes in dogs with MMVD. Because the systematic difference between RT3DE and SMOD was only 7%, SMOD might be considered the method of choice.


area-length method; canine; mitral regurgitation; Simpson's modified method of discs

Published in

Journal of Veterinary Internal Medicine
2019, Volume: 33, number: 2, pages: 455-461
Publisher: WILEY