Echocardiographic reference intervals for right ventricular indices, including 3-dimensional volume and 2-dimensional strain measurements in healthy dogs

Abstract

Background: There is currently a lack of reference intervals (RIs) for the novel measures like 3-dimensional (3D) echocardiography or speckle-tracking strain for assessment of right ventricular (RV) structure and function.

Objectives: To generate RIs and to determine the influence of age, heart rate, and body weight (BW) on various RV function indices using a dedicated RV software for 3D RV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), global and free wall RV longitudinal strain (RVLS), end-diastolic area (RVEDA), end-systolic area (RVESA), fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and tissue Doppler imaging (TVI)-derived systolic myocardial velocity of the lateral tricuspid annulus (S').

Animals: Healthy adult client-owned dogs (n = 211) of various breeds and ages.

Methods: Prospective study. Reference intervals were estimated as statistical prediction intervals using allometric scaling for BW-dependent variables. Right-sided (upper limit) or left-sided (lower limit) 95% RIs were calculated for every variable. Inter- and intraobserver variability was determined.

Results: Most variables showed clinically acceptable repeatability with coefficient of variation less than 10. Upper or respectively lower RI after allometric scaling to normalize for different BWs were: EDVn ≤ 2.5 mL/kg^0.942 , ESVn ≤ 1.2 mL/kg^0.962 , TAPSEn ≥ 4.5 mm^0.285 , RVEDAn ≤ 1.4 cm² /kg^0.665 , RVESAn ≤ 0.8 cm² /kg^0.695 , and TVI S'n ≥ 5.6 cm/s/kg^0.186 . The calculated limits for indices without allometric normalization were: EF > 42.1%, FAC > 30.0%, free wall RVLS < -20.8%, and global RVLS < -18.3%.

Conclusions: Echocardiographic RIs for RV structure and function are provided.

Keywords: canine; heart dimensions; prediction intervals; repeatability; volumetric measurements.