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Abstract
BackgroundThe left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats. Its size is currently measured in one-dimensional methods, while human medicine considers two- and three-dimensional echocardiography as standard. The objectives of this study were to compare monoplane, biplane, triplane and real-time three dimensional echocardiography for volumetric measurement of the left atrium in healthy cats and establish a reference interval for further studies on cats with heart disease. Additionally, the influence of age, sex and weight on left atrial volume (LAV) was tested.ResultsOne dimensional monoplane Simpson method of discs (SMOD) in the right parasternal four chamber view (r4) and the left apical 2 chamber view (l2) as well as biplane SMOD had no significant difference for left atrial maximum volume (LAMax). They can be used as equivalent in future studies and one common reference range was set up (1.96 ± 0.54 ml). Those three methods produced significantly higher volumes than triplane echocardiography (RTTPE) and real time three dimensional echocardiography (RT3DE) using TomTec® software. LA volumetry with RTTPE and RT3DE-TomTec™ was more feasible than expected, but low RT3DE image quality was the main reason for excluding patients. Neither age nor weight had an influence on LA volume in healthy cats. Male LAV results were only slightly, but in 2D and RTTPE significantly higher than those of female cats with a range of + 10.46% to + 19.58%.ConclusionsMonoplane, biplane, triplane and real-time three dimensional echocardiography were feasible for LA volumetry in healthy cats and showed acceptable intra- and interobserver variability. One common LAMax reference range for monoplane r4, l2 and biplane SMOD was set up. Raw data can be used for LA volumes and does not need to be correlated with the cat’s weight or age. Male cats have only slightly but significantly larger atria than females in 2D and RTTPE. Therefore, under reservation, also sex related limit values were defined.
Highlights
The left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats
Apart from that, reference values were established for all methods and one common left atrial maximum volume (LAMax) reference value could be defined for l2, r4 and biplane Simpson method of discs (SMOD)
LAMax and LA minimum (LAMin) were measured with 6 echocardiographic methods: 2D monoplane Simpson method of discs (R4), left apical two chamber view (L2) and four chamber view (L4) measured with 2D monoplane Simpson method of discs, Left apical two chamber view (L2) and Left apical four chamber view (L4) combined to biplane volumetry (Biplane), Real Time Triplane Echocardiography (RTTPE) and 4D-TomTecTM analysing software
Summary
The left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats. Its size is currently measured in one-dimensional methods, while human medicine considers two- and three-dimensional echocardiography as standard. The objectives of this study were to compare monoplane, biplane, triplane and realtime three dimensional echocardiography for volumetric measurement of the left atrium in healthy cats and establish a reference interval for further studies on cats with heart disease. Rauch et al BMC Veterinary Research (2020) 16:263 medicine because it captures the most realistic asymmetrical structure, but the requirement of general anesthesia and high costs make MRI an unsuitable standard examination method in cats [12]. One-dimensional (1D) diameter measurements are most commonly used in cats because they are simple and fast to perform [13]. Some authors have reported that pulmonary vein to pulmonary artery ratio variables were better factors than LA/AO for identifying cats with congestive heart failure [22]
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