Reference intervals for various measurements of canine left atrial size and function obtained using two-dimensional and three-dimensional echocardiography

Background

Many canine cardiac diseases are associated with left atrial (LA) remodeling and decreased function. For accurate assessment of LA indices, large-scale and prospectively determined reference intervals are necessary.

Objectives

To generate reference intervals of LA size and function using two-dimensional and three-dimensional echocardiography.

Animals

Two hundred and one healthy adult dogs.

Methods

Left atrial volume was assessed in right parasternal long-axis, left apical 4-chamber and 2-chamber views using monoplane Simpson’s method, two-dimensional and three-dimensional speckle tracking. Additionally, LA diameter was measured in right parasternal short-axis and long-axis views. Furthermore, LA function was determined by measuring strain and calculating LA fractional shortening and ejection fraction. All variables were tested for correlation to heart rate, age, and body weight. For LA diameter and volume, scaling exponents and prediction intervals were generated using allometric scaling. Reference intervals for LA function parameters were calculated using nonparametric methods.

Results

Left atrial diameter and volume showed a strong correlation with body weight. The scaling exponent for LA diameter was approximately 1/3 (0.34–0.40) and approximately 1 for volume measurements (0.97–1.26). Parameters of LA function showed no clinically relevant correlation with body weight, except for two variables, which showed a mild negative correlation. No clinically relevant correlations with age or heart rate were found.

Conclusions

Reference intervals for linear, two-dimensional and three-dimensional measurements of LA size and function were established. The wide range of measurement methods offers the opportunity to select the appropriate reference values for LA evaluation depending on the available technical possibilities.