非心脏病专家兽医和心脏病专家在对15只健康比格犬的基本超声心动图参数和尾腔静脉直径进行6小时的超声心动图评估培训后达成的观察者间协议。

Elodie Darnis, A. Merveille, L. Desquilbet, S. Boysen, K. Gommeren
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Bland-Altman analysis assessed agreement of each non-cardiologist with the cardiologist; coefficients of variation (CoV) quantified variability between observers. The 95% limits of agreement (LOA) and CoVs were considered acceptable for left atrial diameter, left atrium to aortic ratio, normalized left ventricle diameter in diastole and systole but non-acceptable for fractional shortening and pulmonary vein to pulmonary artery ratio. For CVC-SubX, the 95% LOA for maximum CVC diameter were acceptable, while minimum CVC diameter and CVC collapsibility index were non-acceptable. The CoVs were good for maximum and minimum CVC (7%) and poor for collapsibility index (37%). 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引用次数: 13

摘要

目的评估一名心脏病专家和两名非心脏病专家在6小时的培训课程后,用超声心动图对创伤和分诊(CV-FAST)进行心血管重点评估,观察者之间对超声心动图参数和尾腔静脉(CVC)直径测量的一致性。SETTING大学兽医教学医院。动物饲养健康的比格犬。干预无。测量和主要结果心电图参数通过标准化视图进行评估。通过剑突下窗(CVC SubX)使用3个测量值(最小和最大CVC直径和塌陷指数)评估尾腔静脉,并通过背外侧窗(CVC-DL)使用1个测量值评估尾腔直径。Bland-Altman分析评估了每个非心脏病专家和心脏病专家的一致性;变异系数(CoV)量化了观察者之间的变异性。95%的一致性限度(LOA)和CoVs被认为是左心房直径、左心房与主动脉比率、舒张期和收缩期的标准化左心室直径可接受的,但对于缩短部分和肺静脉与肺动脉比率不可接受。对于CVC SubX,最大CVC直径的95%LOA是可接受的,而最小CVC直径和CVC溃散指数是不可接受的。CoV的最大和最小CVC良好(7%),溃散指数较差(37%)。对于CVC-DL,95%的LOA是不可接受的,尽管CoV被认为是好的(11%)。结论6小时的超声心动图培训课程使非心脏病专家能够评估健康比格犬的左心房直径、左心房与主动脉比率、舒张期和收缩期的标准化左心室直径以及CV-FAST检查的CVCmax。需要对CVC SubX技术进行标准化,并评估呼吸阶段对犬CVC直径的影响。需要进一步的研究来确定在包括不同品种时,观察者之间的一致性是否仍然可以接受。评估基本超声心动图参数和CVC以评估小动物医学中的体积状态值得进一步的临床评估。
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Interobserver agreement between non-cardiologist veterinarians and a cardiologist after a 6-hour training course for echographic evaluation of basic echocardiographic parameters and caudal vena cava diameter in 15 healthy Beagles.
OBJECTIVE To evaluate cardiovascular focused assessment with sonography for trauma and triage (CV-FAST) interobserver agreement for echocardiographic parameters and caudal vena cava (CVC) diameter measurement, between a cardiologist and 2 non-cardiologists after a 6-hour training course. SETTING University veterinary teaching hospital. ANIMALS Fifteen healthy Beagle dogs. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Echocardiography parameters were assessed via standardized views. Caudal vena cava was assessed via a subxiphoid window (CVC-SubX) using 3 measurements (minimal and maximal CVC diameter, and collapsibility index) and via a dorsolateral window (CVC-DL) using 1 measurement (CVC diameter). Bland-Altman analysis assessed agreement of each non-cardiologist with the cardiologist; coefficients of variation (CoV) quantified variability between observers. The 95% limits of agreement (LOA) and CoVs were considered acceptable for left atrial diameter, left atrium to aortic ratio, normalized left ventricle diameter in diastole and systole but non-acceptable for fractional shortening and pulmonary vein to pulmonary artery ratio. For CVC-SubX, the 95% LOA for maximum CVC diameter were acceptable, while minimum CVC diameter and CVC collapsibility index were non-acceptable. The CoVs were good for maximum and minimum CVC (7%) and poor for collapsibility index (37%). For CVC-DL, the 95% LOA were non-acceptable, although the CoV was considered good (11%). CONCLUSIONS A 6-hour training course in echocardiography allows non-cardiologists to assess left atrial diameter, left atrium to aortic ratio, normalized left ventricle diameter in diastole and systole, and CVCmax of the CV-FAST exam in healthy Beagles. Standardization of the CVC-SubX technique and assessment of the impact of the respiratory phase on CVC diameter in dogs is needed. Further studies are required to determine whether interobserver agreement remains acceptable when including different breeds. Assessment of basic echocardiographic parameters and the CVC to estimate volume status in small animal medicine merits further clinical evaluation.
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