Introduction

Mitral valve area (MVA) planimetry is used to diagnose and classify mitral stenosis (MS) in humans using two-dimensional and three-dimensional echocardiography (MVA_2D and MVA_3D). This study aimed to evaluate agreement, feasibility, and observer variability between MVA_2D and MVA_3D in English Bull Terriers (BT). Our hypotheses were (1) that the MVA of BT is generally smaller than that of breeds with similar body weight and (2) that these techniques could be used to diagnose MS in BTs.

Animals

Twenty healthy BTs, 15 healthy Boxers, and 49 BTs with heart disease.

Materials and methods

A prospective diagnostic agreement study was conducted. All dogs underwent a thorough clinical examination, conventional transthoracic echocardiography, and three-dimensional echocardiography.

Results

Bland–Altman plots (limits of agreement: 0.12–1.5) showed consistent bias and poor agreement between MVA_2D and MVA_3D. For the 69 BTs, MVA_3D (2.1 ± 0.50 cm²) measurements were significantly lower than MVA_2D measurements (2.9 ± 0.60 cm²), and healthy BTs had significantly lower MVA parameters than healthy Boxers (p < 0.001). Intraobserver and interobserver variability were excellent for both MVA_2D and MVA_3D (intraclass correlation coefficient >0.9). Six BTs were diagnosed with MS, with MVA_3D less than 1.8 cm² and a mean transmitral gradient (MTG) of more than 5 mmHg.

Conclusions

Both MVA_2D and MVA_3D are feasible, have low observer variability and can be used to diagnose MS in BTs. For assessing the narrowest orifice area, the preferred method is MVA_3D. The smaller MVA in BTs compared to Boxers may indicate some degree of MS.

中文翻译：

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经胸二维和三维超声心动图测量英国斗牛犬患有或不患有心脏病的二尖瓣面积测量法

介绍

二尖瓣面积 (MVA) 面积测量法用于使用二维和三维超声心动图（MVA _2D和 MVA _3D）诊断和分类人类二尖瓣狭窄 (MS )。本研究旨在评估英国斗牛梗 (BT) 中MVA _2D和 MVA _3D之间的一致性、可行性和观察者变异性。我们的假设是 (1) BT 的 MVA 通常小于体重相似的品种的 MVA，以及 (2) 这些技术可用于诊断 BT 中的 MS。

动物

20 名健康 BT，15 名健康拳击手和 49 名患有心脏病的 BT。

材料和方法

进行了一项前瞻性诊断一致性研究。所有狗都接受了彻底的临床检查、常规经胸超声心动图和三维超声心动图。

结果

Bland-Altman 图（一致性限：0.12-1.5）显示 MVA _2D和 MVA _3D之间存在一致的偏差和较差的一致性。对于 69 个 BT，MVA _3D (2.1 ± 0.50 cm ² ) 测量值显着低于 MVA _2D测量值 (2.9 ± 0.60 cm ² )，健康 BT 的 MVA 参数显着低于健康拳击手 ( p  < 0.001)。MVA _2D和 MVA _{3D 的}观察者内和观察者间变异性都非常好（组内相关系数 >0.9）。6 位 BT 被诊断为 MS，MVA _3D小于 1.8 cm ² 平均二尖瓣梯度 (MTG) 超过 5 mmHg。

结论

MVA _2D和 MVA _3D都是可行的，观察者变异性低，可用于诊断 BT 中的 MS。为了评估最窄的孔口区域，首选方法是 MVA _3D。与拳击手相比，BT 中较小的 MVA 可能表明某种程度的 MS。