Interobserver repeatability of interventricular septal wall measurements in cats

Clinically, echocardiography is the gold standard test for diagnosing hypertrophic cardiomyopathy in cats. Low interobserver variability for echocardiographic measurements has generally been reported in the literature. We hypothesized that interobserver variability is high when measuring the interventricular septum (IVS) thickness in cats.

Echocardiographic right-sided parasternal left ventricular (LV) outflow tract views from four cats with different LV morphologies were selected. Five measurements of the IVS in each picture were performed by 29 veterinary cardiologists and cardiology residents from different institutions. Intraclass correlation coefficient (ICC) was applied for data analysis.

Interobserver repeatability was poor for the base of the IVS (partial ICC: 0.4) and moderate for the rest of the IVS (partial ICC: 0.6). A range of 0.7 mm between the lower and upper limits of measurements was found for each picture and region of the IVS. Around 27% of variance in measurements was associated with training location (country), whereas around 73% of the variance was attributable to the observer.

Study limitations included the use of still pictures and assessment of one echocardiographic parameter only.

As hypothesized, the interobserver repeatability of IVS measurements using the right-sided parasternal LV outflow tract view in cats was poor to moderate. This finding is relevant when comparing and interpreting measurements obtained by different observers. Additionally, the influence of training location may need to be considered when interpreting results of variability studies involving observers from the same facility.