Comparing Point-of-Care Ultrasound in Multiple Body Positions in Dogs to Key Cardiac Measurements by Echocardiography

Area of Science:

• Veterinary Cardiology
• Diagnostic Imaging
• Point-of-Care Ultrasound

Background:

• Cardiac point-of-care ultrasound (cPOCUS) offers vital cardiac insights when echocardiography is unavailable.
• Assessing cardiac structure and function in veterinary medicine often requires specialized equipment.
• Standardizing cPOCUS measurements across different patient positions is crucial for clinical application.

Purpose of the Study:

• To compare cardiac point-of-care ultrasound (cPOCUS) measurements of fractional shortening (FS%) and left-atrium-to-aorta ratio (LA:Ao) against echocardiography.
• To evaluate the diagnostic accuracy of cPOCUS in different body positions (left lateral recumbency, right lateral recumbency, standing/sternal recumbency).
• To determine the influence of image quality on the clinical assessment of cardiac parameters using cPOCUS.

Main Methods:

• A prospective, cross-sectional study involving 39 dogs.
• cPOCUS measurements of FS% and LA:Ao were taken in three positions: left lateral recumbency (RT), right lateral recumbency (LT), and standing or sternal recumbency (RST).
• Bland-Altman analysis, generalized estimated equation models, and image quality scoring were used to compare cPOCUS with echocardiography.

Main Results:

• Bland-Altman analysis indicated acceptable bias for FS% and LA:Ao when compared to echocardiography.
• Correct clinical assessments were achieved in the majority of cases for FS% in RST (67%) and RT (67%), and for LA:Ao in RST (55%).
• Higher image quality scores correlated with more accurate clinical assessments; good inter-observer agreement was noted for FS% and LA:Ao in specific positions.

Conclusions:

• Cardiac point-of-care ultrasound (cPOCUS) performed from the right hemithorax (RT) or in standing/sternal recumbency (RST) can provide reliable estimates for FS% and LA:Ao in dogs.
• Measurements obtained in the left lateral recumbency (LT) position are not recommended due to potential inaccuracies.
• cPOCUS is a valuable tool for assessing cardiac function in dogs, with specific positioning enhancing diagnostic accuracy.