The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats
Abstract Background Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients. Hypothesis Focused cardiac ultrasound by a nonspecialist practitioner (NSP) will increase the detection of occult heart disease in asymptomatic cats compared with physical examination and ECG. A...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-09-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.15549 |
| _version_ | 1811341384451358720 |
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| author | Kerry A. Loughran John E. Rush Elizabeth A. Rozanski Mark A. Oyama Éva Larouche‐Lebel Marc S. Kraus |
| author_facet | Kerry A. Loughran John E. Rush Elizabeth A. Rozanski Mark A. Oyama Éva Larouche‐Lebel Marc S. Kraus |
| author_sort | Kerry A. Loughran |
| collection | DOAJ |
| description | Abstract Background Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients. Hypothesis Focused cardiac ultrasound by a nonspecialist practitioner (NSP) will increase the detection of occult heart disease in asymptomatic cats compared with physical examination and ECG. Animals Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed. Methods Multicenter prospective cohort study. Twenty‐two NSPs were trained to perform FCU. Cats without clinical signs of heart disease were recruited, and NSPs performed the following in sequential order: physical examination, ECG, FCU, and point‐of‐care N‐terminal pro‐B‐type natriuretic peptide assay (POC‐BNP). After each step, NSPs indicated yes, no, or equivocal as to whether they believed heart disease was present. The level of agreement between the NSP diagnosis and a blinded cardiologist's diagnosis after echocardiogram was evaluated using Cohen's kappa test. Results Cardiologist diagnoses included 148 normal cats, 102 with heart disease, and 39 equivocal ones. Agreement between NSP and cardiologist was slight after physical examination (kappa 0.253 [95% CI, 0.172‐0.340]), did not increase after ECG (0.256 [0.161‐0.345]; P = .96), increased after FCU (0.468 [0.376‐0.558]; P = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; P = .67). In cats with mild, moderate, and marked occult heart disease, the proportion of cats having a NSP diagnosis of heart disease after FCU was 45.6%, 93.1%, and 100%, respectively. Conclusions and Clinical Importance Focused cardiac ultrasound performed by NSPs increased the detection of occult heart disease, especially in cats with moderate to marked disease. Focused cardiac ultrasound appears to be a feasible and useful tool to assist NSPs in the detection of heart disease in cats. |
| first_indexed | 2024-04-13T18:55:38Z |
| format | Article |
| id | doaj.art-990611ef93df48aebe13ced66457520d |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-13T18:55:38Z |
| publishDate | 2019-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-990611ef93df48aebe13ced66457520d2022-12-22T02:34:16ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762019-09-013351892190110.1111/jvim.15549The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic catsKerry A. Loughran0John E. Rush1Elizabeth A. Rozanski2Mark A. Oyama3Éva Larouche‐Lebel4Marc S. Kraus5Department of Clinical Sciences Cummings School of Veterinary Medicine at Tufts University North Grafton MassachusettsDepartment of Clinical Sciences Cummings School of Veterinary Medicine at Tufts University North Grafton MassachusettsDepartment of Clinical Sciences Cummings School of Veterinary Medicine at Tufts University North Grafton MassachusettsDepartment of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine University of Pennsylvania Philadelphia PennsylvaniaDepartment of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine University of Pennsylvania Philadelphia PennsylvaniaDepartment of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine University of Pennsylvania Philadelphia PennsylvaniaAbstract Background Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients. Hypothesis Focused cardiac ultrasound by a nonspecialist practitioner (NSP) will increase the detection of occult heart disease in asymptomatic cats compared with physical examination and ECG. Animals Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed. Methods Multicenter prospective cohort study. Twenty‐two NSPs were trained to perform FCU. Cats without clinical signs of heart disease were recruited, and NSPs performed the following in sequential order: physical examination, ECG, FCU, and point‐of‐care N‐terminal pro‐B‐type natriuretic peptide assay (POC‐BNP). After each step, NSPs indicated yes, no, or equivocal as to whether they believed heart disease was present. The level of agreement between the NSP diagnosis and a blinded cardiologist's diagnosis after echocardiogram was evaluated using Cohen's kappa test. Results Cardiologist diagnoses included 148 normal cats, 102 with heart disease, and 39 equivocal ones. Agreement between NSP and cardiologist was slight after physical examination (kappa 0.253 [95% CI, 0.172‐0.340]), did not increase after ECG (0.256 [0.161‐0.345]; P = .96), increased after FCU (0.468 [0.376‐0.558]; P = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; P = .67). In cats with mild, moderate, and marked occult heart disease, the proportion of cats having a NSP diagnosis of heart disease after FCU was 45.6%, 93.1%, and 100%, respectively. Conclusions and Clinical Importance Focused cardiac ultrasound performed by NSPs increased the detection of occult heart disease, especially in cats with moderate to marked disease. Focused cardiac ultrasound appears to be a feasible and useful tool to assist NSPs in the detection of heart disease in cats.https://doi.org/10.1111/jvim.15549cardiomyopathyechocardiographyECGfelinemyocardial disease |
| spellingShingle | Kerry A. Loughran John E. Rush Elizabeth A. Rozanski Mark A. Oyama Éva Larouche‐Lebel Marc S. Kraus The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats Journal of Veterinary Internal Medicine cardiomyopathy echocardiography ECG feline myocardial disease |
| title | The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_full | The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_fullStr | The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_full_unstemmed | The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_short | The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_sort | use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| topic | cardiomyopathy echocardiography ECG feline myocardial disease |
| url | https://doi.org/10.1111/jvim.15549 |
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