July 28, 2025Journal of Veterinary Cardiology1 citationsOpen Access

Veterinary echocardiographers’ preferences for image selection, timing, and caliper placement for left atrial two-dimensional size assessment in dogs: the BENEFIT project

MKM.Y.-W. KuoSwedish University of Agricultural Sciences MDM. DirvenRadboud University Nijmegen JHJens HäggströmLinköping University

Structured PICO

Population

533 veterinary echocardiographers (63% non-specialists and 37% specialists, of which 43% were cardiology board certified)

Intervention

Measuring left atrial (LA) size using static echocardiographic images

Outcome

Preferences for image selection, timing, caliper placement, and thresholds used for LA enlargement

The right parasternal short-axis view is the most favored for assessing left atrial size in dogs among veterinary echocardiographers, though significant variations exist in measurement techniques.

Abstract

INTRODUCTION/OBJECTIVES: This study aimed to investigate veterinary echocardiographers' preferences for assessing left atrial (LA) size in dogs using linear two-dimensional echocardiography, focusing on image selection, timing, caliper placement, and thresholds used for LA enlargement. A secondary aim was to explore the impact of experience and training on echocardiographers' linear two-dimensional measurements of LA size in dogs. ANIMALS, MATERIALS AND METHODS: A global online study was conducted, asking veterinary echocardiographers to measure LA size using static echocardiographic images. RESULTS: A total of 533 echocardiographers (63% non-specialists and 37% specialists, of which 43% were cardiology board certified) completed the study. Most echocardiographers (86%, n = 459/533) used a right parasternal short-axis (RPSAX) view for LA and aortic (Ao) measurements. Of these, 57% (n = 261/459) favored the same image angulation for performing measurements and 76% (n = 351/459) timed measurements at end-systole/early-diastole. Caliper placement near pulmonary venous inlets impacted their LA dimension measurements the most. Thirty-nine percent (n = 207/533) used right parasternal long-axis (RPLAX) views. The upper limit for LA enlargement varied across all commonly used methods. Training and experience level influenced interobserver variation for LA dimension measurements obtained from a RPLAX four-chamber view, but not from a RPSAX view. STUDY LIMITATIONS: Static images may not reflect real-time clinical settings or allow precise identification of anatomical structures. CONCLUSIONS: The RPSAX view was most favored for LA size assessment in dogs, but variations existed in image selection, timing, caliper placement, and threshold used for LA enlargement. Training and experience level influenced interobserver variation in LA dimension measurements obtained from a RPLAX four-chamber view.

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