Key result
Leading-edge-to-trailing-edge method yields ~28% larger LV wall thickness measurements than trailing-edge-to-leading-edge.
Why the study?
Consensus is lacking on which endocardial borders to include when measuring left ventricular wall thickness in cats, affecting classification of hypertrophic cardiomyopathy.
Does the inclusion of different endocardial borders affect left ventricular wall thickness measurements and hypertrophic cardiomyopathy diagnosis in cats?
Cross-Sectional (n=52)
Single-blind
No
Does the inclusion of different endocardial borders affect left ventricular wall thickness measurements and hypertrophic cardiomyopathy diagnosis in cats?
Absolute Event Rate: 5.5% vs 4.3%
p-value: p=<0.001
The number of endocardial borders included in echocardiographic measurements significantly alters left ventricular wall thickness values in cats, potentially changing a diagnosis from healthy to hypertrophic cardiomyopathy.
Different endocardial border alignments yield discrepant LV wall thicknesses in cats and may change HCM diagnoses; leaves open optimal measurement protocol.
BACKGROUND: Consensus is lacking on which endocardial borders to include when measuring left ventricular wall thickness (LVWT) in cats. HYPOTHESIS/OBJECTIVES: The number of endocardial borders included can influence whether an individual cat is classified as having hypertrophic cardiomyopathy (HCM) or not. ANIMALS: Fifty-two cats that previously were diagnosed as either healthy, equivocal for HCM, or having an HCM phenotype. METHODS: Single-center retrospective cross-sectional study. Three observers measured LVWT using 4 different LVWT measurement protocols: leading edge-to-leading edge (L-L); leading edge-to-trailing edge, trailing edge-to-leading edge, and trailing edge-to-trailing edge for the interventricular septum and L-L and trailing edge-to-leading edge methods for the left ventricular free wall (LVFW). Measurements were made using stored echocardiographic images on 2 occasions by 2 observers. A Friedman test and post-hoc Wilcoxon signed rank test with Bonferroni correction were performed to detect differences between measurement techniques. RESULTS: Interventricular septum (IVS) wall thickness was significantly larger for leading-edge-to-trailing-edge measurement (median and [interquartile range (IQR)]: 5.5 [3.8-7.2] millimeters) compared with other methods (P < .001). The trailing-edge-to-leading-edge method produced significantly smaller results (4.3 [IQR, 3.4-6.2] millimeters for the interventricular septum and 4.8 [IQR, 3.4-6.2] millimeters for the LVFW) compared with other methods (P < .001). Median IVS thickness measured as leading-edge-to-trailing-edge was 1.2 millimeters larger than when measured as trailing-edge-to-leading-edge. CONCLUSIONS AND CLINICAL IMPORTANCE: LVWT varies depending on the number of endocardial borders included. The number of endocardial borders included in LVWT measurements should be standardized.
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Sehn et al. (2026) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=52). Leading edge-to-trailing edge measurement vs. Trailing edge-to-leading edge measurement was evaluated on Interventricular septum (IVS) wall thickness (p=<0.001). The leading-edge-to-trailing-edge measurement method yielded significantly larger left ventricular wall thickness values than the trailing-edge-to-leading-edge method (median 5.5 vs 4.3 mm, P < .001).
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