Assessing aortic regurgitation severity from 2D, M-mode and pulsed wave Doppler echocardiographic measurements in horses.
Authors: Ven S, Decloedt A, Van Der Vekens N, De Clercq D, van Loon G
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Quantifying Aortic Regurgitation in Horses Aortic regurgitation (AR) remains challenging to assess objectively in clinical practice, yet accurate severity grading is essential because progressive left ventricular remodelling can precipitate arrhythmias and heart failure. Ven and colleagues examined 32 healthy horses and 35 with AR (classified as mild, moderate or severe) using standard 2D echocardiography, M-mode imaging and pulsed wave Doppler to identify measurable parameters that correlate with disease severity. Affected horses displayed characteristic enlargement of the left ventricle, left atrium and aorta, with significantly increased stroke volume (using all three calculation methods, though the bullet method proved most sensitive), reduced pre-ejection period, and notably greater aortic diameter collapse between early and late diastole compared to controls. Two variables emerged as particularly valuable for practitioners: the pre-ejection period shortened predictably with AR severity, whilst the newly characterised aortic diastolic run-off measurement (AoDiastDecr) was straightforward to acquire and provided reliable severity grading. These accessible measurements offer farriers, veterinarians and equine physiotherapists improved confidence in quantifying AR progression during routine echocardiographic examinations, facilitating more informed decisions about workload management and intervention timing in performance and leisure horses.
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Practical Takeaways
- •PEP and aortic diastolic run-off measurements provide practical, easy-to-perform echocardiographic parameters for objectively grading aortic regurgitation severity in clinical practice
- •Stroke volume calculated by the bullet method is more sensitive than other methods for detecting increased severity of aortic regurgitation
- •Standard 2D, M-mode and pulsed wave Doppler echocardiography can reliably quantify AR severity to guide prognosis and management decisions in affected horses
Key Findings
- •Horses with AR showed significant enlargement of left ventricle, left atrium, and aorta compared to healthy controls
- •Stroke volume was significantly increased in AR horses using all three measurement methods, with SVbullet being superior for detecting AR severity
- •Pre-ejection period (PEP) decreased significantly in AR horses while ejection time (LVET) remained unchanged
- •Aortic diastolic run-off (AoDiastDecr) and its rate of change were reliable, easily measurable parameters for assessing AR severity