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The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats
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| Zeitschriftentitel: | Journal of Veterinary Internal Medicine |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | Journal of Veterinary Internal Medicine, 33, 2019, 5, S. 1892-1901 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Wiley
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| Schlagwörter: |
| author_facet |
Loughran, Kerry A. Rush, John E. Rozanski, Elizabeth A. Oyama, Mark A. Larouche‐Lebel, Éva Kraus, Marc S. Loughran, Kerry A. Rush, John E. Rozanski, Elizabeth A. Oyama, Mark A. Larouche‐Lebel, Éva Kraus, Marc S. |
|---|---|
| author |
Loughran, Kerry A. Rush, John E. Rozanski, Elizabeth A. Oyama, Mark A. Larouche‐Lebel, Éva Kraus, Marc S. |
| spellingShingle |
Loughran, Kerry A. Rush, John E. Rozanski, Elizabeth A. Oyama, Mark A. Larouche‐Lebel, Éva Kraus, Marc S. Journal of Veterinary Internal Medicine The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats General Veterinary |
| author_sort |
loughran, kerry a. |
| spelling |
Loughran, Kerry A. Rush, John E. Rozanski, Elizabeth A. Oyama, Mark A. Larouche‐Lebel, Éva Kraus, Marc S. 0891-6640 1939-1676 Wiley General Veterinary http://dx.doi.org/10.1111/jvim.15549 <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients.</jats:p></jats:sec><jats:sec><jats:title>Hypothesis</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Animals</jats:title><jats:p>Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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]; <jats:italic>P</jats:italic> = .96), increased after FCU (0.468 [0.376‐0.558]; <jats:italic>P</jats:italic> = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; <jats:italic>P</jats:italic> = .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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Clinical Importance</jats:title><jats:p>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.</jats:p></jats:sec> The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats Journal of Veterinary Internal Medicine |
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Wiley, 2019 |
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Journal of Veterinary Internal Medicine |
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| title |
The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_unstemmed |
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 |
the use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| topic |
General Veterinary |
| url |
http://dx.doi.org/10.1111/jvim.15549 |
| publishDate |
2019 |
| physical |
1892-1901 |
| description |
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients.</jats:p></jats:sec><jats:sec><jats:title>Hypothesis</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Animals</jats:title><jats:p>Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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]; <jats:italic>P</jats:italic> = .96), increased after FCU (0.468 [0.376‐0.558]; <jats:italic>P</jats:italic> = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; <jats:italic>P</jats:italic> = .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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Clinical Importance</jats:title><jats:p>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.</jats:p></jats:sec> |
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| author | Loughran, Kerry A., Rush, John E., Rozanski, Elizabeth A., Oyama, Mark A., Larouche‐Lebel, Éva, Kraus, Marc S. |
| author_facet | Loughran, Kerry A., Rush, John E., Rozanski, Elizabeth A., Oyama, Mark A., Larouche‐Lebel, Éva, Kraus, Marc S., Loughran, Kerry A., Rush, John E., Rozanski, Elizabeth A., Oyama, Mark A., Larouche‐Lebel, Éva, Kraus, Marc S. |
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| description | <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients.</jats:p></jats:sec><jats:sec><jats:title>Hypothesis</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Animals</jats:title><jats:p>Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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]; <jats:italic>P</jats:italic> = .96), increased after FCU (0.468 [0.376‐0.558]; <jats:italic>P</jats:italic> = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; <jats:italic>P</jats:italic> = .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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Clinical Importance</jats:title><jats:p>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.</jats:p></jats:sec> |
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| spelling | Loughran, Kerry A. Rush, John E. Rozanski, Elizabeth A. Oyama, Mark A. Larouche‐Lebel, Éva Kraus, Marc S. 0891-6640 1939-1676 Wiley General Veterinary http://dx.doi.org/10.1111/jvim.15549 <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Focused cardiac ultrasound (FCU) helps detect occult heart disease in human patients.</jats:p></jats:sec><jats:sec><jats:title>Hypothesis</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Animals</jats:title><jats:p>Three hundred forty‐three client‐owned cats: 54 excluded and 289 analyzed.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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]; <jats:italic>P</jats:italic> = .96), increased after FCU (0.468 [0.376‐0.558]; <jats:italic>P</jats:italic> = .002), and the level of agreement was similar after POC‐BNP (0.498 [0.419‐0.580]; <jats:italic>P</jats:italic> = .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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Clinical Importance</jats:title><jats:p>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.</jats:p></jats:sec> The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats Journal of Veterinary Internal Medicine |
| spellingShingle | Loughran, Kerry A., Rush, John E., Rozanski, Elizabeth A., Oyama, Mark A., Larouche‐Lebel, Éva, Kraus, Marc S., Journal of Veterinary Internal Medicine, The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats, General Veterinary |
| 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 | the use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| title_unstemmed | The use of focused cardiac ultrasound to screen for occult heart disease in asymptomatic cats |
| topic | General Veterinary |
| url | http://dx.doi.org/10.1111/jvim.15549 |