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P wave duration in the identification of left atrial enlargement in dogs
The duration of the P wave is thought to be diagnostic to diagnose left atrial enlargement in dogs. Is this really the case? This study determines sensitivity and specificity of P wave duration in the identification of left atrial enlargement in more than 150 dogs.

Electrocardiograms from normal dogs and dogs with various cardiovascular diseases were evaluated.

Inclusion criteria were the availability of an electrocardiogram showing a stable isoelectric line, easily recognizable P waves and good quality two-dimensional echocardiographic estimate of left atrial dimensions using the left atrial to aortic root ratio.

Using a metal caliper system, P wave duration was measured to the nearest 10 milliseconds for six consecutive heart beats; data were then averaged for each dog. The accuracy of P wave duration in predicting left atrial enlargement was determined using a receiver operating characteristic analysis.

Results: One hundred and fifty-six dogs were included in the study.

Average P wave durations of 20, 30, 40 and 50 milliseconds yielded sensitivities of 100, 85, 68 and 40% and specificities of 0, 16, 64 and 93%, respectively, for the diagnosis of Left Atrial Enlargement by echocardiography.

The estimated area under curve of the receiver operating characteristic curve was 0·70 (95% confidence interval: 0·60 to 0·80).

Clinical Significance: The diagnostic performance of P wave duration for identification of left atrial enlargement in dogs presents considerable limitations.


Source: Savarino, P., Borgarelli, M., Tarducci, A., Crosara, S., Bello, N. M. and Margiocco, M. L. (2012), Diagnostic performance of P wave duration in the identification of left atrial enlargement in dogs. Journal of Small Animal Practice, 53: 267–272. doi: 10.1111/j.1748-5827.2012.01200.x




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