M-Mode Echocardiographic Measurements of Interventricular Septum, Left Ventricular Internal Diameter, and Left Ventricular Free-Wall Thickness in Normal Horses-A Meta-Analytical Study.

The purpose of this study was to provide a systematic meta-analysis on echocardiographic measurements in normal Thoroughbred and Standardbred horses. The current systematic meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All the available published papers on the reference values of echocardiographic assessment via M-mode echocardiography were searched, and fifteen studies were finally selected for analysis. In both fixed and random effect, the confidence interval (CI) for the interventricular septum (IVS) was 2.8-3.1 and 4.7-7.5; for the left ventricular free-wall (LVFW) thickness, it was 2.9-3.2 and 4.2-6.7; and for the left ventricular internal diameter (LVID), it was -5.0-4.6 and -10.0--6.7, respectively. For IVS, the Q statistic, I-squared, and tau-squared were 925.3, 98.1, and 7.9, respectively. Similarly, for LVFW, all the effects were on the positive side of zero, with a range of 1.3-68.1. The CI indicated a significant variation among the studies (fixed, 2.9-3.2; random, 4.2-6.7). The z-values of LVFW for fixed and random effects were, respectively, 41.1 ( p < 0.001) and 8.5 ( p < 0.001). However, the Q statistic was 886.6 ( p < 0.001). Moreover, the I-squared was 98.08, and the tau-squared was 6.6. By contrast, the effects of LVID fell on the negative side of zero, (2.8-83.9). The present meta-analysis provides an overview of the echocardiographic measurements of cardiac diameters in healthy Thoroughbred and Standardbred horses. The meta-analysis indicates variations in results among different studies. This result should be considered when evaluating a horse for heart disease and each case should be evaluated independently.