How is LVIDdn calculated in the Echo Calculator?

LVIDdn (normalized Left Ventricular Internal Diameter in diastole) is calculated using the Cornell allometric scaling formula: LVIDd (cm) / Weight (kg)^0.294. A value > 1.7 is typically considered indicative of left ventricular enlargement.

What are the EPIC trial criteria for Stage B2 MMVD?

The EPIC trial defines Stage B2 as a patient with a murmur grade > 3/6 and echocardiographic evidence of cardiomegaly, specifically an LA:Ao ratio > 1.6 and an LVIDdn > 1.7.

Should I use breed-specific normals or Cornell scaling?

Standard Cornell scaling is appropriate for most breeds. However, for 'deviant' breeds like Sighthounds or Boxers, published breed-specific reference intervals should be used to avoid mis-staging heart disease.

Should I use LA:Ao or LAD?

The LA:Ao ratio measurement has been the gold standard metric for assessing left atrial size, but has been shown to be challenging to measure reliably especially in inexperienced hands. Moving towards the LAD (left atrial diameter in long axis) is now recommended, and can be scaled to body weight using the allometric scaling formula LAD (cm) / Weight (kg)^0.309. A value > 1.6 is typically considered indicative of left atrial enlargement.

What parameters are required to calculate the Canine MINE score?

The 4-parameter MINE 1 scoring system requires the LA:Ao ratio, LVIDdn, Fractional Shortening (FS), and E-wave peak velocity. The simplified 3-parameter MINE 2 system utilizes LA:Ao, LVIDdn, and E-wave velocity to classify myxomatous mitral valve disease (MMVD) severity and estimate median survival time (MST).

How is the Qp:Qs ratio calculated on a veterinary echocardiogram?

The Qp:Qs shunt ratio evaluates pulmonary to systemic blood flow. Systemic stroke volume (Qs) is calculated using the LVOT diameter and LVOT VTI, while pulmonary stroke volume (Qp) uses the RVOT diameter and RVOT VTI via the formula: Stroke Volume = VTI × π × (Diameter / 20)^2. A ratio of 1.0 is normal, while values > 1.5 indicate a hemodynamically significant left-to-right shunt.

Veterinary Echocardiography Calculator & Advanced Diagnostics

Enter measurements in mm and weight in kg.

Body Weight (kg)

Species/Breed Reference Model:

LV Measurements:

LVIDd (mm)

LVIDs (mm)

IVSd (mm)

LVPWd (mm)

LVEDV modified Simpsons (ml)

LVESV modified Simpsons (ml)

LA Measurements:

LA short-axis (mm)

Ao Diameter (mm)

LA Long Axis (LAD) (mm)

Ao D - Long Axis (mm)

E-wave Peak Vel (m/s)

A-wave Peak Vel (m/s)

IVRT (ms)

Mitral DT (ms)

Mitral E' (cm/s)

Ao VMax (m/s)

PA VMax (m/s)

LVOT diam (mm)

LVOT VTI (cm)

RVOT diam (mm)

RVOT VTI (cm)

Right Heart Model Analysis

STILL UNDER CONSTRUCTION

TR Peak Vel (m/s)

PR Peak Vel (m/s)

RV Basal Diam (mm)

RVWT (mm)

RV Area Diast (cm²)

RV Area Syst (cm²)

TAPSE (mm)

RAD Ap4Ch (mm)

RAD RPLA (mm)

LVIDd perp. (mm)

RPA max (mm)

RPA min (mm)

MPA min (mm)

This tool automatically evaluates your left and right structural inputs to predict Pulmonary Hypertension severity in dogs lacking a measurable TR jet. Note: Reduced accuracy in cases of left-sided heart disease (post-capillary PH).

Visual IVS Flattening

RVOT Mid-Systolic Notching

Present on Doppler profile

Echocardiography Report
Date:

Weight: kg | BSA: m² | Model:

Patient Name: | Owner: | Species: CanineFeline | Breed:

Left Ventricle:

LVIDd mm (Enlarged) (Small) (Normal)

LVIDs mm

IVSd mm (Thickened) (Normal)

LVFWd mm (Thickened) (Normal)

Fractional Shortening (Normal) (Abnormal) (ref >25)

Ejection Fraction (Normal) (Abnormal) (ref >50)

LVEDV ml (Dilated) (Normal) (Underfilled)

LVESV ml (Dilated) (Normal) (Underfilled)

LVIDDN (Cornell) (Enlarged) (Borderline Enlarged) (Normal) (Underfilled) (ref 1.27 - 1.7)

LVIDSN (Cornell) (Enlarged) (Normal) (Underfilled) (ref 0.71 - 1.26)

Relative Wall Thickness (Thick Walls) (Normal Walls) (Thin Walls) (ref 0.32-0.42)

LVEDV / BW (Enlarged) (Normal) (Underfilled)

LVESV / BW (Enlarged) (Normal) (Underfilled)

LVEDV / m² (Normal) (Enlarged) ml/m² (ref <100)

LVESV / m² (Enlarged) ml/m² (ref <30)

LV Stroke Vol ml

Systemic Stroke Vol ml

Mitral Regurgitant Vol ml

MR Fraction (Severe Regurgitation) (Moderate) (Mild)

Left Atrium:

LA mm

Ao mm

LAD (Long Axis) mm

LA:Ao Ratio (Enlarged) (Normal) (ref <1.65)

LA (short axis) Normalised (Enlarged) (Normal) (ref <1.17)

LAD : Ao(short axis) (Enlarged) (Normal) (ref <2.1)

LAD : Ao(long axis) (Enlarged) (Normal) (ref <2.4)

LADN (Enlarged) (Normal) (ref <1.6)

Spectral Doppler and Flow:

E vel (High) (Normal) (Low) m/s (ref 0.6 - 1.0)

A vel (High) (Normal) (Low) m/s (ref 0.3 - 0.8)

IVRT (prolonged) (Normal) (short) (ref 50 - 80)

E wave DT (prolonged) (Normal) (short) (ref 60 - 100)

E:A Ratio (High) (Normal) (Low) (ref 0.95 - 1.6)

E:IVRT Ratio (HIGH LAP) (Normal)

LVEIO (HIGH LAP) (Normal) (Eqivocal)

E' (Normal) (Low)

E:E' ratio (HIGH LAP) (Normal) (Equivocal)

Aortic VMax m/s

Pulmonic VMax m/s

PAdia:Ao(LA) (Low) (Normal) (High)

Shunt Ratios (Qp:Qs):

LVOT diameter mm

RVOT diameter mm

LVOT VTI cm

RVOT VTI cm

VTI Ratio P:S (High) (Normal) (Low) (ref 0.9 - 1.1)

Qp:Qs Ratio (High) (Normal) (Low) (ref 0.9 - 1.1)

Right Heart:

TR Vel (HIGH) (Normal) (Equivocal)

TR PG (HIGH) (Normal) (Equivocal)

PR Vel (HIGH) (Normal) (Equivocal)

PR PG (HIGH) (Normal) (Equivocal)

TAPSE mm (High) (Reduced Dysfunction) (Normal)

TAPSEn (Low) (Normal)

TAPSE:Ao(LA) (Low) (Normal)

RVWT mm (Hypertrophy / Thickened) (Thin) (Normal)

RVWT:Ao(LA) (Thick) (Normal)

RVWT:LVPWD (Thick) (Normal)

RVEDA cm² (Enlarged) (Small) (Normal)

RVEDAn (High) (Normal)

RVESA cm² (Enlarged Failure) (Small) (Normal)

RVESAn (High) (Normal)

RV FAC % (Low) (Normal) (Equivocal)

RVD Basal mm (Dilation Overload) (Small) (Normal)

RVD (Basal) n (Enlarged) (Normal)

RVD1 (basal):Ao(LA) (Enlarged) (Normal)

RAD1 (Ap4Ch view) mm (RA Enlargement) (Small) (Normal)

RAD1 (Ap4Ch view):Ao (LA) (Enlarged) (Normal)

RADn (Ap4Ch) (Enlarged) (Normal)

RAD2 (RPLA view) mm (RA Enlargement) (Small) (Normal)

RAD2 (RPLA):LAD (Enlarged) (Normal)

RAD (RPLA):Ao (LA) (Enlarged) (Normal)

LVEI (Normal Circular)

MPA min mm (Enlargement) (Small) (Normal)

MPA:Ao [Enlarged PA] (Normal)

RPA max mm (Enlargement) (Small) (Normal)

RPAmin:Ao [Enlarged PA] (Normal)

RPA min mm (Enlargement) (Small) (Normal)

RPAmin:Ao [Enlarged PA] (Normal)

RPAD index % (Reduced) (Normal)

ePLAR Pre-Capillary PH Pattern Post-Capillary Left-Heart Backup Borderline Zone

Clinical Observations & Plan:

Patient Name

Owner Name

Breed

Breed-Specific Reference Data

Selected species:

CanineFeline

Change species:

Report Date

Report Export Options

Report Copied to Clipboard!

Smart Paste Auto-Fill

Paste raw text or CSV export from your echo machine. The calculator will attempt to find and extract the measurements automatically.

Canine EPIC Check

(Applicable to Degenerative Mitral Valve Disease cases only)

Left Atrial Enlargement (LA:Ao > 1.65) - Very Enlarged Slightly Enlarged - Check LAD Normal Awaiting measurements...

LV Enlargement (LVIDDN > 1.7) - Very Enlarged Slightly Enlarged - Check Breed Normal Normal Awaiting measurements...

EPIC - Meets Echo Criteria for Stage B2 Does Not Meet Criteria Awaiting measurements...

⚠️ Stage B2 Potential

This patient meets the EPIC Trial echo criteria for Stage B2. In the presence of a grade ≥3/6 murmur, pimobendan may be indicated.

💡 Clinical Nuance: The EPIC trial uses a threshold of >1.70 for LVIDdn to define cardiomegaly. This is more sensitive than the statistical 95% limit (1.85) to ensure at-risk patients aren't missed. 5% of dogs will have normal hearts > 1.7 and especially athletic/sighthound breeds.

Feline Risk Assessment

(ISCAID / HCM Screening Guidelines)

HCM Phenotype (Wall ≥ 6mm):

ATE / Thrombus Risk:

Severe LA Enlargement: High risk of ATE. Recommend Clopidogrel and screening for "smoke" or thrombus.

Moderate LA Enlargement: Risk of thrombus formation present. Clinical monitoring and consideration of antiplatelet therapy indicated.

Diastolic Functional Profile

Hemodynamic Progression Waveform Map

1

Physiologic

(Normal)

E > A Inflow

2

Grade I

(Diastolic Impairment)

E < A Rev

3

Grade II

(Pseudo-normal)

Pseudo E>A

4

Grade III

(Restrictive)

E >> A Spike

Pathological Points Audit

Echo Metric	Entry	Interpretation	Weight

Hemodynamic Profile Analysis:

MINE Score Risk Stratification

Applicable to Degenerative Mitral Valve Disease Cases Only

MINE Score

Prognostic Risk Category

Median Survival Time (MST)

*Survival estimates represent median time to cardiac death or congestive heart failure entry as validated by Vezzosi et al.

MINE Scoring Points Breakdown

Variable	Patient	Interval	Pts

Is your patient a breed with recorded echo normals?

Select a breed to compare patient results with published breed-specific intervals.

Breed-Specific Reference Data

Allometric Prediction Tool

Patient Weight (kg):

Dataset Selection:

Awaiting Weight Entry
Reference ranges will appear once a weight is entered.

Current Weight: kg | Reference:

Metric	Patient	Mean	95% Range (mm)

Dataset Note:

ACVIM Pulmonary Hypertension

Awaiting Data

Enter Doppler velocities or structural markers to calculate clinical probability.

Key Triggers: TR Velocity • PA:Ao • RPA Index • RVWT • LVEI

Low Likelihood

Normal TR / No Signs

Intermediate

Borderline TR, ≥2 Sites, or High Chang Score

High Likelihood

Severe TR (≥3.4 m/s)

Clinical Evidence Audit

Anatomic Sites Positive: / 3

ePLAR Differentiation

Because this patient shows signs of Pulmonary Hypertension, the ePLAR helps differentiate the underlying etiology by comparing pulmonary pressures to left atrial filling pressures.

(ePLAR)

Pre-Capillary PH Pattern Post-Capillary (Left Heart Backup) Borderline Zone

Parameter	Formula (Normalised)	Limit
LVIDdn	$$\frac{LVIDd}{Wt^{0.294}}$$	<1.7
LAsaxn	$$\frac{LA}{Wt^{0.355}}$$	<1.17
LADn	$$\frac{LAD}{Wt^{0.309}}$$	<1.6

Echo Calculator