Study supports tissue Doppler imaging in neonatal foals
Bottom line
A new Equine Veterinary Journal study reports that pulsed-wave tissue Doppler imaging, or TDI, is feasible for evaluating left ventricular myocardial function in healthy neonatal foals during the first five days of life, with strong inter- and intra-observer reproducibility. In the study, 25 healthy foals were followed prospectively, and the authors found that systolic and early diastolic myocardial velocities increased over the first days after birth, consistent with rapid cardiovascular adaptation in the neonatal period. The work builds on earlier conference abstracts from the same research group, which had already shown strong repeatability of pulsed-wave TDI measurements in healthy Standardbred neonatal foals and described use of both right parasternal and subcostal views to assess radial and longitudinal left ventricular motion. (academic.oup.com)
Why it matters: For equine practitioners and referral hospitals, the study adds a practical functional imaging tool to neonatal echocardiography, not just structural assessment. That matters because the first days of life are a period of major circulatory transition in foals, and prior work has shown that normal echocardiographic parameters, including shunt-related findings such as ductus arteriosus and foramen ovale changes, evolve quickly after birth. A reproducible TDI approach could help clinicians distinguish normal adaptation from early myocardial dysfunction, although this study was conducted in healthy foals and should be seen as a baseline reference rather than a disease-validation study. (pmc.ncbi.nlm.nih.gov)
What to watch: The next step is whether investigators validate these TDI measurements in sick, premature, or septic foals, where functional cardiac assessment could have the most clinical value. (sciencedirect.com)
Key facts
- Study type
- Prospective observational study
- Journal
- Equine Veterinary Journal
- Sample size
- 25 healthy neonatal foals
- Population
- Healthy foals in the first five days of life
- Method
- Pulsed-wave tissue Doppler imaging (TDI) of left ventricular myocardial function
- Main finding
- TDI was feasible and showed strong inter- and intra-observer reproducibility
- Physiologic trend
- Systolic and early diastolic myocardial velocities increased over the first days after birth
- Clinical context
- Baseline reference in healthy foals, not a disease-validation study
A new study in Equine Veterinary Journal suggests pulsed-wave tissue Doppler imaging may be ready for broader use in neonatal foal cardiology. The prospective observational study found that left ventricular TDI was feasible in 25 healthy neonatal foals over their first five days of life, with excellent reproducibility, and showed that systolic and early diastolic myocardial velocities rose over time as the cardiovascular system adapted after birth. (agris.fao.org)
The paper fits into a growing body of work aimed at moving beyond basic structural echocardiography in foals. Conventional neonatal equine echo has helped define normal postnatal changes, including closure patterns of the ductus arteriosus and foramen ovale, as well as shifts in chamber dimensions and hemodynamics over the first days of life. But functional myocardial assessment has remained less developed, even though cardiovascular monitoring is central in compromised foals. (pmc.ncbi.nlm.nih.gov)
This research group had previewed parts of the work in earlier abstracts. A 2024 ACVIM Forum abstract described the feasibility of pulsed-wave TDI for characterizing radial and longitudinal left ventricular wall motion in healthy Standardbred newborn foals and reported changing TDI features during the first days of life. A separate ECEIM abstract reported excellent interobserver agreement for most variables and good-to-excellent intraobserver reliability overall, with weaker performance for some septal measurements. Together, those earlier reports hinted that the technique was practical, but the full journal publication gives the findings more weight for clinicians looking for usable reference data. (onlinelibrary.wiley.com)
The technical appeal is straightforward. TDI measures myocardial motion directly rather than relying only on chamber size or blood-flow patterns. In adult horses, pulsed-wave TDI has already been studied as a way to assess left ventricular function and detect dysfunction in cardiac disease. The neonatal foal study extends that concept into a population where rapid physiologic transition can make conventional interpretation more difficult. The authors’ finding that systolic and early diastolic velocities increase over the first days of life is biologically plausible and aligns with what is known from neonatal cardiovascular adaptation in both veterinary and human neonatal echocardiography. (onlinelibrary.wiley.com)
Outside commentary specific to this new paper appears limited so far, but the broader field supports the importance of reliable functional imaging in newborn patients. Reviews of neonatal echocardiography in human medicine describe tissue Doppler as a useful adjunct for assessing systolic and diastolic performance during the newborn transition, while equine cardiology literature has already established TDI as a meaningful research and clinical tool in older horses. That doesn’t automatically translate to bedside adoption in every foal unit, but it does support the study’s relevance. (nature.com)
Why it matters: For veterinary professionals, especially equine internists, cardiologists, and critical care teams, the main value here is standardization. If TDI can be performed consistently in awake or minimally restrained neonatal foals and interpreted against age-specific expectations, it could strengthen evaluation of foals with sepsis, prematurity, neonatal maladjustment, murmurs, poor perfusion, or suspected myocardial compromise. Just as important, the study underscores that “normal” is not static in the first week of life. A single measurement may be less informative than understanding the expected trajectory over time. (sciencedirect.com)
There are still limits. The study focused on healthy foals, so it doesn’t yet answer how well TDI separates normal adaptation from pathology or whether it changes management or outcomes. It also appears to build from Standardbred-focused datasets, which may leave open questions about breed effects, referral-center reproducibility, and training requirements for general practice settings. Those are common next-step issues whenever an imaging method moves from feasibility work toward routine clinical use. (academic.oup.com)
What to watch: The key next phase will be disease-focused validation studies, especially in critically ill foals, along with publication of practical reference intervals and protocols that make the technique easier to use across hospitals and among operators with different levels of echocardiography experience. (academic.oup.com)