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Echocardiographic evaluation of the right ventricular dimension and systolic function in dogs with pulmonary hypertension


Vezzosi, T; Domenech, O; Costa, G; Marchesotti, F; Venco, L; Zini, Eric; Del Palacio, M J; Tognetti, R (2018). Echocardiographic evaluation of the right ventricular dimension and systolic function in dogs with pulmonary hypertension. Journal of Veterinary Internal Medicine, 32(5):1541-1548.

Abstract

BACKGROUND: Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH).
HYPOTHESIS/OBJECTIVES: To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right-sided congestive heart failure (R-CHF).
ANIMALS: 89 dogs with PH and 74 healthy dogs.
METHODS: Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end-diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively).
RESULTS: RVEDA index was higher in dogs with moderate PH (10.8 cm /m ; range, 6.2-14.4 cm /m ) and severe PH (12.4 cm /m ; range, 7.7-21.4 cm /m ) than in those with mild PH (8.4 cm /m ; range, 4.8-11.6 cm /m ) and control dogs (8.5 cm /m ; range, 2.8-11.6 cm /m ; P < .001). RVEDA index was significantly higher in dogs with R-CHF (13.7 cm /m ; range, 11.0-21.4 cm /m ) than in dogs without R-CHF (9.4 cm /m ; range, 4.8-17.1 cm /m ; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R-CHF.
CONCLUSIONS AND CLINICAL IMPORTANCE: The RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R-CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.

Abstract

BACKGROUND: Right ventricular (RV) enlargement and dysfunction are associated with prognosis in humans with pulmonary hypertension (PH).
HYPOTHESIS/OBJECTIVES: To assess RV size and systolic function in dogs with PH and to determine if they are associated with disease severity and right-sided congestive heart failure (R-CHF).
ANIMALS: 89 dogs with PH and 74 healthy dogs.
METHODS: Prospective observational study. PH was classified according to the tricuspid regurgitation pressure gradient. RV end-diastolic area (RVEDA) index was calculated as RVEDA divided by body surface area. RV systolic function was assessed with the tricuspid annular plane systolic excursion (TAPSE) and the RV fractional area change (FAC) normalized for body weight (TAPSEn and FACn, respectively).
RESULTS: RVEDA index was higher in dogs with moderate PH (10.8 cm /m ; range, 6.2-14.4 cm /m ) and severe PH (12.4 cm /m ; range, 7.7-21.4 cm /m ) than in those with mild PH (8.4 cm /m ; range, 4.8-11.6 cm /m ) and control dogs (8.5 cm /m ; range, 2.8-11.6 cm /m ; P < .001). RVEDA index was significantly higher in dogs with R-CHF (13.7 cm /m ; range, 11.0-21.4 cm /m ) than in dogs without R-CHF (9.4 cm /m ; range, 4.8-17.1 cm /m ; P < .001). The severity of tricuspid regurgitation (TR) was the only independent predictor of the RVEDA index (P < .001). TAPSEn and FACn were not significantly different among varying degrees of PH severity and between dogs with and without R-CHF.
CONCLUSIONS AND CLINICAL IMPORTANCE: The RVEDA index can be used to evaluate RV size in dogs. It can provide additional information in dogs with PH and predict R-CHF. Severity of TR is the main determinant of RV enlargement in dogs with PH.

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Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Uncontrolled Keywords:congestive heart failure; right ventricular enlargement; right ventricular size; tricuspid regurgitation
Language:English
Date:September 2018
Deposited On:07 Dec 2018 15:18
Last Modified:24 Sep 2019 23:56
Publisher:Wiley Open Access
ISSN:0891-6640
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/jvim.15253
PubMed ID:30216561

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