Clinical features and outcome of dogs and cats with bidirectional and continuous right-to-left shunting patent ductus arteriosus.
congenital heart disease
polycythemia
right-sided congestive heart failure
sildenafil
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
revised:
27
01
2021
received:
14
06
2020
accepted:
04
02
2021
pubmed:
27
2
2021
medline:
29
6
2021
entrez:
26
2
2021
Statut:
ppublish
Résumé
Studies describing the clinical progression of animals with reverse patent ductus arteriosus (PDA) are lacking. To describe the signalment, presenting signs, echocardiographic features, and survival in a group of dogs and cats with bidirectional and continuous right-to-left PDA. Forty-six client-owned animals included, comprising 43 dogs and 3 cats with bidirectional or continuous right-to-left PDA. Retrospective multicenter study. Medical records and echocardiographic findings reviewed from animals diagnosed with bidirectional or continuous right-to-left PDA. Impact of ductal morphology, spectral Doppler flow profile, PCV, sildenafil treatment at presentation, sildenafil dose, severity of pulmonary hypertension, general anesthesia with or without surgery and the presence of right-sided congestive heart failure (R-CHF) on crude mortality rate were evaluated via Mantel-Cox log rank comparison of Kaplan-Meier survival curves. Univariable and multivariable Cox proportional hazards analysis was performed, and hazard ratio (HR) (95% confidence intervals [CI]) was presented. Hindlimb collapse was the most common presenting sign in dogs (n = 16). Clinical signs in cats were variable. Median survival time was 626 days in dogs (range 1-3628 days). Dogs with R-CHF had a shorter median survival time (58 days vs 1839 days, P = .03). Dogs treated with sildenafil at initial presentation survived longer (1839 days vs 302 days, P = .03), which was the only independent predictor of survival (HR 0.35, CI 0.15-0.86, P = 0.021). Dogs and cats with reverse PDA have a variable clinical presentation and prognosis. Survival time was longer in animals prescribed sildenafil at diagnosis. Dogs with R-CHF at presentation have a worse overall outcome.
Sections du résumé
BACKGROUND
BACKGROUND
Studies describing the clinical progression of animals with reverse patent ductus arteriosus (PDA) are lacking.
OBJECTIVES
OBJECTIVE
To describe the signalment, presenting signs, echocardiographic features, and survival in a group of dogs and cats with bidirectional and continuous right-to-left PDA.
ANIMALS
METHODS
Forty-six client-owned animals included, comprising 43 dogs and 3 cats with bidirectional or continuous right-to-left PDA.
METHODS
METHODS
Retrospective multicenter study. Medical records and echocardiographic findings reviewed from animals diagnosed with bidirectional or continuous right-to-left PDA. Impact of ductal morphology, spectral Doppler flow profile, PCV, sildenafil treatment at presentation, sildenafil dose, severity of pulmonary hypertension, general anesthesia with or without surgery and the presence of right-sided congestive heart failure (R-CHF) on crude mortality rate were evaluated via Mantel-Cox log rank comparison of Kaplan-Meier survival curves. Univariable and multivariable Cox proportional hazards analysis was performed, and hazard ratio (HR) (95% confidence intervals [CI]) was presented.
RESULTS
RESULTS
Hindlimb collapse was the most common presenting sign in dogs (n = 16). Clinical signs in cats were variable. Median survival time was 626 days in dogs (range 1-3628 days). Dogs with R-CHF had a shorter median survival time (58 days vs 1839 days, P = .03). Dogs treated with sildenafil at initial presentation survived longer (1839 days vs 302 days, P = .03), which was the only independent predictor of survival (HR 0.35, CI 0.15-0.86, P = 0.021).
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
Dogs and cats with reverse PDA have a variable clinical presentation and prognosis. Survival time was longer in animals prescribed sildenafil at diagnosis. Dogs with R-CHF at presentation have a worse overall outcome.
Identifiants
pubmed: 33634497
doi: 10.1111/jvim.16072
pmc: PMC7995355
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
780-788Informations de copyright
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Références
J Vet Intern Med. 2007 Nov-Dec;21(6):1258-64
pubmed: 18196735
J Small Anim Pract. 2013 Sep;54(9):445-52
pubmed: 23889710
J Small Anim Pract. 2004 Mar;45(3):148-53
pubmed: 15049573
J Vet Intern Med. 2001 Jul-Aug;15(4):418-21
pubmed: 11467603
J Clin Pharmacol. 2013 Jun;53(6):611-8
pubmed: 23553708
J Vet Cardiol. 2015 Dec;17 Suppl 1:S215-9
pubmed: 26776580
J Am Vet Med Assoc. 1993 Mar 1;202(5):761-4
pubmed: 8454510
Circulation. 2008 Mar 18;117(11):1436-48
pubmed: 18347220
Int J Cardiol. 2007 Aug 21;120(2):198-204
pubmed: 17182132
Vet Rec. 2016 Jul 2;179(1):17
pubmed: 27302919
Blood Rev. 1989 Mar;3(1):59-65
pubmed: 2650777
J Vet Intern Med. 2000 Jul-Aug;14(4):429-35
pubmed: 10935894
Chest. 1989 Jul;96(1):31-9
pubmed: 2736990
J Vet Cardiol. 2015 Jun;17(2):83-96
pubmed: 25547662
J Vet Intern Med. 2014 Mar-Apr;28(2):401-10
pubmed: 24372855
Int J Cardiol. 1994 Jul;45(3):199-207
pubmed: 7960265
J Vet Cardiol. 2006 Nov;8(2):109-14
pubmed: 19083344
J Vet Cardiol. 2014 Sep;16(3):197-203
pubmed: 25108347
Circulation. 1994 Feb;89(2):911
pubmed: 8313583
Eur Heart J. 2016 May 07;37(18):1449-55
pubmed: 26843280
J Small Anim Pract. 1981 Sep;22(9):603-8
pubmed: 6119398
J Am Vet Med Assoc. 1982 Feb 15;180(4):415-8
pubmed: 7061327
Vet Clin North Am. 1977 May;7(2):323-39
pubmed: 325872
J Vet Cardiol. 2008 Dec;10(2):129-32
pubmed: 19010756
J Vet Intern Med. 2003 Mar-Apr;17(2):167-71
pubmed: 12683616
J Vet Intern Med. 2020 Mar;34(2):549-573
pubmed: 32065428
J Vet Intern Med. 2006 Sep-Oct;20(5):1132-5
pubmed: 17063705
J Small Anim Pract. 2004 Sep;45(9):461-6
pubmed: 15460205
Circ Res. 1971 Jul;29(1):1-13
pubmed: 5105435
Circulation. 2004 Jan 20;109(2):159-65
pubmed: 14734504
J Vet Intern Med. 2001 Jan-Feb;15(1):39-42
pubmed: 11215909
J Small Anim Pract. 1997 Mar;38(3):94-8
pubmed: 9097239
J Am Vet Med Assoc. 2015 Aug 1;247(3):278-85
pubmed: 26176727
J Small Anim Pract. 2008 Jul;49(7):349-55
pubmed: 18638059
Thorax. 1994;49 Suppl:S39-45
pubmed: 7974326
Heart. 2007 Apr;93(4):514-8
pubmed: 16954130
J Small Anim Pract. 2019 Oct;60(10):607-615
pubmed: 31280488
Curr Cardiol Rev. 2010 Nov;6(4):356-62
pubmed: 22043212
J Small Anim Pract. 2003 Apr;44(4):184-8
pubmed: 12703872
J Vet Intern Med. 2006 Jul-Aug;20(4):912-20
pubmed: 16955816
Vet Clin North Am Small Anim Pract. 2010 Jul;40(4):623-41
pubmed: 20610015
J Vet Intern Med. 2021 Mar;35(2):780-788
pubmed: 33634497
Vet J. 2007 Mar;173(2):443-8
pubmed: 16442821
Ann Intern Med. 1988 Sep 1;109(5):406-13
pubmed: 3044212
Drugs. 2008;68(8):1049-66
pubmed: 18484798
J Vet Cardiol. 2015 Sep;17(3):192-202
pubmed: 26363941
J Vet Cardiol. 2017 Feb;19(1):35-43
pubmed: 27919727
J Am Coll Cardiol. 2009 Jun 30;54(1 Suppl):S20-S31
pubmed: 19555855
J Vet Cardiol. 2001 May;3(1):7-16
pubmed: 19081333
Aust Vet J. 1998 Dec;76(12):786-91
pubmed: 9972428
J Small Anim Pract. 2018 Jan;59(1):38-44
pubmed: 29193096
J Small Anim Pract. 2011 Nov;52(11):595-8
pubmed: 21985577
J Vet Intern Med. 2011 May-Jun;25(3):477-83
pubmed: 21418326
J Am Vet Med Assoc. 1981 Mar 15;178(6):565-71
pubmed: 7263461