Accuracy of echocardiographically estimated pulmonary artery pressure in dogs with myxomatous mitral valve disease.
Canine
Catheterization
Doppler
Imaging
Journal
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology
ISSN: 1875-0834
Titre abrégé: J Vet Cardiol
Pays: Netherlands
ID NLM: 101163270
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
06
11
2020
revised:
08
03
2021
accepted:
09
03
2021
pubmed:
26
4
2021
medline:
26
11
2021
entrez:
25
4
2021
Statut:
ppublish
Résumé
Echocardiographically identified pulmonary hypertension is an independent predictor of poor outcome in dogs affected by myxomatous valvular degeneration (MMVD). Systolic pulmonary arterial pressure is routinely estimated based on its relationship with the Doppler-determined velocity of tricuspid regurgitation as defined by the simplified Bernoulli equation (sPAP_D). Experimental studies suggest that the method is imperfect, but its accuracy in dogs with MMVD is not known. Twenty dogs affected by MMVD that had cardiac remodeling and measurable tricuspid regurgitation. A flow-directed thermodilution monitoring catheter was percutaneously placed in the right external jugular vein and advanced to the main pulmonary artery. Pulmonary arterial systolic pressure was recorded (systolic pulmonary arterial pressure obtained by right heart catheterization [sPAP_C]). A second operator contemporaneously acquired tricuspid regurgitant velocity spectra to calculate sPAP_D. Each operator was blinded to the result of the other techniques. Technical difficulties prevented the analysis of catheterization data in two dogs. Eighteen measurement pairs were therefore used for comparison of sPAP_C and sPAP_D through correlation and Bland-Altman analysis. A statistically significant bias between sPAP_C and sPAP_D (mean difference = 0.5 mmHg; confidence interval = -6.5 mmHg, +7.5 mmHg) was not detected. The interval of agreement between the techniques was wide (-27.3 mmHg, +28.2 mmHg). A significant linear association between the two techniques was not identified (r = 0.11, p=0.17). Echocardiographically estimated pulmonary artery pressure poorly agrees with sPAP_C measurement in dogs affected by MMVD and cardiac remodeling with or without previously diagnosed congestive heart failure. In these dogs, sPAP_D could under- or over-estimate sPAP_C by more than 20 mmHg, and therefore caution should be used when interpreting sPAP_D.
Identifiants
pubmed: 33895627
pii: S1760-2734(21)00028-X
doi: 10.1016/j.jvc.2021.03.003
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
90-100Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest Statement The authors do not have any conflicts of interest to disclose.