Survival Characteristics and Prognostic Importance of Echocardiographic Measurements of Right Heart Size and Function in Dogs with Pulmonary Hypertension

Overview

Journal J Vet Intern Med

Specialties General Medicine
Veterinary Medicine

Date 2020 Jun 6

PMID 32501601

Citations 17

Authors

Lance C Visser

James E Wood

Lynelle R Johnson

Affiliations

Soon will be listed here.

Abstract

Background: The clinical relevance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension (PH) is unknown.

Objective: To determine if echocardiographic measurements of right heart size and right ventricular (RV) function are associated with survival times in dogs with PH.

Animals: Eighty-two client-owned dogs.

Methods: Retrospective study where data from medical records and baseline echocardiographic examinations were collected and measured in a standardized manner. Owners or primary veterinarians were contacted for outcome data.

Results: Enlargement of the right atrium (88%), RV (69%), and pulmonary artery (72%) was common. One-third of the cases had reduced RV function quantified by two-dimensional echocardiography-derived tricuspid annular plane systolic excursion (TAPSE). Decreased TAPSE was significantly (P = .008) more common in dogs with PH not secondary to left heart disease (LHD; 43%) compared to dogs with PH secondary to LHD (14%) but median survival times (182, 95% confidence interval [CI] = 39-309 versus 298, 95% CI = 85-314 days, respectively) were not significantly different (P = .78). Right atrial area (hazard ratio [HR] = 2.72, 95% CI = 1.58-4.70), TAPSE < 3.23 mm/kg (HR = 2.19, 95% CI = 1.28-3.74), and right heart failure (HR = 2.05, 95% CI = 1.18-3.57) were independently associated with shorter survival time (P ≤ .04).

Conclusions And Clinical Importance: Right atrial area, RV function (TAPSE < 3.23 mm/kg ), and right heart failure offer clinically relevant prognostic information in dogs with PH. Results support the quantitative assessment of right heart size and function in dogs with PH.

Citing Articles

Echocardiographic evaluation of the size of the main pulmonary artery and right pulmonary artery in dogs with pulmonary hypertension.

Grosso G, Tognetti R, Domenech O, Della Pina A, Marchesotti F, Patata V J Vet Intern Med. 2025; 39(1):e17241.

PMID: 39846767 PMC: 11755767. DOI: 10.1111/jvim.17241.

Two-dimensional echocardiographic right heart ratios for assessment of right heart size in dogs: Reference intervals and reproducibility.

Sankisov J, Visser L, Davis K, Boon J, Ross E, Laws A J Vet Intern Med. 2024; 38(6):3005-3015.

PMID: 39350563 PMC: 11586550. DOI: 10.1111/jvim.17159.

Indicators for pulmonary hypertension in dogs with degenerative mitral valve disease.

Chalermpromma P, Surachetpong S Vet World. 2024; 16(12):2515-2520.

PMID: 38328363 PMC: 10844776. DOI: 10.14202/vetworld.2023.2515-2520.

Utility of vertebral left atrial size and vertebral heart size to aid detection of congestive heart failure in dogs with respiratory signs.

Ross E, Visser L, Sbardellati N, Potter B, Ohlendorf A, Scansen B J Vet Intern Med. 2023; 37(6):2021-2029.

PMID: 37882250 PMC: 10658574. DOI: 10.1111/jvim.16918.

Echocardiographic characteristics of dogs with pulmonary hypertension secondary to respiratory diseases.

Yuchi Y, Suzuki R, Saito T, Yasumura Y, Teshima T, Matsumoto H J Vet Intern Med. 2023; 37(5):1656-1666.

PMID: 37593765 PMC: 10472999. DOI: 10.1111/jvim.16836.

References

Hansson K, Haggstrom J, Kvart C, Lord P . Left atrial to aortic root indices using two-dimensional and M-mode echocardiography in cavalier King Charles spaniels with and without left atrial enlargement. Vet Radiol Ultrasound. 2002; 43(6):568-75. DOI: 10.1111/j.1740-8261.2002.tb01051.x. View

Rishniw M, Erb H . Evaluation of four 2-dimensional echocardiographic methods of assessing left atrial size in dogs. J Vet Intern Med. 2000; 14(4):429-35. DOI: 10.1892/0891-6640(2000)014<0429:eofemo>2.3.co;2. View

Johnson L, Boon J, Orton E . Clinical characteristics of 53 dogs with Doppler-derived evidence of pulmonary hypertension: 1992-1996. J Vet Intern Med. 1999; 13(5):440-7. DOI: 10.1892/0891-6640(1999)013<0440:ccodwd>2.3.co;2. View

Visser L, Wood J, Johnson L . Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension. J Vet Intern Med. 2020; 34(4):1379-1388. PMC: 7379050. DOI: 10.1111/jvim.15826. View

Vonk-Noordegraaf A, Haddad F, Chin K, Forfia P, Kawut S, Lumens J . Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology. J Am Coll Cardiol. 2013; 62(25 Suppl):D22-33. DOI: 10.1016/j.jacc.2013.10.027. View

Vezzosi T, Domenech O, Iacona M, Marchesotti F, Zini E, Venco L . Echocardiographic Evaluation of the Right Atrial Area Index in Dogs with Pulmonary Hypertension. J Vet Intern Med. 2018; 32(1):42-47. PMC: 5787176. DOI: 10.1111/jvim.15035. View

Jaffey J, Wiggen K, Leach S, Masseau I, Girens R, Reinero C . Pulmonary hypertension secondary to respiratory disease and/or hypoxia in dogs: Clinical features, diagnostic testing and survival. Vet J. 2019; 251:105347. DOI: 10.1016/j.tvjl.2019.105347. View

Reinero C, Jutkowitz L, Nelson N, Masseau I, Jennings S, Williams K . Clinical features of canine pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis. J Vet Intern Med. 2018; 33(1):114-123. PMC: 6335444. DOI: 10.1111/jvim.15351. View

Tidholm A, Hoglund K, Haggstrom J, Ljungvall I . Diagnostic Value of Selected Echocardiographic Variables to Identify Pulmonary Hypertension in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med. 2015; 29(6):1510-7. PMC: 4895671. DOI: 10.1111/jvim.13609. View

10.

Abbott J, Gentile-Solomon J . Measurement Variation and Repeatability of Echocardiographic Variables Used to Estimate Pulmonary Artery Pressure in Dogs. J Vet Intern Med. 2017; 31(6):1622-1628. PMC: 5697183. DOI: 10.1111/jvim.14846. View

11.

Vezzosi T, Domenech O, Costa G, Marchesotti F, Venco L, Zini E . Echocardiographic evaluation of the right ventricular dimension and systolic function in dogs with pulmonary hypertension. J Vet Intern Med. 2018; 32(5):1541-1548. PMC: 6189358. DOI: 10.1111/jvim.15253. View

12.

Soydan L, Kellihan H, Bates M, Stepien R, Consigny D, Bellofiore A . Accuracy of Doppler echocardiographic estimates of pulmonary artery pressures in a canine model of pulmonary hypertension. J Vet Cardiol. 2015; 17(1):13-24. PMC: 4550702. DOI: 10.1016/j.jvc.2014.10.004. View

13.

Forfia P, Fisher M, Mathai S, Housten-Harris T, Hemnes A, Borlaug B . Tricuspid annular displacement predicts survival in pulmonary hypertension. Am J Respir Crit Care Med. 2006; 174(9):1034-41. DOI: 10.1164/rccm.200604-547OC. View

14.

Chan I, Weng M, Hsueh T, Lin Y, Lin S . Prognostic value of right pulmonary artery distensibility in dogs with pulmonary hypertension. J Vet Sci. 2019; 20(4):e34. PMC: 6669208. DOI: 10.4142/jvs.2019.20.e34. View

15.

Kellum H, Stepien R . Sildenafil citrate therapy in 22 dogs with pulmonary hypertension. J Vet Intern Med. 2008; 21(6):1258-64. DOI: 10.1892/07-006.1. View

16.

Chapel E, Scansen B, Schober K, Bonagura J . Echocardiographic Estimates of Right Ventricular Systolic Function in Dogs with Myxomatous Mitral Valve Disease. J Vet Intern Med. 2017; 32(1):64-71. PMC: 5787149. DOI: 10.1111/jvim.14884. View

17.

Johnson L, Stern J . Clinical features and outcome in 25 dogs with respiratory-associated pulmonary hypertension treated with sildenafil. J Vet Intern Med. 2019; 34(1):65-73. PMC: 6979098. DOI: 10.1111/jvim.15679. View

18.

Kyranis S, Latona J, Platts D, Kelly N, Savage M, Brown M . Improving the echocardiographic assessment of pulmonary pressure using the tricuspid regurgitant signal-The "chin" vs the "beard". Echocardiography. 2018; 35(8):1085-1096. DOI: 10.1111/echo.13893. View

19.

Bonagura J, Schober K . Can ventricular function be assessed by echocardiography in chronic canine mitral valve disease?. J Small Anim Pract. 2009; 50 Suppl 1:12-24. DOI: 10.1111/j.1748-5827.2009.00803.x. View

20.

Gentile-Solomon J, Abbott J . Conventional echocardiographic assessment of the canine right heart: reference intervals and repeatability. J Vet Cardiol. 2016; 18(3):234-247. DOI: 10.1016/j.jvc.2016.05.002. View