Prognostic Value of Pulmonary Vascular Resistance Estimated by Echocardiography in Dogs with Myxomatous Mitral Valve Disease and Pulmonary Hypertension

Overview

Journal J Vet Intern Med

Specialties General Medicine
Veterinary Medicine

Date 2023 Mar 30

PMID 36994902

Authors

Yunosuke Yuchi

Ryohei Suzuki

Yuyo Yasumura

Takahiro Saito

Takahiro Teshima

Hirotaka Matsumoto

Hidekazu Koyama

Affiliations

Soon will be listed here.

Abstract

Background: Progression to combined post- and pre-capillary pulmonary hypertension (PH) provides prognostic information in human patients with post-capillary PH. Pulmonary vascular resistance estimated by echocardiography (PVRecho) is useful for the stratification of dogs with myxomatous mitral valve disease (MMVD) and detectable tricuspid regurgitation.

Objectives: To evaluate the prognostic value of PVRecho in dogs with MMVD.

Animals: Fifty-four dogs with MMVD and detectable tricuspid regurgitation.

Methods: Prospective cohort study. All dogs underwent echocardiography. The PVRecho was calculated based on tricuspid regurgitation and the velocity-time integral of the pulmonary artery flow. To evaluate the influence of echocardiographic variables on cardiac-related deaths, Cox proportional hazard analysis was performed. Additionally, Kaplan-Meier curves classified by PVRecho tertiles were made and compared using log-rank tests to evaluate the influence of PVRecho on all-cause mortality and cardiac-related death.

Results: The median follow-up time was 579 days. Forty-one dogs with MMVD (PH severity [number]: no or mild, 21/33; moderate, 11/11; severe, 9/10) died during the study. In the multivariable Cox proportional hazard analysis adjusted for age, sildenafil administration, and American College of Veterinary Internal Medicine stage of MMVD, left atrial to aortic diameter ratio and PVRecho remained significant (adjusted hazard ratio [95% confidence interval]: 1.2 [1.1-1.3] and 2.1 [1.6-3.0], respectively). Higher PVRecho showed a significant association with lower survival rates.

Conclusions And Clinical Importance: Left atrial enlargement and high PVRecho were independent prognostic factors in dogs with MMVD and detectable tricuspid regurgitation.

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