Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension

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 surv...

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Main Authors: Lance C. Visser, James E. Wood, Lynelle R. Johnson
Format: Article
Language:English
Published: Wiley 2020-07-01
Series:Journal of Veterinary Internal Medicine
Subjects:
Online Access:https://doi.org/10.1111/jvim.15826
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author Lance C. Visser
James E. Wood
Lynelle R. Johnson
author_facet Lance C. Visser
James E. Wood
Lynelle R. Johnson
author_sort Lance C. Visser
collection DOAJ
description 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/kg0.284 (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/kg0.284), 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.
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spelling doaj.art-c7d379bb2735497b97155603afbd85932022-12-22T01:31:59ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762020-07-013441379138810.1111/jvim.15826Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertensionLance C. Visser0James E. Wood1Lynelle R. Johnson2Department of Medicine and Epidemiology School of Veterinary Medicine, University of California, Davis Davis California USADepartment of Medicine and Epidemiology School of Veterinary Medicine, University of California, Davis Davis California USADepartment of Medicine and Epidemiology School of Veterinary Medicine, University of California, Davis Davis California USAAbstract 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/kg0.284 (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/kg0.284), 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.https://doi.org/10.1111/jvim.15826canineDoppler echocardiographymitral valve diseasepostcapillaryprecapillarypulmonary vascular resistance
spellingShingle Lance C. Visser
James E. Wood
Lynelle R. Johnson
Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
Journal of Veterinary Internal Medicine
canine
Doppler echocardiography
mitral valve disease
postcapillary
precapillary
pulmonary vascular resistance
title Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
title_full Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
title_fullStr Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
title_full_unstemmed Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
title_short Survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
title_sort survival characteristics and prognostic importance of echocardiographic measurements of right heart size and function in dogs with pulmonary hypertension
topic canine
Doppler echocardiography
mitral valve disease
postcapillary
precapillary
pulmonary vascular resistance
url https://doi.org/10.1111/jvim.15826
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AT lynellerjohnson survivalcharacteristicsandprognosticimportanceofechocardiographicmeasurementsofrightheartsizeandfunctionindogswithpulmonaryhypertension