Canine pulmonary vein-to-pulmonary artery ratio: echocardiographic technique and reference intervals

Birettoni, Francesco; Caivano, Domenico; Patata, Valentina; Moı̈se, N. Sydney; Guglielmini, Carlo; Rishniw, Mark; Porciello, Francesco

doi:10.1016/j.jvc.2016.07.004

Cited by 16 publications

(34 citation statements)

References 21 publications

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“…Several studies have shown an increase in Ao stiffness in humans suffering from chronic arterial hypertension. [9][10][11][12]20,41 In veterinary medicine, the echocardiographic-derived right pulmonary artery distensibility index [42][43][44][45] has been used as an index of PH in dogs. 45,46 To the best of our knowledge, ours is the first study in which Ao stiffness has been assessed using ultrasonography in dogs with SH.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs

Corda

Caivano

et al. 2020

Veterinary Internal Medicne

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Background: Systemic hypertension (SH) is a persistent and pathological increase in arterial blood pressure (BP). Chronic SH leads to an increase in aortic (Ao) stiffness, and measuring Ao elasticity is useful for estimating Ao stiffness in humans. Currently, no literature in veterinary medicine describes noninvasive assessment of abdominal Ao elasticity in dogs with SH. Objective: Compare ultrasonographic-derived abdominal Ao strain (AoSt) between hypertensive (HT) and normotensive (NT) dogs. Animals: Fifty privately-owned dogs with clinical signs, conditions, or both potentially associated with SH. Methods: Prospective observational case-control study. Aortic stiffness was estimated by calculating AoSt as follows: AoSt = ([AoDs − AoDd]/AoDd) × 100, where AoDs and AoDd are the Ao diameter in systole and in diastole, respectively. Aortic stiffness was calculated from 2 different Ao transverse sections, the first caudal to the left renal artery (K_AoSt), and the second cranial to the external iliac arteries (I_AoSt). Results: Thirty-two dogs were included in the HT group and 18 in the NT group. Both K_AoSt and I_AoSt in HT dogs were significantly lower (P < .05) than in NT dogs (7.4 ± SD 3.6) vs 10.3 (±3.8) and 5.7 (interquartile range [IQR], 3.9-7.5) vs 8.1 (IQR, 7-10.3), respectively. Only K_AoSt was significantly influenced by age. Conclusions and Clinical Importance: Ultrasonographic Ao elasticity assessment was feasible to compare HT and NT dogs. Results indicated that K_AoSt and I_AoSt indices can be used to assess SH-related Ao stiffness, especially when indirect BP

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Section: Discussionmentioning

confidence: 99%

Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs

Corda

Caivano

et al. 2020

Veterinary Internal Medicne

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“…Briefly, the sonographers modified the right parasternal long axis view as follows: to visualize the third pulmonary venous ostium and RPA, the sonographers moved the ultrasound probe slightly apically and angled it dorso-cranially, to obtain a somewhat oblique view of the heart base (Fig 1). To conserve nomenclature that has been adopted in companion animals, we refer to the third pulmonary venous ostium as the right pulmonary vein (RPV) throughout the remainder of this manuscript, as this ostium receives blood from the largest part of the right lung [4,5], and is analogous to the right pulmonary vein in dogs and cats [6–8].…”

Section: Methodsmentioning

confidence: 99%

“…Investigators have evaluated the right pulmonary vein ostium (RPV) and right pulmonary artery ostium (RPA) in dogs and cats as an echocardiographic index for estimating severity of canine myxomatous mitral valve disease [6,7] and feline cardiomyopathies [8], and for identifying pulmonary hypertension in dogs [9,10]. These studies demonstrated that the RPV/RPA ratio, obtained from a modified right parasternal long axis view, imperfectly discriminated dogs with congestive heart failure from dogs with subclinical mitral valve disease [7,11].…”

Section: Introductionmentioning

confidence: 99%

Transthoracic M-mode echocardiographic assessment of pulmonary vein-to-pulmonary artery ratio in healthy horses

et al. 2019

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Equine cardiovascular structures and function are routinely assessed by transthoracic echocardiography. Recently, investigators have described the echocardiographic visualization of equine pulmonary vein ostia. In companion animals, the right pulmonary vein (RPV) to right pulmonary artery (RPA) ratio has been used as an index to estimate the severity of cardiac diseases resulting in left ventricular volume overload. We sought to assess the feasibility of measuring RPV and RPA dimensions, and sought to provide various previously examined RPV and RPA variables in clinically healthy horses that could be used to assess cardiopulmonary disease status. Echocardiographic examination was prospectively performed in 70 healthy horses. The RPV and RPA were visualized using a modified right parasternal long-axis view and maximum and minimum diameters of both vessels were measured from 2D guided M-mode traces. The aortic diameter (Ao) was measured from the right parasternal short-axis view in early diastole. These measurements were then used to produce various ratio indices. RPV and RPA were imaged in all 70 horses. Median of the minimum and maximum RPV/RPA was 0.51 and 0.60, respectively. Median fractional dimensional change of vessels was 33% for RPV and 22% for RPA. The medians of the minimum and maximum RPV/Ao and RPA/Ao were 0.18, 0.28, 0.35 and 0.46, respectively. No relationships between either bodyweight or heart rate and any of the vein or artery variables were identified (maximum r 2 = 0.04). Inter- and intra-observer measurement variability was very good for all RPV and RPA measurements. Measuring of RPV and RPA diameters using M-mode transthoracic echocardiography is feasible in healthy horses. Further studies of these variables in horses with cardiac diseases are needed to determine the clinical applicability and utility.

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“…As the phase of the cardiac cycle, the diameter of the veins and pulmonary arteries change. It is possible to measure the diameters of these vessels by transthoracic echocardiography in the short axis views modified to the right side, obtaining images in the M or 2D mode, presenting a good repeatability for both methods (Merveille et al, 2015;Birettoni et al, 2016). For the evaluation of pulmonary artery (AP) and pulmonary veia (PV), or M mode allows melhores informações on as alterações phasic deses glasses during or cardiac cycle.…”

Section: Pulmonary Artery and Pulmonary Vein Ratiomentioning

confidence: 99%

“…For the evaluation of pulmonary artery (AP) and pulmonary veia (PV), or M mode allows melhores informações on as alterações phasic deses glasses during or cardiac cycle. The measurement can be carried out according to the electrical events (peak of QRS and end of wave T) or mechanical (maximum and minimum diameter), both in artery and vein, and no difference between the two methods (Birettoni et al, 2016). The normal relationship between pulmonary vein and pulmonary artery is approaching 1.0, and a diastole is maintained (Merveille et al, 2015;Birettoni et al, 2016).…”

Section: Pulmonary Artery and Pulmonary Vein Ratiomentioning

confidence: 99%

Echocardiographic techniques for assessing pulmonary artery pressure

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et al. 2020

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ResumoO presente trabalho tem como objetivo realizar uma análise dos métodos indiretos da avaliação da pressão da artéria pulmonar com base na literatura científica. Por meio de levantamento bibliográfico, artigos científicos foram selecionados conforme a sua relevância para o tema. A avaliação da pressão da artéria pulmonar permite inferir se o paciente apresenta hipertensão arterial pulmonar (HAP), a qual está associada a um prognóstico ruim em cães. O exame padrão é a cateterização da artéria pulmonar, porém este método não tem Development, v. 9, n. 3, e44932309, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i3.2309 2 sido utilizado na rotina da medicina veterinária porque o quadro clínico do animal comumente não permite a sedação e por se tratar de um procedimento oneroso. O diagnóstico da HAP em pequenos animais por meio da ecodopplercardiografia pode ser obtido com a avaliação da regurgitação da valva tricúspide ou pulmonar, características subjetivas e mensuração do tempo de aceleração (TA) e relação entre o tempo de aceleração e o tempo de ejeção do fluxo pulmonar (TA:TE), relação entre a artéria pulmonar e a veia pulmonar, distensibilidade da artéria pulmonar direita (RPAD), e ainda por avaliação da função do ventrículo direito, principalmente o índice de TEI e o strain. O objetivo desta revisão foi demonstrar as principais técnicas ecocardiográficas para estimar HAP, com o intuito de contribuir com o cardiologista no diagnóstico da HAP. Todas as técnicas apresentam fatores positivos e negativos, porém é importante ressaltar que não existe uma técnica ideal, e a forma mais assertiva de se chegar ao diagnóstico é associando as diversas técnicas. Palavras-chave: Hipertensão Arterial Pulmonar; Índice de Distensibilidade da Artéria Pulmonar Direita; Regurgitação da Pulmonar; Regurgitação da Tricúspide. Abstract This paper aims to perform an analysis of the indirect methods of pulmonary artery pressure assessment based on the scientific literature. Through bibliographic survey, scientific articles were selected according to their relevance to the theme.The assessment of pulmonary artery pressure allows to infer whether the individual has pulmonary arterial hypertension (PAH), which is associated with a poor prognosis in dogs diagnosed with mitral valve degeneration. The standard examination is pulmonary artery catheterization, but this method has not been used in routine veterinary medicine because the clinical status of the animal usually does not allow sedation and it is a costly procedure. The diagnosis of PAH in small animals through Doppler echocardiography can be obtained by evaluating the regurgitation of the tricuspid or pulmonary valve, subjective characteristics and measurement of the acceleration time (AT) and the acceleration time-to-ejection time ratio of pulmonary artery (AT:ET), pulmonary artery-to-pulmonary vein ratio, distensibility of the right pulmonary artery (RAPD), and assessment of right ventricular function, especially TEI index and strain. The aim of this...

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Canine pulmonary vein-to-pulmonary artery ratio: echocardiographic technique and reference intervals

Cited by 16 publications

References 21 publications

Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs

Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs

Transthoracic M-mode echocardiographic assessment of pulmonary vein-to-pulmonary artery ratio in healthy horses

Echocardiographic techniques for assessing pulmonary artery pressure

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