Evaluation of the right ventricular function in dogs with brachycephalic syndrome before and after rhinoplasty

Abstract

Brachycephalic dogs are usually affected by primary and secondary anatomical changes in the airways that contribute to the brachycephalic syndrome. Chronically, these changes contribute to an increase in pulmonary arterial pressure and right cardiac overload (cor pulmonale). The right cardiac function in 17 dogs with brachycephalic syndrome was assessed using echocardiography before, and at 30 and 60 days after rhinoplasty. The maximum pulmonary systolic flow velocity, the pressure gradient between the AP and RV (GrFP), the right ventricular systolic function (tricuspid ring systolic excursion (TAPSE), the variation of the right ventricular area (FAC), the velocity of the systolic displacement of the right ventricular myocardium (S') by tissue Doppler) and right ventricular diastolic function (transtricuspid flow and the relationship between the E and A waves, evaluation of the E' and A' waves using tissue Doppler of the free wall of the right ventricle) were evaluated. The right ventricular fractional area, velocity, and pressure gradient of pulmonary arterial flow showed the best sensitivity in these analyses. The present study reinforces the concept that obstructions in the anterior airways contribute to pulmonary hypoxia. However, the correction of these obstructions proved to be beneficial in the reduction of right heart overload.

Reference ranges for standard-echocardiography in pugs and impact of clinical severity of Brachycephalic Obstructive Airway Syndrome (BOAS) on echocardiographic parameters

“…However, no significant differences between BOAS- and BOAS+ or BOAS Grades in pugs could be found in the present study. This is in accordance with findings of the study by Hainfellner et al (2021), in which there was no significant change in TAPSE before compared to after rhinoplasty [ 48 ]. When further comparing measurements of TAPSE in pugs to those of interbreed references, overall, lower TAPSE and TAPSE:Ao values were detected in pugs than in previous studies of various breeds, even when compared to an RI of a similar BW [ 41 , 42 ].…”

“…This aforementioned study found no evidence of changes in PAP in dogs with Brachycephalic Syndrome and no explanation for lower pulmonic velocities. In another study, 16 brachycephalic dogs (four pugs and 12 French Bulldogs) underwent rhinoplasty, and RV function as well as pulmonic velocity and pressure gradient between pulmonary artery and right ventricle was examined via echocardiography before and after surgery [ 48 ]. This study revealed a significant increase in Pvel and a change in pressure gradient after rhinoplasty, and they hypothesised this may be due to a reduction of the upper airway obstruction and consequently a decrease of pulmonary vascular resistance.…”

Echocardiographic analysis of dogs before and after surgical treatment of brachycephalic obstructive airway syndrome

“…However, no studies have been published on whether rhinoplasty and folded-flap palatoplasty affect cardiac morphology and function. Evaluation of right ventricular function 30 and 60 days after rhinoplasty showed that the elevated values of fractional area change of the right ventricle normalized 60 days after the procedure ( 24 ). Therefore, we aimed to compare echocardiographic variables in brachycephalic dogs before and six to 12 months after surgical correction of BOAS and also to compare them with echocardiographic variables in non-brachycephalic control dogs.…”