Doppler Echocardiographic Prediction of Pulmonary Hypertension in West Highland White Terriers with Chronic Pulmonary Disease

Schober, Karsten E.; Baade, Hanno

doi:10.1111/j.1939-1676.2006.tb01805.x

Cited by 116 publications

(163 citation statements)

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“…By means of Doppler echocardiography, evaluations of the peak flow velocity of tricuspid valve regurgitation and pulmonary artery regurgitation and an estimation of pressure gradients can be used as diagnostic methods for PH (Kellihan and Stepien 2010). In addition to these measurements, the assessment of the systolic time interval of the right ventricle by AT, ET and the AT:ET ratio and the pre-ejection period (PEP) have been used to support the diagnosis of PH in dogs (Uehara 1993, Johnson et al 1999, Baade andSchober 2006). Kellum and Stepien (2007) and Nakamura et al (2011) obtained values of the PA AT:ET ratio consistent with PH.…”

Section: Discussionmentioning

confidence: 99%

“…Kellum and Stepien (2007) and Nakamura et al (2011) obtained values of the PA AT:ET ratio consistent with PH. According to Schober and Baade (2006), values of AT:ET less than or equal to 0.31 seconds and an AT value less than or equal to 0.058 seconds are predictive of PH and are useful to diagnose the disease in animals that do not present insufficient valve flows. In the study by Nakamura et al (2011), the diagnosis of PH was performed by means of the AT: ET ratio, probably since none of the five animals presented pulmonary or tricuspid regurgitation during the study.…”

Section: Discussionmentioning

confidence: 99%

“…Two-dimensional and echodopplercardiographic examinations provide the diagnosis in most clinical veterinary patients and are the methods of choice to diagnose naturally occurring PH (Johnson et al 1999, Schober and Baade 2006, Kellihan and Stepien 2010. In all selected studies, the diagnostic method of PH was made by echocardiography in its various modalities.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of sildenafil therapy for pulmonary hypertension in dogs: a systematic review

Silva¹,

Oberlender²,

Mantovani³

et al. 2014

Arch. med. vet.

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RESUMENEl objetivo de esta revisión sistemática fue evaluar la eficacia del sildenafil en el tratamiento de la hipertensión pulmonar (HP) en perros y, cuando posible, proponer recomendaciones a favor o en contra de su uso. Se realizaron búsquedas electrónicas en seis bases de datos internacionales. El criterio de inclusión fue estudios clínicos in vivo que evaluaron la eficacia del sildenafil en el tratamiento de la HP de origen natural. El sistema de clasificación se diseñó para considerar aspectos como la forma de distribución y enmascaramiento de los tratamientos experimentales, número de animales empleados, asociación con otros medicamentos, métodos de diagnóstico para HP, evaluaciones de la respuesta clínica al tratamiento y efectos adversos. Un total de cinco artículos fueron obtenidos. En general, la condición clínica y la calidad de vida de los animales mejoraron después de la terapia con el sildenafil, y la incidencia de efectos adversos fue poco común. Los hallazgos ecocardiográficos proporcionaron evidencia de cambios en la presión arterial pulmonar que podrían asociarse con alteraciones en la actividad física y tiempo de supervivencia. Aún así, la calidad metodológica de los estudios fue baja, ya que sólo un estudio fue un ensayo clínico al azar, placebo-controlado y doble ciego. Con poca evidencia, este estudio permitió establecer que el sildenafil es una terapia importante que puede tener un papel terapéutico positivo en el tratamiento de HP canina. Se recomienda realizar estudios prospectivos al azar, ciegos y controlados con un mayor número de animales para evaluar la actividad física y los efectos adversos del sildenafil y otras drogas, así como la eficacia de este medicamento en perros.Palabras clave: caninos, enfermedad pulmonary, terapia, sildenafil. SUMMARYThis systematic review aimed to assess the efficacy of sildenafil in the treatment of pulmonary hypertension (PH) in dogs and, when possible, to propose recommendations for or against its use. Electronic searches were carried out using six international databases. The inclusion criterion was in vivo clinical trials that assessed the efficacy of sildenafil in the treatment of naturally occurring PH. The scoring system was designed to take into account aspects such as the form of distribution and masking of experimental treatments, the number of animals, association with other drugs, diagnostic methods for PH, evaluations of the clinical response to treatment and adverse effects. A total of five papers were found. In general, the clinical condition and quality of life of the animals improved after sildenafil therapy, and the occurrence of adverse effects was uncommon. Echocardiographic findings provided evidence for changes in pulmonary arterial pressure which could be associated with alterations in physical activity and survival time. Still, the methodological quality of the studies was low, only one of them was a randomised, placebo-controlled and double-blind clinical trial. Furthermore, with modest evidence, this study allowed the recomm...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of sildenafil therapy for pulmonary hypertension in dogs: a systematic review

Silva¹,

Oberlender²,

Mantovani³

et al. 2014

Arch. med. vet.

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“…Primary pulmonary artery hypertension in dogs has rarely been studied. Common secondary causes of PH in dogs include left-sided heart failure, increased pulmonary blood flow, increased pulmonary vascular resistance caused by conditions such as obstructive pulmonary vascular disease, thromboembolic disease, pulmonary parenchymal disease, and chronic hypoxia (Glaus et al 2004;Schober and Baade 2006;Serres et al 2006). CDMD can lead to left heart dilation and increased left atrial pressure, causing elevated pulmonary venous pressure (post-capillary PH), pulmonary oedema and chronic post-capillary hypoxia.…”

mentioning

confidence: 99%

“…HWD infested by Dirofilaria immitis and associated thromboembolism is the most commonly reported cause of severe pre-capillary PH in dogs (Sasaki et al 1992). CRD, such as tracheobronchial disease, brachycephalic syndrome, and interstitial lung diseases, lead to chronic hypoxia, mechanical stress, and inflammation, which may cause pre-capillary PH (Schober and Baade 2006).…”

mentioning

confidence: 99%

Echocardiographic assessment of right heart indices in dogs with elevated pulmonary artery pressure associated with chronic respiratory disorders, heartworm disease, and chronic degenerative mitral valvular disease

Tai¹,

Huang²

2013

Vet. Med. - Czech

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ABSTRACT:The aim of this study was to evaluate right ventricular (RV) remodeling and right heart failure associated with different causes of elevated pulmonary arterial pressure (PAP) in dogs. In total, 169 client-owned dogs with tricuspid regurgitation (TR) and 40 client-owned clinically healthy dogs were included. Dogs with TR were further categorised as suffering from chronic respiratory disorders (CRD), heartworm disease (HWD), mild/ moderate chronic degenerative mitral valvular disease (CDMD), and severe CDMD. Among the echocardiographic indices of the right heart, no significant difference in the tricuspid annular plane systolic excursion to aortic root diameter ratio was found among the clinical healthy controls and the four different TR categories. No significant differences in TR peak velocity and pulmonic regurgitation peak velocity were found among dogs in the four different TR categories. The ratio of the right to left ventricular basal diameter in the right ventricular-focused view was significantly higher in dogs with chronic respiratory disorders and dogs with heartworms. Left ventricular compression quantified using the eccentricity index and the ratio of the main pulmonary artery to aortic root diameter were significantly higher in dogs with HWD. Their right ventricular acceleration to ejection time (AT/ET) was significantly lower in dogs with HWD. Based on these findings, we conclude that right heart indices are affected by CRD, HWD, and moderate to severe CDMD. However, right heart indices derived from left heart measurements might be underestimated in dogs with CDMD.Keywords: left ventricular eccentricity indices; mean electrical axis; pulmonary hypertension; right heart remodelling; tricuspid annular plane systolic excursion List of abbreviationsAo = aortic root diameter, AT = acceleration time, CDMD = chronic degenerative mitral valvular disease, CRD = chronic respiratory disorders, CV = coefficient of variation, ECG = electrocardiography, ET = ejection time, HWD = heartworm disease, LA/Ao = left atrial/aortic root ratio, LVD = left ventricular basal diameter, LV-EI = left ventricular eccentricity index, MEA = mean electrical axis, MPA = main pulmonary artery, PAP = pulmonary arterial pressure, PH = pulmonary hypertension, PR = pulmonic valve regurgitation, RVD = right ventricular basal diameter, SBP = systemic blood pressure, SD = standard deviation, TAPSE = tricuspid annular plane systolic excursion, TR = tricuspid regurgitation, VHS = vertebral heart scale Pulmonary hypertension (PH) is defined by high diastolic or systolic PAP and may lead to right ventricular concentric or eccentric hypertrophy, right atrial enlargement, and right-sided heart failure (Serres et al. 2006). High PAP values above the reference range indicate PH, which can result from pre-and post-capillary haemodynamic changes (Kellihan and Stepien 2012). PH is a wellrecognised clinical condition in human patients and can be primary or secondary to various diseases of the pulmonary vasculature (Galie et al. 2009). Primar...

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Valvular Heart Disease

MacGregor

2018

Textbook of Small Animal Emergency Medicine

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Doppler Echocardiographic Prediction of Pulmonary Hypertension in West Highland White Terriers with Chronic Pulmonary Disease

Abstract: PH is common in WHWT with IPD. Analysis of right ventricular AT and AT : ET may be predictive of PH and should be particularly useful if TR is absent.

Cited by 116 publications

References 31 publications

Efficacy of sildenafil therapy for pulmonary hypertension in dogs: a systematic review

Efficacy of sildenafil therapy for pulmonary hypertension in dogs: a systematic review

Echocardiographic assessment of right heart indices in dogs with elevated pulmonary artery pressure associated with chronic respiratory disorders, heartworm disease, and chronic degenerative mitral valvular disease

Valvular Heart Disease

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