Prognostic value of right pulmonary artery distensibility in dogs with pulmonary hypertension

Abstract

The right pulmonary artery distensibility (RPAD) index has been used in dogs with pulmonary hypertension (PH) caused by heartworm infection, myxomatous mitral valve disease, or patent ductus arteriosus. We hypothesized that this index correlates with the tricuspid regurgitation pressure gradient (TRPG) assessed by echocardiography and could predict survival in dogs with PH secondary to various causes. To assess this hypothesis, the medical records of 200 client-owned dogs at a referral institution were retrospectively reviewed. The RPAD index and the ratios of acceleration time to peak pulmonary artery flow (AT) and to the ejection time of pulmonary artery flow (ET) were recorded for each dog. The owners were contacted for follow-up assessments. The findings indicated that the RPAD index was correlated with the TRPG (R 2 = 0. 362, p < 0.001). The survival time was significantly shorter in dogs with an RPAD index ≤ 21% that were followed up for 3 months and in dogs with an RPAD index ≤ 24% that were followed up for 1 year. Thus, the RPAD index was correlated with the TRPG and could predict the clinical outcome in dogs with PH caused by various diseases. This index could be used to evaluate the severity of PH in dogs without tricuspid regurgitation.

Intracardiac heartworms in dogs: Clinical and echocardiographic characteristics in 72 cases (2010‐2019)

“…34 Values < 30% indicated reduced RPAD and values < 22% were consistent with severe PH. 24,34,35 Tricuspid valve regurgitation (TR) and pulmonary valve regurgitation (PR) were recorded as present, absent, or in the case of TR, present but unable to be measured owing to the presence of intracardiac heartworms. Peak velocity of tricuspid (systolic timing) and pulmonary (early diastolic timing) valve regurgitation was measured when Doppler recordings were available.…”

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

“…These measurements are largely based on characteristic cardiac changes that occur secondary to PH and have been previously evaluated in dogs diagnosed with PH. For example, the pulmonary artery might dilate, 7,14 exhibit reduced distensibility (quantified by the right pulmonary artery distensibility [RPAD] index), [14][15][16][17] or both. The blood flow profile in the pulmonary artery might exhibit a shortened acceleration time when indexed to ejection time (AT/ET).…”

​​Importance of Right Pulmonary Artery Distensibility Index in the Diagnosis and Management of Pulmonary Arterial Hypertension Secondary to Canine Dilated Cardiomyopathy

“…In the present study, there was a significant positive correlation between RPAD index with AT/ET while the correlation between RPAD index with MPa/ Ao and TRPG was negative. The values of the RPAD index was correlated with the TRPG and can be used for evaluating the PH in the absence of measurable tricuspid regurgitation or pulmonic regurgitation and help to predict the prognosis (Chan et al, 2019). The aim of the therapy was to ameliorate clinical signs, improve exercise intolerance, decrease the pulmonary artery pressure, decrease the right ventricle Importance of Right Pulmonary Artery Distensibility Index in the Diagnosis and Management of Pulmonary Arterial.... workload, improve patient longevity and quality of life.…”