Pulmonary hypertension secondary to respiratory disease and/or hypoxia in dogs: Clinical features, diagnostic testing and survival

Jaffey, Jared A.; Wiggen, Kelly; Leach, Stacey B.; Masseau, Isabelle; Girens, Renee; Reinero, Carol R.

doi:10.1016/j.tvjl.2019.105347

Cited by 42 publications

(37 citation statements)

References 63 publications

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“…Right heart enlargement is present in 43.5% of dogs with PH caused by a respiratory disease or hypoxia or both 33 . Fifty‐six percent of the dogs with heart murmurs had detectable PH (>35 mm Hg) in our study, which could be secondary to heart disease or to a concurrent respiratory disorder 33 . However, a PH confounding effect was not supported by our multivariate analysis.…”

Section: Discussioncontrasting

confidence: 58%

“…33 Fifty-six percent of the dogs with heart murmurs had detectable PH (>35 mm Hg) in our study, which could be secondary to heart disease or to a concurrent respiratory disorder. 33 However, a PH confounding effect was not supported by our multivariate analysis. These results support a direct association between heart size and bronchial narrowing, which might explain why airway narrowing is more prevalent in dogs with heart murmurs, and cardiac enlargement measured by VHS is significantly associated with cough.…”

Section: Discussionmentioning

confidence: 54%

“…Chronic respiratory diseases might cause PH, resulting in right ventricular enlargement and increased VHS 31,32 . Right heart enlargement is present in 43.5% of dogs with PH caused by a respiratory disease or hypoxia or both 33 . Fifty‐six percent of the dogs with heart murmurs had detectable PH (>35 mm Hg) in our study, which could be secondary to heart disease or to a concurrent respiratory disorder 33 .…”

Section: Discussionmentioning

confidence: 55%

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Evaluation of bronchial narrowing in coughing dogs with heart murmurs using computed tomography

Lebastard

Boedec

Howes

et al. 2021

Veterinary Internal Medicne

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Background: The origin of cough in dogs with heart murmurs is controversial, because the cough could be primary cardiac (eg, pulmonary edema, bronchi compression by left-sided cardiomegaly) or respiratory (eg, bronchomalacia, other bronchial or bronchiolar disease, interstitial lung disease) in origin.Hypothesis/Objectives: To study the association between left atrium (LA) dilatation and cardiomegaly and bronchial narrowing in coughing dogs with heart murmurs using computed tomography (CT).Animals: Twenty-one client-owned coughing dogs with heart murmurs and 14 historical control dogs.Methods: Dogs with cough and murmur were prospectively recruited over 4 months.Cervical and thoracic radiography, echocardiography, and thoracic CT were performed in enrolled dogs. Control dogs, with no disease on thoracic CT and no records of heart murmur and coughing, were gathered from the institution's computerized database. Degree of bronchial narrowing was assessed using the bronchial-to-aorta (Ao) ratio, measured by 3 radiologists blinded to the clinical findings. After identifying bronchi that were significantly narrowed in dogs with murmur compared to controls, the relationship between degree of narrowing and LA/Ao ratio (measured echocardiographically) and vertebral heart scale (VHS) measured radiographically was studied in dogs with murmur using mixed-effects regression.Result: Significant narrowing was identified for all left-sided bronchi and the right principal, middle, and caudal bronchi in the coughing dogs, compared with controls.Increasing LA size and VHS were significantly inversely associated with diameter for all left-sided and right-sided bronchi indicated above.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 55%

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Evaluation of bronchial narrowing in coughing dogs with heart murmurs using computed tomography

Lebastard

Boedec

Howes

et al. 2021

Veterinary Internal Medicne

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“…In human patients with interstitial lung disease, the presence of PH is associated with a worse prognosis (28,29). A same observation has been made in a population of dogs with various respiratory disease and concomitant PH (30). Accordingly, early diagnosis can optimize treatment and potentially improves survival and quality of life (28,29).…”

Section: Discussionmentioning

confidence: 72%

Utility of Computed Tomographic Angiography for Pulmonary Hypertension Assessment in a Cohort of West Highland White Terriers With or Without Canine Idiopathic Pulmonary Fibrosis

Soliveres

Entee

Couvreur³

et al. 2021

Front. Vet. Sci.

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West Highland white terriers (WHWTs) affected with canine idiopathic pulmonary fibrosis (CIPF) are at risk of developing precapillary pulmonary hypertension (PH). In humans, thoracic computed tomography angiography (CTA) is commonly used to diagnose and monitor patients with lower airway diseases. In such patients, CTA helps to identify comorbidities, such as PH, that could negatively impact prognosis. Diameter of the pulmonary trunk (PT), pulmonary trunk-to-aorta ratio (PT/Ao), and right ventricle-to-left ventricle ratio (RV/LV) are CTA parameters commonly used to assess the presence of PH. Pulmonary vein-to-right pulmonary artery ratio (PV/PA) is a new echocardiographic parameter that can be used in dogs to diagnose PH. The primary aim of this study was to evaluate the use of various CTA parameters to diagnose PH. An additional aim was to evaluate the correlation of RV/LV measurements between different CTA planes. CTA and echocardiography were prospectively performed on a total of 47 WHWTs; 22 affected with CIPF and 25 presumed healthy control dogs. Dogs were considered to have PH if pulmonary vein-to-right pulmonary artery ratio (PV/PA) measured on 2D-mode echocardiography was less than to 0.7. WHWTs affected with CIPF had higher PT/Ao compared with control patients. In WHWTs affected with CIPF, PT size was larger in dogs with PH (15.4 mm) compared with dogs without PH (13 mm, p = 0.003). A cutoff value of 13.8 mm predicted PH in WHWTs affected with CIPF with a sensitivity of 90% and a specificity of 87% (AUC = 0.93). High correlations were observed between the different CTA planes of RV/LV. Results suggest that diameter of the PT measured by CTA can be used to diagnose PH in WHWTs with CIPF.

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“…In contrast, in dogs with group 3 PH, there may be benefit to additional PH‐specific treatment during or after treatment for underlying pulmonary disease. In a recent study of dogs with diverse causes of group 3 PH, administration of PDE5i was the only independent predictor of survival in a multivariable analysis …”

Section: Treatmentmentioning

confidence: 99%

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

Reinero

Visser

Kellihan

et al. 2020

Veterinary Internal Medicne

Self Cite

192

383

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Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.

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Pulmonary hypertension secondary to respiratory disease and/or hypoxia in dogs: Clinical features, diagnostic testing and survival

Cited by 42 publications

References 63 publications

Evaluation of bronchial narrowing in coughing dogs with heart murmurs using computed tomography

Evaluation of bronchial narrowing in coughing dogs with heart murmurs using computed tomography

Utility of Computed Tomographic Angiography for Pulmonary Hypertension Assessment in a Cohort of West Highland White Terriers With or Without Canine Idiopathic Pulmonary Fibrosis

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs

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