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Doppler echocardiography–derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease: 86 cases (2001–2005)

François J. SerresUnité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.

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Valérie ChetboulUnité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.
UMR INSERM U660, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.

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Renaud TissierUMR INSERM U660, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.
Unité de Pharmacie-Toxicologie, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.

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Carolina Carlos SampedranoUnité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.

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Vassiliki GouniUnité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.

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Audrey P. NicolleUnité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.

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Jean-Louis PouchelonUnité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort Institution, 7 avenue du Général de Gaulle, 94 704 Maisons-Alfort cedex, France.
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Abstract

Objective—To determine the prevalence of Doppler echocardiography–derived evidence of pulmonary arterial hypertension (DEE-PAH) in dogs with mitral valve disease (MVD) classified according to the International Small Animal Cardiac Health Council (ISACHC) heart failure classification scheme and various echocardiographic and Doppler indices of MVD severity.

Design—Retrospective case series.

Animals—617 dogs examined from 2001 to 2005 with MVD in ISACHC classes I to III.

Procedures—Dogs were examined echocardiographically. Criteria used for systolic and diastolic DEE-PAH were detection of high tricuspid (≥ 2.5 m/s) and telediastolic pulmonic (≥ 2.0 m/s) valvular peak regurgitant jet velocities, respectively, by use of continuous-wave Doppler echocardiography.

Results—86 (13.9%) dogs with MVD had a diagnosis of DEE-PAH. Severity and prevalence of DEE-PAH increased with ISACHC class (3.0%, 16.9%, 26.7%, and 72.2% prevalences for ISACHC classes Ia, Ib, II, and III, respectively). A significant correlation between systolic or diastolic pulmonary arterial pressure and left atrial-to-aortic diameter ratio (LA/Ao) was detected. Doppler echocardiography–derived evidence of pulmonary arterial hypertension was detected in 18 dogs with values of LA/Ao within reference range, all of which had moderate (n = 2 dogs) or severe (16) mitral valve regurgitation on color Doppler imaging.

Conclusions and Clinical Relevance—The prevalence and degree of DEE-PAH were related to the severity of MVD. Changes associated with DEEPAH may be detected in early stages of the disease, but only in dogs with severe mitral valve regurgitation.

Abstract

Objective—To determine the prevalence of Doppler echocardiography–derived evidence of pulmonary arterial hypertension (DEE-PAH) in dogs with mitral valve disease (MVD) classified according to the International Small Animal Cardiac Health Council (ISACHC) heart failure classification scheme and various echocardiographic and Doppler indices of MVD severity.

Design—Retrospective case series.

Animals—617 dogs examined from 2001 to 2005 with MVD in ISACHC classes I to III.

Procedures—Dogs were examined echocardiographically. Criteria used for systolic and diastolic DEE-PAH were detection of high tricuspid (≥ 2.5 m/s) and telediastolic pulmonic (≥ 2.0 m/s) valvular peak regurgitant jet velocities, respectively, by use of continuous-wave Doppler echocardiography.

Results—86 (13.9%) dogs with MVD had a diagnosis of DEE-PAH. Severity and prevalence of DEE-PAH increased with ISACHC class (3.0%, 16.9%, 26.7%, and 72.2% prevalences for ISACHC classes Ia, Ib, II, and III, respectively). A significant correlation between systolic or diastolic pulmonary arterial pressure and left atrial-to-aortic diameter ratio (LA/Ao) was detected. Doppler echocardiography–derived evidence of pulmonary arterial hypertension was detected in 18 dogs with values of LA/Ao within reference range, all of which had moderate (n = 2 dogs) or severe (16) mitral valve regurgitation on color Doppler imaging.

Conclusions and Clinical Relevance—The prevalence and degree of DEE-PAH were related to the severity of MVD. Changes associated with DEEPAH may be detected in early stages of the disease, but only in dogs with severe mitral valve regurgitation.

Contributor Notes

Supported by the resident grant program of Vetoquinol Pharmaceutical Laboratory, Lure cedex, France, and Novartis Animal Health, Rueil Malmaison, France.

Address correspondence to Dr. Chetboul.