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Transthoracic M-mode echocardiographic assessment of pulmonary vein-to-pulmonary artery ratio in healthy horses.

ABSTRACT: Equine cardiovascular structures and function are routinely assessed by transthoracic echocardiography. Recently, investigators have described the echocardiographic visualization of equine pulmonary vein ostia. In companion animals, the right pulmonary vein (RPV) to right pulmonary artery (RPA) ratio has been used as an index to estimate the severity of cardiac diseases resulting in left ventricular volume overload. We sought to assess the feasibility of measuring RPV and RPA dimensions, and sought to provide various previously examined RPV and RPA variables in clinically healthy horses that could be used to assess cardiopulmonary disease status. Echocardiographic examination was prospectively performed in 70 healthy horses. The RPV and RPA were visualized using a modified right parasternal long-axis view and maximum and minimum diameters of both vessels were measured from 2D guided M-mode traces. The aortic diameter (Ao) was measured from the right parasternal short-axis view in early diastole. These measurements were then used to produce various ratio indices. RPV and RPA were imaged in all 70 horses. Median of the minimum and maximum RPV/RPA was 0.51 and 0.60, respectively. Median fractional dimensional change of vessels was 33% for RPV and 22% for RPA. The medians of the minimum and maximum RPV/Ao and RPA/Ao were 0.18, 0.28, 0.35 and 0.46, respectively. No relationships between either bodyweight or heart rate and any of the vein or artery variables were identified (maximum r2 = 0.04). Inter- and intra-observer measurement variability was very good for all RPV and RPA measurements. Measuring of RPV and RPA diameters using M-mode transthoracic echocardiography is feasible in healthy horses. Further studies of these variables in horses with cardiac diseases are needed to determine the clinical applicability and utility.

SUBMITTER: Caivano D

PROVIDER: S-EPMC6693752 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Transthoracic M-mode echocardiographic assessment of pulmonary vein-to-pulmonary artery ratio in healthy horses.

Caivano Domenico D Corda Andrea A Rishniw Mark M Giorgi Maria Elena ME Parpaglia Maria Luisa Pinna MLP Conti Maria Beatrice MB Porciello Francesco F Birettoni Francesco F

PloS one 20190814 8

Equine cardiovascular structures and function are routinely assessed by transthoracic echocardiography. Recently, investigators have described the echocardiographic visualization of equine pulmonary vein ostia. In companion animals, the right pulmonary vein (RPV) to right pulmonary artery (RPA) ratio has been used as an index to estimate the severity of cardiac diseases resulting in left ventricular volume overload. We sought to assess the feasibility of measuring RPV and RPA dimensions, and sou ...[more]

PMID: 31412072

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Project description:AimsThis study aimed to evaluate a novel echocardiographic algorithm for quantitative estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR) in patients with heart failure and pulmonary hypertension (PH) scheduled to right heart catheterization (RHC).Methods and resultsIn this monocentric study, 795 consecutive patients (427 men; age 68.4 ± 12.1 years) undergoing echocardiography and RHC were evaluated. Multiple regression analysis was performed to identify echocardiographic predictors of PAWP and PVR measured by RHC in the derivation group (the first 200 patients). The diagnostic accuracy of the model was then tested in the validation group (the remaining 595 patients). PH was confirmed by RHC in 507 (63.8%) patients, with 192 (24.2%) cases of precapillary PH, 248 (31.2%) of postcapillary PH, and 67 (8.4%) of combined PH. At regression analysis, tricuspid regurgitation maximal velocity, mitral E/e' ratio, left ventricular ejection fraction, right ventricular fractional area change, inferior vena cava diameter, and left atrial volume index were included in the model (R = 0.8, P < 0.001). The model showed a high diagnostic accuracy in estimating elevated PAWP (area under the receiver operating characteristic curve = 0.97, 92% sensitivity, and 93% specificity, P < 0.001) and PVR (area under the receiver operating characteristic curve = 0.96, 89% sensitivity, and 92% specificity, P < 0.001), outperforming 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations (P < 0.001) and Abbas' equation (P < 0.001). Bland-Altman analysis showed satisfactory limits of agreement between echocardiography and RHC for PAWP (bias 0.7, 95% confidence interval -7.3 to 8.7) and PVR (bias -0.1, 95% confidence interval -2.2 to 1.9 Wood units), without indeterminate cases.ConclusionsA novel quantitative echocardiographic approach for the estimation of PAWP and PVR has high diagnostic accuracy in patients with heart failure and PH.

Dataset Information

Transthoracic M-mode echocardiographic assessment of pulmonary vein-to-pulmonary artery ratio in healthy horses.

Publications

Transthoracic M-mode echocardiographic assessment of pulmonary vein-to-pulmonary artery ratio in healthy horses.

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