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Research Article

volume 54 issue 9 (september 2020) : 1136-1142,   Doi: 10.18805/ijar.B-3704

Prevalence of Pulmonary Hypertension in Dogs with Degenerative Mitral Valve Disease 

S
S. Hamsa Yamini
K
K. Jeyaraja
M
M. Chandrasekhar
S
S.Kavitha
1Department of Veterinary Clinical Medicine, Madras Veterinary College, Chennai- 600 007, Tamil Nadu Veterinary and Animal Sciences University, Tamil Nadu, India. 
Cite article:- Yamini Hamsa S., Jeyaraja K., Chandrasekhar M., S.Kavitha (2020). Prevalence of Pulmonary Hypertension in Dogs with Degenerative Mitral Valve Disease. Indian Journal of Animal Research. 54(9): 1136-1142. doi: 10.18805/ijar.B-3704.

ABSTRACT

The study was conducted to record the various clinical, electrocardiographic, radiographic and echocardiographic changes in dogs with Pulmonary Hypertension (PH) due to mitral valve disease (MVD). Among the MVD, dogs 15.5 per cent, 8.7 per cent and 4.8 per cent had mild PH, moderate PH and severe PH respectively. A highly significant increase in tricuspid regurgitation velocity (>2.5 mm/Hg), tricuspid regurgitation peak gradient (>25 mm Hg), was recorded in dogs with mild, moderate and severe PH due to MVD when compared to their disease control. A highly significant increase in of MPA/Ao (>0.8)  ratio was recorded in dogs with various degree of PH (mild, moderate and severe) when compared with dogs without PH. According to the severity tricuspid regurgitation flow pattern in the right atrium during systole was recorded in all these dogs. In dogs with MVD, moderate to severe PH worsens outcome. 

REFERENCES

  1. Bach, J.F., Rozanski, E.A., MacGregor, J., Betkowski, J. M., and Rush, J. E. (2006). Retrospective evaluation of sildenafil citrate as a therapy for pulmonary hypertension in dogs. J. Vet. Intern. Med. 20: 1132-1135
  2. Bonagura, J.D. and Schober, K.E. (2009). Can ventricular function be assessed by echocardiography in chronic canine mitral valve disease? J. Small. Anim. Pract. 50(1):12-24. 
  3. Boon, J.A., (1998). Acquired heart disease: mitral insufficiency. In: Manual of veterinary echocardiography: Williams & Wilkins, Baltimore. pp. 261–286. 
  4. Borgarelli, M., Abbot, J L. Braz-Ruivo, D. Chiavegato, S. Crosara, K. Lamb, I. Ljungvall, M. Poggi, R.A. Santilli and J. Haggstrom, (2015). Prevalence and prognostic significance of pulmonary hypertension in dogs with myxomatousmitral valve degeneration. J. Vet. Intern. Med. 29: 569–574.
  5. Buchanan, J.W. and Bucheler, J. (1995). Vertebral scale system to measure canine heart size in radiographs. J. Am. Vet. Med. Assoc. 206: 194-199. 
  6. Chetboul, V. and Tissier, R. (2012). Echocardiographic assessment of canine degenerative mitral valve disease. J. Vet. Cardiol. 14: 127-148.
  7. Chetboul, V., Gouni,V., Sampedrano, C.C., Tissier, R., Serres, F., and Pouchelon,J.L (2007). Assessment of Regional Systolic and Diastolic Myocardial Function using tissue doppler and strain imaging in dogs with dilated cardiomyopathy. J. Vet. Intern. Med. 21: 719-730. 
  8. Cornell, C.C., Kittleson, M.D., Della-Torre, P., Haggstrom, J., Lombard, C.W.., Pedersen, H.D., Vollmar, A. and Wey, A. (2004). Allometric scaling of M-mode cardiac measurements in normal adult dogs. J. Vet. Intern. Med. 18: 311–321.
  9. Dugas, B.N. and. Macintire, D.K. (2007). Pulmonary hypertension in dogs. Standards of care: Emerg. Crit. Care Med. 9: 1-7. 
  10. Galie. N., Hoeper, M.M. and Humbert, M. (2009). Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 34: 1219–1263 
  11. Guazzi, M. and Arena, R. (2010). Pulmonary Hypertension with left sided heart disease. Nat. Rev. Cardiol. 7: 648–659. 
  12. Hansson K, Haggstrom J, Kvart C and Lord, P. (2002) Left atrial to aortic root indices using two-dimensional and M-mode echocardiogra- phy in Cavalier King Charles Spaniels with and without left atrial enlargement. Vet. Radiol. Ultrasound. 43: 568–575. 
  13. Johnson, L., Boon, J. and Orton, E.C. (1999). Clinical characteristics of 53 dogs with Doppler-derived evidence of pulmonary hypertension: 1992–1996. J. Vet. Intern. Med. 13: 440–477.
  14. Kellihan, H.B and Stepien, R.L. (2012).Puolmonary hypertension in canine mitral valve insufficiency. J. Vet. Cardiol. 14: 149-164.
  15. Kellihan, H.B. and Stepien, R.L. (2010). Pulmonary hypertension in dogs: diagnosis and therapy. Vet. Clin. North Am. Small Anim. Pract. 40: 623-641.
  16. Kellum, H.B. and Stepien, R.L. (2007). Sildenafil citrate therapy in 22 dogs with pulmonary hypertension. J. Vet. Intern. Med. 21: 1258-126.
  17. Kettelson, M. and Kienele, R. (1998). Primary myocardial disease leading to chronic myocardial failure.In Small Animal Cardiovascular Medicine. St. Louis: Mosby pp. 319-346.
  18. Lamb, C.R., Tyler, M., Boswood, A., Askelly. B.J. and Cain, M. (2000). Assessment of the value of vertebral heart scale in the radiographic diagnosis of cardiac disease in dogs. Vet. Rec.146: 687-690
  19. Lord, P., Hansson, K., Kvart, C. and Haggstrom, J. (2010). Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation. J. Small Anim. Pract. 51: 210-218. 
  20. Mazzotta,E., Guglielmini, C., Menciotti, G., Contiero, B., BaronToaldo, M., Berlandaand, M. and Poser, H. (2016). Red blood cell distribution width, hematology in dogs with echocardio
  21. -graphically estimated precapillary and postcapillary pulmonary arterial hypertension. J. Vet. Intern. Med. 30 (6): 1806–1815. 
  22. Ohad, D.G., Letchener, I., Bdolah-abram, T. and Segev, G. (2013). A loud-apical systolic murmur is associated with the diagnosis of secondary arterial hypertension: retrospective analysis of data 201 consecutive client owned dogs (2006-2007). Vet. J. 198: 690-695 
  23. Pyle, R.L., Abbott, J.A. and Maclean, H. (2004). Pulmonary hypertension and cardiovascular sequelae in 54 dogs. Int. J. Appl. Res. Vet. Med. 2: 99-109. 
  24. Schober, K.E. and Baade, H. (2006). Doppler echocardiographic prediction of pulmonary hypertension in West Higland white terriers with chronic pulmonary disease. J. Vet. Intern. Med. 20: 912–920.
  25. Serres, F., Chetboul, V., Tissier, R., Poujol. L., Gouni, V., Carlos Sampedrano, C. and Pouchelon, J.L. (2008). Comparison of 3 ultrasound methods for quantifying left ventricular systolic function: correlation with disease severity and prognostic value in dogs with mitral valve disease. J. Vet. Intern. Med. 22: 566-577.
  26. Serres, F.J., Chetboul, V. and Tissier, R. (2006). Doppler echocardio graphy-derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease: 86 cases (2001–2005). J. Am. Vet. Med. Assoc. 229: 1772–1778. 
  27. Sigrist, N.E., Adamik, K.N., Doherr, M.G. and Spreng, D.E. (2011). Evaluation of respiratory parameters at presentation as clinical indicators of the respiratory localization in dogs and cats with respiratory distress. J. Vet. Emerg. Crit. Care 21(1): 19-23.
  28. Snedecor, C.W and Cochran, W.G. (1994). Statistical Methods. 8th Ed. Iowa State University Press, USA.
  29. Teicholz, L.E., Kreulen, T., Herman, M.V. and Gorlin, R. (1976). Problems in echocardiographic volume determinations: echocardiographic- angiographic correlations in the presence or absence of asynergy. Am. J. Cardiol. 37: 7.
  30. Terzo, E., Di Marcello, M., McAllister, H., Glazier, B., Lo Coco, D., Locatelli, C., Palermo, V. and Brambilla, P.G., (2009). Echocardiographic assessment of 537 dogs with mitral valve prolapse and leaflet involvement. Vet. Radiol. Ultrasound. 50: 416- 422. 
  31. Tidholm, A., Höglund, K., Häggström, J. and Ljungvall, I. (2015). Diagnostic value of selected echocardiographic variables to identify pulmonary hypertension in dogs with myxomatous mitral valve disease. J. Vet. Intern. Med., 29(6): 1510–1517.
  32. Toyoshima, Y., Kanemoto, I. and Arai, S. (2007). A case of long- term sildenafil therapy in a young dog with pulmonary hypertension. J. Vet. Med. Sci. 69(10): 1073–1075.
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Indian Journal of Animal Research
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    Research Article

    volume 54 issue 9 (september 2020) : 1136-1142,   Doi: 10.18805/ijar.B-3704

    Prevalence of Pulmonary Hypertension in Dogs with Degenerative Mitral Valve Disease 

    S
    S. Hamsa Yamini
    K
    K. Jeyaraja
    M
    M. Chandrasekhar
    S
    S.Kavitha
    1Department of Veterinary Clinical Medicine, Madras Veterinary College, Chennai- 600 007, Tamil Nadu Veterinary and Animal Sciences University, Tamil Nadu, India. 
    Cite article:- Yamini Hamsa S., Jeyaraja K., Chandrasekhar M., S.Kavitha (2020). Prevalence of Pulmonary Hypertension in Dogs with Degenerative Mitral Valve Disease. Indian Journal of Animal Research. 54(9): 1136-1142. doi: 10.18805/ijar.B-3704.

    ABSTRACT

    The study was conducted to record the various clinical, electrocardiographic, radiographic and echocardiographic changes in dogs with Pulmonary Hypertension (PH) due to mitral valve disease (MVD). Among the MVD, dogs 15.5 per cent, 8.7 per cent and 4.8 per cent had mild PH, moderate PH and severe PH respectively. A highly significant increase in tricuspid regurgitation velocity (>2.5 mm/Hg), tricuspid regurgitation peak gradient (>25 mm Hg), was recorded in dogs with mild, moderate and severe PH due to MVD when compared to their disease control. A highly significant increase in of MPA/Ao (>0.8)  ratio was recorded in dogs with various degree of PH (mild, moderate and severe) when compared with dogs without PH. According to the severity tricuspid regurgitation flow pattern in the right atrium during systole was recorded in all these dogs. In dogs with MVD, moderate to severe PH worsens outcome. 

    REFERENCES

    1. Bach, J.F., Rozanski, E.A., MacGregor, J., Betkowski, J. M., and Rush, J. E. (2006). Retrospective evaluation of sildenafil citrate as a therapy for pulmonary hypertension in dogs. J. Vet. Intern. Med. 20: 1132-1135
    2. Bonagura, J.D. and Schober, K.E. (2009). Can ventricular function be assessed by echocardiography in chronic canine mitral valve disease? J. Small. Anim. Pract. 50(1):12-24. 
    3. Boon, J.A., (1998). Acquired heart disease: mitral insufficiency. In: Manual of veterinary echocardiography: Williams & Wilkins, Baltimore. pp. 261–286. 
    4. Borgarelli, M., Abbot, J L. Braz-Ruivo, D. Chiavegato, S. Crosara, K. Lamb, I. Ljungvall, M. Poggi, R.A. Santilli and J. Haggstrom, (2015). Prevalence and prognostic significance of pulmonary hypertension in dogs with myxomatousmitral valve degeneration. J. Vet. Intern. Med. 29: 569–574.
    5. Buchanan, J.W. and Bucheler, J. (1995). Vertebral scale system to measure canine heart size in radiographs. J. Am. Vet. Med. Assoc. 206: 194-199. 
    6. Chetboul, V. and Tissier, R. (2012). Echocardiographic assessment of canine degenerative mitral valve disease. J. Vet. Cardiol. 14: 127-148.
    7. Chetboul, V., Gouni,V., Sampedrano, C.C., Tissier, R., Serres, F., and Pouchelon,J.L (2007). Assessment of Regional Systolic and Diastolic Myocardial Function using tissue doppler and strain imaging in dogs with dilated cardiomyopathy. J. Vet. Intern. Med. 21: 719-730. 
    8. Cornell, C.C., Kittleson, M.D., Della-Torre, P., Haggstrom, J., Lombard, C.W.., Pedersen, H.D., Vollmar, A. and Wey, A. (2004). Allometric scaling of M-mode cardiac measurements in normal adult dogs. J. Vet. Intern. Med. 18: 311–321.
    9. Dugas, B.N. and. Macintire, D.K. (2007). Pulmonary hypertension in dogs. Standards of care: Emerg. Crit. Care Med. 9: 1-7. 
    10. Galie. N., Hoeper, M.M. and Humbert, M. (2009). Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 34: 1219–1263 
    11. Guazzi, M. and Arena, R. (2010). Pulmonary Hypertension with left sided heart disease. Nat. Rev. Cardiol. 7: 648–659. 
    12. Hansson K, Haggstrom J, Kvart C and Lord, P. (2002) Left atrial to aortic root indices using two-dimensional and M-mode echocardiogra- phy in Cavalier King Charles Spaniels with and without left atrial enlargement. Vet. Radiol. Ultrasound. 43: 568–575. 
    13. Johnson, L., Boon, J. and Orton, E.C. (1999). Clinical characteristics of 53 dogs with Doppler-derived evidence of pulmonary hypertension: 1992–1996. J. Vet. Intern. Med. 13: 440–477.
    14. Kellihan, H.B and Stepien, R.L. (2012).Puolmonary hypertension in canine mitral valve insufficiency. J. Vet. Cardiol. 14: 149-164.
    15. Kellihan, H.B. and Stepien, R.L. (2010). Pulmonary hypertension in dogs: diagnosis and therapy. Vet. Clin. North Am. Small Anim. Pract. 40: 623-641.
    16. Kellum, H.B. and Stepien, R.L. (2007). Sildenafil citrate therapy in 22 dogs with pulmonary hypertension. J. Vet. Intern. Med. 21: 1258-126.
    17. Kettelson, M. and Kienele, R. (1998). Primary myocardial disease leading to chronic myocardial failure.In Small Animal Cardiovascular Medicine. St. Louis: Mosby pp. 319-346.
    18. Lamb, C.R., Tyler, M., Boswood, A., Askelly. B.J. and Cain, M. (2000). Assessment of the value of vertebral heart scale in the radiographic diagnosis of cardiac disease in dogs. Vet. Rec.146: 687-690
    19. Lord, P., Hansson, K., Kvart, C. and Haggstrom, J. (2010). Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation. J. Small Anim. Pract. 51: 210-218. 
    20. Mazzotta,E., Guglielmini, C., Menciotti, G., Contiero, B., BaronToaldo, M., Berlandaand, M. and Poser, H. (2016). Red blood cell distribution width, hematology in dogs with echocardio
    21. -graphically estimated precapillary and postcapillary pulmonary arterial hypertension. J. Vet. Intern. Med. 30 (6): 1806–1815. 
    22. Ohad, D.G., Letchener, I., Bdolah-abram, T. and Segev, G. (2013). A loud-apical systolic murmur is associated with the diagnosis of secondary arterial hypertension: retrospective analysis of data 201 consecutive client owned dogs (2006-2007). Vet. J. 198: 690-695 
    23. Pyle, R.L., Abbott, J.A. and Maclean, H. (2004). Pulmonary hypertension and cardiovascular sequelae in 54 dogs. Int. J. Appl. Res. Vet. Med. 2: 99-109. 
    24. Schober, K.E. and Baade, H. (2006). Doppler echocardiographic prediction of pulmonary hypertension in West Higland white terriers with chronic pulmonary disease. J. Vet. Intern. Med. 20: 912–920.
    25. Serres, F., Chetboul, V., Tissier, R., Poujol. L., Gouni, V., Carlos Sampedrano, C. and Pouchelon, J.L. (2008). Comparison of 3 ultrasound methods for quantifying left ventricular systolic function: correlation with disease severity and prognostic value in dogs with mitral valve disease. J. Vet. Intern. Med. 22: 566-577.
    26. Serres, F.J., Chetboul, V. and Tissier, R. (2006). Doppler echocardio graphy-derived evidence of pulmonary arterial hypertension in dogs with degenerative mitral valve disease: 86 cases (2001–2005). J. Am. Vet. Med. Assoc. 229: 1772–1778. 
    27. Sigrist, N.E., Adamik, K.N., Doherr, M.G. and Spreng, D.E. (2011). Evaluation of respiratory parameters at presentation as clinical indicators of the respiratory localization in dogs and cats with respiratory distress. J. Vet. Emerg. Crit. Care 21(1): 19-23.
    28. Snedecor, C.W and Cochran, W.G. (1994). Statistical Methods. 8th Ed. Iowa State University Press, USA.
    29. Teicholz, L.E., Kreulen, T., Herman, M.V. and Gorlin, R. (1976). Problems in echocardiographic volume determinations: echocardiographic- angiographic correlations in the presence or absence of asynergy. Am. J. Cardiol. 37: 7.
    30. Terzo, E., Di Marcello, M., McAllister, H., Glazier, B., Lo Coco, D., Locatelli, C., Palermo, V. and Brambilla, P.G., (2009). Echocardiographic assessment of 537 dogs with mitral valve prolapse and leaflet involvement. Vet. Radiol. Ultrasound. 50: 416- 422. 
    31. Tidholm, A., Höglund, K., Häggström, J. and Ljungvall, I. (2015). Diagnostic value of selected echocardiographic variables to identify pulmonary hypertension in dogs with myxomatous mitral valve disease. J. Vet. Intern. Med., 29(6): 1510–1517.
    32. Toyoshima, Y., Kanemoto, I. and Arai, S. (2007). A case of long- term sildenafil therapy in a young dog with pulmonary hypertension. J. Vet. Med. Sci. 69(10): 1073–1075.
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