College of Veterinary Medicine, Kyungpook National University, Daegu, 41566, South Korea.
College of Veterinary Medicine, Seoul National University, Seoul, 08826, South Korea.
Vet Radiol Ultrasound. 2023 Jan;64(1):18-27. doi: 10.1111/vru.13145. Epub 2022 Sep 1.
Pulmonary hypertension (PH) is an important predictor of poor outcomes in dogs with mitral regurgitation (MR). The feasibility of radiography to predict PH in dogs with MR is unknown. This retrospective, observational, and analytic study aimed to identify a radiographic parameter to predict PH in dogs with MR. A total of 302 dogs diagnosed with MR on echocardiography were enrolled. Medical record and radiographic findings such as the size of the main pulmonary artery, left atrium, left ventricle, and right chamber, and cranial and caudal pulmonary arteries and veins were evaluated according to the presence of PH. The diameters of the cranial and caudal pulmonary vessels were compared to the fourth rib and the ninth rib, respectively, and the ratio of the pulmonary artery to the corresponding vein (CdPA/CdPV) was calculated. Pulmonary hypertension was diagnosed in 77 dogs (25.5%) and the prevalence of PH increased with MR grade. The CdPA/CdPV was significantly higher (P < 0.001) in the presence of PH. Multivariate analysis showed that the CdPA/CdPV was the only independent radiographic parameter that had a significant association with PH in dogs with MR (P = 0.028). The cut-off value of the CdPA/CdPV = 1.10 showed 90.6% specificity and 31.1% sensitivity for detecting PH in dogs with MR. In dogs with MR, PH can be predicted with high specificity when the caudal pulmonary artery is 1.1 times larger than the corresponding vein on radiographs.
肺动脉高压（PH）是二尖瓣反流（MR）犬预后不良的重要预测指标。X 射线摄影术预测 MR 犬 PH 的可行性尚不清楚。本回顾性、观察性和分析性研究旨在确定一种 X 射线摄影参数来预测 MR 犬的 PH。共纳入 302 只经超声心动图诊断为 MR 的犬。根据 PH 的存在，评估了病历和 X 射线检查结果，如主肺动脉、左心房、左心室和右心房的大小，以及颅侧和尾侧肺动脉和静脉。分别比较了颅侧和尾侧肺动脉的直径与第 4 肋骨和第 9 肋骨的直径，并计算了肺动脉与相应静脉（CdPA/CdPV）的比值。77 只（25.5%）犬被诊断为 PH，PH 的患病率随 MR 分级的增加而增加。存在 PH 时 CdPA/CdPV 显著升高（P < 0.001）。多变量分析显示，在 MR 犬中，CdPA/CdPV 是与 PH 有显著关联的唯一独立 X 射线摄影参数（P = 0.028）。当 CdPA/CdPV = 1.10 时，对 MR 犬 PH 的检测具有 90.6%的特异性和 31.1%的敏感性。在 MR 犬中，当尾侧肺动脉在 X 射线上比相应的静脉大 1.1 倍时，可以高度特异性地预测 PH。
