Woo In-Sun, Kim Jung-Hyun
Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea.
Front Vet Sci. 2024 Aug 16;11:1441839. doi: 10.3389/fvets.2024.1441839. eCollection 2024.
Left atrial volume (LAV) obtained using real-time three-dimensional echocardiography (RT3DE) is an independent predictor of post-capillary pulmonary hypertension (PH) in humans; however, no studies have investigated LAV obtained using RT3DE as a predictor of post-capillary PH in dogs with myxomatous mitral valve disease (MMVD). Therefore, we aimed to evaluate the clinical applicability of LAV obtained using RT3DE compared to that obtained using two-dimensional echocardiography (2DE) in dogs with MMVD, with or without PH.
Medical records and echocardiographic images of 237 privately owned dogs with naturally occurring MMVD with or without PH were retrospectively reviewed. A total of 49 privately owned dogs with naturally occurring MMVD, with or without PH, were finally included (35 MMVD without PH, 14 MMVD with PH). The LAV and left ventricular volumes were obtained using 2DE and RT3DE. Echocardiographic parameters were analyzed to identify independent predictors of post-capillary PH.
We found that the left atrial and left ventricular volumes obtained using 2DE and RT3DE indexed to body weight and several 2DE-derived variables were univariately associated with post-capillary PH. Furthermore, multivariable logistic regression analysis revealed that the RT3DE minimum LAV indexed to body weight (LAVi min) was the only significant independent predictor of post-capillary PH (odds ratio, 12.86; 95% confidence interval [CI], 2.40-68.99; = 0.003), with the highest area under the curve value of 0.86 (95% CI, 0.75-0.96; < 0.001).
In conclusion, LAV indexed to body weight obtained using 2DE and RT3DE, can be a useful predictor of post-capillary PH in dogs with MMVD. In particular, the RT3DE LAVi min was observed to be the strongest predictor of post-capillary PH.
使用实时三维超声心动图（RT3DE）测得的左心房容积（LAV）是人类毛细血管后肺动脉高压（PH）的独立预测指标；然而，尚无研究调查使用RT3DE测得的LAV作为黏液瘤性二尖瓣疾病（MMVD）犬毛细血管后PH的预测指标。因此，我们旨在评估与二维超声心动图（2DE）相比，RT3DE测得的LAV在患有或未患有PH的MMVD犬中的临床适用性。
回顾性分析237只自然发生MMVD且患有或未患有PH的私人饲养犬的病历和超声心动图图像。最终纳入49只自然发生MMVD且患有或未患有PH的私人饲养犬（35只无PH的MMVD犬，14只患有PH的MMVD犬）。使用2DE和RT3DE获取LAV和左心室容积。分析超声心动图参数以确定毛细血管后PH的独立预测指标。
我们发现，使用2DE和RT3DE测得的以体重为指标的左心房和左心室容积以及几个2DE衍生变量与毛细血管后PH单变量相关。此外，多变量逻辑回归分析显示，以体重为指标的RT3DE最小LAV（LAVi min）是毛细血管后PH的唯一显著独立预测指标（比值比，12.86；95%置信区间[CI]，2.40 - 68.99；P = 0.003），曲线下面积值最高为0.86（95% CI，0.75 - 0.96；P < 0.001）。
总之，使用2DE和RT3DE测得的以体重为指标的LAV可作为MMVD犬毛细血管后PH的有用预测指标。特别是，观察到RT3DE的LAVi min是毛细血管后PH的最强预测指标。
