Right Pulmonary Artery Distensibility Index (RPAD Index). A field study of an echocardiographic method to detect early development of pulmonary hypertension and its severity even in the absence of regurgitant jets for Doppler evaluation in heartworm-infected dogs
Right Pulmonary Artery Distensibility Index (RPAD Index). A field study of an echocardiographic method to detect early development of pulmonary hypertension and its severity even in the absence of regurgitant jets for Doppler evaluation in heartworm-infected dogs
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DOI：
10.1016/j.vetpar.2014.08.016
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发表时间：
2014-11-15
影响因子：
2.6
通讯作者：
Boon, June A.
中科院分区：
文献类型：
--
作者：
Venco, Luigi;Mihaylova, Liliya;Boon, June A.
尽管有“心丝虫病”一词，但犬的肺丝虫感染应被认为是一种肺动脉疾病，在其晚期可能只累及右心结构。犬心脏成虫的慢性感染导致增殖性动脉内膜炎，由于弹性降低，导致肺动脉压力进行性升高。弹性使肺动脉可以根据每个脉搏而伸展，并有助于保持动脉中相对恒定的压力，尽管血液流动具有脉动的性质。用核磁共振研究了人类急性和慢性肺动脉高压的肺动脉扩张性，并与高血压的严重程度及其转归和治疗反应相关。本研究的目的是探讨超声心动图测量右肺动脉收缩和舒张期内径变化的百分比(扩张性)是否对评估心虫感染犬的肺动脉高压的存在和严重程度有价值。计算健康和自然感染心虫阳性犬的右肺动脉扩张性指数(RPAD指数)(以右肺动脉收缩和舒张期内径之差计算)。选择右肺动脉是因为它通常受影响更早、程度更大。数据来自没有任何临床、放射或超声心动图迹象的健康心虫阳性犬；自然感染的心虫阳性犬在疾病的不同阶段，可以使用多普勒超声心动图(使用三尖瓣和/或肺返流速度和压力梯度)测量肺动脉压；以及自然感染的心虫阳性犬在疾病的不同阶段(有或不伴有三尖瓣和/或肺返流)，尽可能以侵入性和非侵入性方式测量肺动脉压。这些评估结果表明，RPAD指数是一种有价值的方法，即使在没有返流喷射的情况下也可以早期检测心虫感染犬的肺动脉高压的存在和严重程度，并且RPAD指数与肺动脉高压水平有很强的相关性。(C)2014爱思唯尔B.V.保留所有权利。
Despite the term "heartworm disease" Dirofilaria immitis infection in dogs should be considered a pulmonary arterial disease that might only involve the right heart structures in its late stage. Chronic infection by adult heartworms in dogs results in proliferative endoarteritis leading to progressively increasing pulmonary artery pressure due to reduced elasticity. Elasticity allows the pulmonary arteries to stretch in response to each pulse and helps maintain a relatively constant pressure in the arteries despite the pulsating nature of the blood flow. Pulmonary artery distensibility for both acute and chronic pulmonary hypertension has been investigated in humans using MRI and has been correlated with the severity of hypertension and its outcome and treatment response. The aim of the present study was to investigate whether echocardiographic measurement of the percentage change in diameter of the right pulmonary artery in systole and diastole (distensibility) may be of value in assessing the presence and severity of pulmonary hypertension in heartworm-infected dogs. The Right Pulmonary Artery Distensibility Index (RPAD Index) (which is calculated as the difference in diameter of the right pulmonary artery in systole and diastole) was calculated in healthy and naturally infected heartworm-positive dogs. The right pulmonary artery was chosen because it is usually affected earlier and to a greater degree. Data were obtained from healthy heartworm-free dogs without any clinical, radiographic, or echocardiographic signs of pulmonary hypertension; naturally infected heartworm-positive dogs in different stages of the disease in which pulmonary pressure could be measured by Doppler echocardiography (using tricuspid and or pulmonary regurgitation velocity and pressure gradient); and naturally infected heartworm-positive dogs in different stages of the disease (with or without tricuspid and or pulmonary regurgitation) in which the pulmonary pressure was measured invasively and noninvasively if possible. Results of these evaluations indicated that RPAD Index is a valuable method for early detection of the presence and severity of pulmonary hypertension in heartworm-infected dogs even in the absence of regurgitant jets for Doppler evaluation and that there is a strong correlation between the RPAD Index and the level of pulmonary hypertension. (C) 2014 Elsevier B.V. All rights reserved.