The prevalence of pulmonary hypertension assessed using the pulmonary vein\u2010to\u2010right pulmonary artery ratio and its association with survival in West Highland white terriers with canine idiopathic pulmonary fibrosis

Elodie Roels,Géraldine Bolen,Erik Teske,Cécile Clercx,Aline Fastrès,Kathleen Mc Entee,Anne-Christine Merveille

doi:10.1186/s12917-021-02879-w

Abstract

BackgroundPulmonary hypertension (PH) is a known co-morbidity in West Highland white terriers (WHWTs) affected with canine idiopathic pulmonary fibrosis (CIPF). The pulmonary vein-to-right pulmonary artery ratio (PV/PA) has recently been described for the detection of pre-capillary PH in dogs. The objective of the present study was to estimate the prevalence of PH at diagnostic, in WHWTs affected with CIPF, by using PV/PA, in comparison with a group of healthy breed-matched controls (CTRLs). Additional study objective was to explore whether the presence of PH at initial diagnosis of CIPF impacted survival time in dogs treated with sildenafil.ResultsTwenty-five client-owned WHWTs presented with CIPF and 19 CTRLs were included in the study. PV/PA in either two-dimensional mode (2D) or time-motion mode or both were measured from cineloops in each dog. Dogs were classified according to PV/PA value into non/mild PH (PV/PA measured in 2D ≥ 0.7) or moderate/severe PH (PV/PA < 0.7). Survival data of WHWTs affected with CIPF were extracted from medical record to assess association between presence of PH at diagnosis and outcome. 60 % overall prevalence for moderate/severe PH was estimated in this cohort of WHWTs presented with CIPF vs. 5 % in CTRLS (P = 0.0002). The presence of moderate/severe PH at initial presentation was not associated with survival.ConclusionsResults of the present study confirm a high prevalence of PH at diagnosis in WHWTs affected with CIPF and highlight the utility of PV/PA as a non-invasive surrogate for assessment of PH in this population.

Highlights

Pulmonary hypertension (PH) is a known co-morbidity in West Highland white terriers (WHWTs) affected with canine idiopathic pulmonary fibrosis (CIPF)
Using the cut-off value for pulmonary vein (PV)/pulmonary artery (PA) measured in 2-dimensional mode (2D) of < 0.7 corresponding to a tricuspid regurgitation systolic pressure gradient (TRPG) > 50mmHg [14], moderate to severe PH was identified in 15/24 (63 %) WHWTs affected with CIPF and in 1/19 (5 %) CTRLs (P = 0.0002)
Lower pulmonary vein-to-right pulmonary artery ratio (PV/PA) values were observed in WHWTs affected with CIPF compared with CTRLs, attributed to both an increase in the right pulmonary artery (PA) size and a decrease in the right pulmonary vein (PV) size (Table 2)

Summary

Introduction

Pulmonary hypertension (PH) is a known co-morbidity in West Highland white terriers (WHWTs) affected with canine idiopathic pulmonary fibrosis (CIPF). Canine idiopathic pulmonary fibrosis (CIPF) is a progressive fibrotic lung disease mainly reported in aged West Highland white terriers (WHWTs) [1, 2]. CIPF shares clinical, imaging and histopathological findings from both human idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases displaying nonspecific interstitial pneumonia pattern [1,2,3,4,5]. In human IPF, pulmonary hypertension (PH) occurs in up to 85 % of patients, depending on disease severity, evaluation method and diagnostic criteria employed [6, 7]. Doppler-echocardiography can be used to non-invasively assess pulmonary arterial pressures (PAP) in the presence of tricuspid or pulmonic regurgitation by applying the simplified Bernoulli equation [11]. In the absence of a tricuspid or pulmonic regurgitant jet, or in situation of poor Doppler alignment, this measurement may be not feasible or inaccurate [12, 13]

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