Presented in part at the 17th Congress of the ECVIM, Budapest, Hungary, September 13–15, 2007.
Estimation of Left Ventricular Filling Pressure by Doppler Echocardiography in Dogs with Pacing-Induced Heart Failure
Version of Record online: 10 JUL 2008
Copyright © 2008 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 22, Issue 3, pages 578–585, May–June 2008
How to Cite
Schober, K.E., Stern, J.A., DaCunha, D.N.Q.T., Pedraza-Toscano, A.M., Shemanski, D. and Hamlin, R.L. (2008), Estimation of Left Ventricular Filling Pressure by Doppler Echocardiography in Dogs with Pacing-Induced Heart Failure. Journal of Veterinary Internal Medicine, 22: 578–585. doi: 10.1111/j.1939-1676.2008.0099.x
- Issue online: 10 JUL 2008
- Version of Record online: 10 JUL 2008
- Submitted November 25, 2007; Revised January 14, 2008; Accepted February 11, 2008.
- Congestive heart failure;
- End-diastolic pressure;
Background: Congestive heart failure (CHF) is a common clinical syndrome characterized by elevated filling pressure.
Hypothesis: Doppler echocardiographic (DE) variables of left ventricular (LV) filling can predict a decline of LV end-diastolic pressure (LVEDP) induced by acute preload reduction in dogs with compensated CHF.
Animals: Five male hound dogs.
Methods: Dogs previously instrumented with a transvenous cardiac pacemaker and a LV pressure gauge were paced at 160–180 bpm to induce mild CHF characterized by LVEDP > 20 mmHg. LVEDP and 9 DE variables of LV filling derived from diastolic time intervals, transmitral and pulmonary venous flow, and tissue Doppler imaging were measured simultaneously at baseline and 30, 60, 120, and 240 minutes after furosemide (4 mg/kg, IV) or placebo (0.9% saline, IV). Repeated measures analysis of variance and correlation analysis were used to determine the association between the decline of LVEDP after furosemide and DE measures of LV filling pressure (LVFP).
Results: Furosemide but not placebo decreased LVEDP (P < .001). The ratio of early transmitral flow velocity to LV isovolumic relaxation time (E : IVRT) predicted LVEDP best (R2= .50; P < .001). Correlations were also found between LVEDP and IVRT, E, ratio between E and late diastolic transmitral flow velocity (E : A), and early diastolic velocity of the mitral annulus (Ea). The ratio of E to Ea (E : Ea) was not useful in the prediction of LVEDP in this model.
Conclusion and Clinical Importance: E : IVRT can be used to predict LVFP in dogs with mild left-sided CHF induced by rapid pacing.