What is the clinical evidence from this study?

Study design: Case-Control. Population: Pulmonary hypertension (n=90). Intervention: Tissue motion annular displacement (TMAD) echocardiography vs. Healthy control dogs. Primary outcome: Tissue motion annular displacement (TMAD) relative to right ventricular length (%) (p=0.002).

What question did this study set out to answer?

The aim is to evaluate right ventricular systolic function in dogs with and without pulmonary hypertension using echocardiography and TMAD.

May 29, 2026American Journal of Veterinary Research0 citationsOpen Access

Right ventricular systolic function in dogs with pulmonary hypertension can be assessed using tissue motion annular displacement

Q: What does this research mean for the field?

Tissue motion annular displacement (TMAD) can serve as a supplementary tool, but does not replace conventional echocardiographic techniques, for assessing right ventricular systolic function in dogs with pulmonary hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

VSVinícius Bentivóglio Costa SilvaUniversidade Federal do Paraná SLStephany Buba LucinaUniversidade Federal do Paraná MWMarcela WolfUniversidade Federal do Paraná

Key Result

Tissue motion annular displacement was significantly reduced in dogs with precapillary pulmonary hypertension (17.5%) compared to healthy controls (21.0%), serving as a supplementary tool for assessing right ventricular systolic function.

Key Points

The aim is to evaluate right ventricular systolic function in dogs with and without pulmonary hypertension using echocardiography and TMAD.
Case-control study involving 46 dogs with pulmonary hypertension and 44 healthy controls.
Assessment included conventional echocardiography, strain, and TMAD measurements.
Dogs with PH were classified into precapillary or postcapillary PH categories.
TMAD values were lowest in dogs with precapillary PH compared to controls and those with postcapillary PH.
TMAD showed weak to moderate positive correlations with RV structural variables and fractional area change.
No significant correlation was found between TMAD and peak velocity of systolic tricuspid annular motion.

Study Design

Type

Case-Control (n=90)

Multicenter

Yes

Structured PICO

Can tissue motion annular displacement (TMAD) accurately assess right ventricular systolic function in dogs with pulmonary hypertension compared to conventional echocardiography?

Population

90 dogs, including 46 with pulmonary hypertension (27 precapillary, 19 postcapillary) and 44 healthy client-owned dogs (control group), evaluated from March 2018 through June 2022.

Intervention

Echocardiographic evaluation using tissue motion annular displacement (TMAD)

Comparator

Healthy controls and conventional echocardiographic techniques

Outcome

Right ventricular systolic function assessed by TMAD and its correlation with conventional echocardiographic variablessurrogate

Tissue motion annular displacement (TMAD) may serve as a supplementary tool, but does not replace conventional techniques, for assessing right ventricular systolic function in dogs with pulmonary hypertension.

Main Result

Absolute Event Rate: 17.5% vs 21%

p-value: p=0.002

Limitations

Nonclinical comorbidities cannot be excluded as specific ancillary examinations were not performed
Severity of pulmonary hypertension was characterized only through echocardiography, not right heart catheterization
Groups were not homogeneous, and the control group was not age and breed matched
Small sample size
Pulmonary hypertension severity was classified based solely on tricuspid regurgitation velocity
Software used for TMAD has not yet been validated for right ventricular evaluation
Absence of a gold standard technique (nuclear magnetic resonance) to evaluate right ventricular systolic function
Intra- and interobserver variability were not assessed

Abstract

Objective: To assess right ventricular (RV) systolic function using conventional echocardiography and advanced techniques, including strain and tissue motion annular displacement (TMAD), in dogs with and without pulmonary hypertension (PH). Methods: Dogs with PH and healthy client-owned dogs (control group) evaluated from March 2018 through June 2022 were eligible for inclusion in this case-control study. Dogs in the PH group were classified as having either precapillary or postcapillary PH. All dogs underwent physical examination, blood pressure measurement, electrocardiography, and echocardiographic evaluation, including conventional and speckle-tracking techniques. Right ventricular systolic function was assessed using multiple variables, including TMAD, measured as midpoint displacement (millimeters), midpoint displacement relative to RV length (percentage), and TMAD indexed to body weight (mm/kg) and body surface area (mm/m2). The results were compared among groups and subgroups. Results: There were 46 dogs in the PH group (precapillary PH, n = 27; postcapillary PH, 19) and 44 dogs in the control group. The TMAD values were lowest in dogs with precapillary PH compared with the control group and dogs with postcapillary PH. Tissue motion annular displacement (mm/kg) showed weak to moderate positive correlations with RV structural variables and fractional area change percentage, a weak negative correlation with tricuspid annular plane systolic excursion normalized by body weight, and no significant correlation with peak velocity of systolic tricuspid annular motion as determined by tissue Doppler imaging (S'). Conclusions: TMAD does not replace conventional techniques for assessing RV systolic function. Clinical Relevance: The evaluated technique may serve as a supplementary tool for assessing RV systolic function in dogs with PH.

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