Echocardiographic Evaluation of Indices of Severity of Pulmonary Stenosis in Dogs: Reproducibility and Effects of General Anesthesia

Figures

• 

  FIGURE 1. A flow chart indicating sequence of events for dogs enrolled in the study. All dogs underwent six echocardiographic examinations. On day one (the day before the transcatheter interventional procedure), dogs underwent two consecutive echocardiographic examinations. One was performed by a cardiology resident (AwakePreOpEcho1) and the other by a cardiologist (AwakePreOpEcho2) to assess inter‐operator (within‐day) reproducibility. The order was determined by coin flip. The next day (day of the interventional procedure) a third echocardiographic examination was performed (AwakePreOpEcho3) to assess intra‐operator between‐day reproducibility. Dogs then underwent general anesthesia (GA) for their transcatheter interventional procedure and an echocardiographic examination was repeated (GA_PreOpEcho4) immediately prior to the transcatheter procedure. The final echocardiographic examination was performed the day after the transcatheter procedure (AwakePostOpEcho5). With the exception of AwakePreOp2, all echocardiographic examinations were acquired and measured by the same investigator, a cardiology resident. Solid black arrows represent where statistical comparisons were made.

• 

  FIGURE 2. Pulmonary valve mean pressure gradient (PVmeanPG; A), pulmonary valve maximum pressure gradient (PVmaxPG; B), maximum velocity ratio of the aortic valve indexed to pulmonary valve (VmaxAV/VmaxPV; C), velocity time integral ratio of the aortic valve indexed to pulmonary valve (VTIAV/VTIPV; D), pulmonary valve area indexed to body weight (iPVA; E), and heart rate (F) before (AwakePreOpEcho3) and after general anesthesia (GA) but before a transcatheter interventional procedure (GA_PreOpEcho4).