Why the study?
Echocardiographic diagnosis of pulmonary hypertension in horses typically relies on Doppler interrogation of tricuspid or pulmonic regurgitation, prompting investigation of two-dimensional echocardiographic variables.
Do two-dimensional echocardiographic measurements of PAD and PADI accurately detect pulmonary hypertension in horses?
Do two-dimensional echocardiographic measurements of PAD and PADI accurately detect pulmonary hypertension in horses?
Two-dimensional echocardiographic measurements of PAD and PADI are moderately specific but lack sensitivity for diagnosing pulmonary hypertension in horses, though they may serve as complementary indices when tricuspid or pulmonic regurgitation is absent.
Low sensitivity limits ruling out equine PH; leaves open adjunctive value in prospective validation.
Echocardiographic diagnosis of pulmonary hypertension (PH) in horses is usually based on Doppler interrogation of tricuspid (TR) or pulmonic regurgitation (PR). This study aimed at investigating two-dimensional echocardiographic (2DE) variables, including pulmonary artery diameter (PAD) and pulmonary artery distensibility index (PADI), to diagnose PH. 41 healthy horses, 82 horses with TR or PR and normal intracardiac pressure gradients, and 35 horses with TR or PR velocities indicating PH. The 2DE variables were compared between groups, cut-offs for diagnosis of PH were determined and conditional inference trees served to identify the variable best predicting PH in absence of TR or PR. Horses with PH had larger end-diastolic short-axis PAD (PADed-sx) (5.8 ± 1.0 cm; mean ± SD) and smaller PADI[/PADps] (15.4 ± 7.7 %) than healthy horses (5.0 ± 0.6 cm, P<0.0001; 20.5 ± 4.4 %, P<0.001) and horses with TR or PR but no PH (5.3 ± 0.6 cm, P=0.003; 18.8 ± 4.2 %, P=0.005). PADed-sx predicted PH with sensitivity (Se)=36% and specificity (Sp)=94% (cut-off 6.0 cm, AUC=0.668, P=0.002), while PADI[/PADps] predicted PH with Se=43% and Sp=92% (cut-off 13.7%, AUC=0.662, P=0.004). In the absence of TR, PADed-sx and end-diastolic long-axis aortic diameter-to-PADed-sx ratio (AoDed-lx/PADed-sx), were most suitable to diagnose PH. PADed-sx and PADI were moderately specific but not very sensitive to diagnose PH. Nonetheless, they may be used as complementary indices suggesting PH in the absence of TR or PR.
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Ferraro et al. (2023) studied this question.
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