Echocardiographic evaluation of velocity ratio, velocity time integral ratio, and pulmonary valve area in dogs with pulmonary valve stenosis

Satoko Nishimura, Lance C Visser, Catherine Bélanger, Maureen S. Oldach, Catherine Gunther-Harrington, Joshua A Stern

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Velocity ratio, velocity time integral (VTI) ratio, and pulmonary valve area indexed to body surface area (iPVA) are methods of assessment of pulmonary valve stenosis (PS) severity that are less dependent on blood flow. Studies evaluating these methods are limited. Objectives: To determine the effects of butorphanol, atenolol, and balloon valvuloplasty (BV) on velocity ratio, VTI ratio, iPVA, mean PG, and max PG. Animals: Twenty-seven dogs with PS (max PG >50 mm Hg). Methods: Prospective study. All dogs underwent an echocardiogram at baseline, 5-minutes after administration of butorphanol (0.2-0.25 mg/kg IV), and 2-to-4 weeks after atenolol (1-1.5 mg/kg q12h). Twenty-one of these were evaluated 24-hours after BV. Results: There were no significant differences (P >.05) amongst any of the methods of assessment of PS severity after butorphanol. After atenolol, mean (SD) of mean (57.0 [21.0] mm Hg) and max PG (93.1 [33.8] mm Hg) were significantly decreased (P ≤.047) compared with baseline (65.2 [26.2] mm Hg and 108 [44.4] mm Hg, respectively). After atenolol, there were no significant (P ≥.12) differences in velocity ratio (0.29 [0.09]), VTI ratio (0.18 [0.05]), or iPVA (0.43 [0.16] cm2/m2) compared with baseline (0.30 [0.09], 0.19 [0.09], 0.44 [0.17] cm2/m2, respectively). Conclusions and Clinical Importance: Atenolol might reduce mean and max PG but does not alter less flow-dependent methods of assessment of PS severity (velocity ratio, VTI ratio, and iPVA) in dogs with PS. Results support an integrative approach to assessment of PS severity that includes less flow-dependent methods, particularly in states of altered flow or right ventricular function.

Original languageEnglish (US)
Pages (from-to)1570-1578
Number of pages9
JournalJournal of Veterinary Internal Medicine
Volume32
Issue number5
DOIs
StatePublished - Sep 1 2018

Fingerprint

Pulmonary Valve
Pulmonary Valve Stenosis
Atenolol
lungs
Butorphanol
Dogs
dogs
butorphanol
Balloon Valvuloplasty
Right Ventricular Function
Body Surface Area
methodology
prospective studies
Prospective Studies
blood flow
surface area

Keywords

  • canine
  • echocardiography
  • effective orifice area
  • pressure gradient
  • pulmonic stenosis
  • sedation

ASJC Scopus subject areas

  • veterinary(all)

Cite this

@article{88636d8d37c848c4b9941c0a1eef99e6,
title = "Echocardiographic evaluation of velocity ratio, velocity time integral ratio, and pulmonary valve area in dogs with pulmonary valve stenosis",
abstract = "Background: Velocity ratio, velocity time integral (VTI) ratio, and pulmonary valve area indexed to body surface area (iPVA) are methods of assessment of pulmonary valve stenosis (PS) severity that are less dependent on blood flow. Studies evaluating these methods are limited. Objectives: To determine the effects of butorphanol, atenolol, and balloon valvuloplasty (BV) on velocity ratio, VTI ratio, iPVA, mean PG, and max PG. Animals: Twenty-seven dogs with PS (max PG >50 mm Hg). Methods: Prospective study. All dogs underwent an echocardiogram at baseline, 5-minutes after administration of butorphanol (0.2-0.25 mg/kg IV), and 2-to-4 weeks after atenolol (1-1.5 mg/kg q12h). Twenty-one of these were evaluated 24-hours after BV. Results: There were no significant differences (P >.05) amongst any of the methods of assessment of PS severity after butorphanol. After atenolol, mean (SD) of mean (57.0 [21.0] mm Hg) and max PG (93.1 [33.8] mm Hg) were significantly decreased (P ≤.047) compared with baseline (65.2 [26.2] mm Hg and 108 [44.4] mm Hg, respectively). After atenolol, there were no significant (P ≥.12) differences in velocity ratio (0.29 [0.09]), VTI ratio (0.18 [0.05]), or iPVA (0.43 [0.16] cm2/m2) compared with baseline (0.30 [0.09], 0.19 [0.09], 0.44 [0.17] cm2/m2, respectively). Conclusions and Clinical Importance: Atenolol might reduce mean and max PG but does not alter less flow-dependent methods of assessment of PS severity (velocity ratio, VTI ratio, and iPVA) in dogs with PS. Results support an integrative approach to assessment of PS severity that includes less flow-dependent methods, particularly in states of altered flow or right ventricular function.",
keywords = "canine, echocardiography, effective orifice area, pressure gradient, pulmonic stenosis, sedation",
author = "Satoko Nishimura and Visser, {Lance C} and Catherine B{\'e}langer and Oldach, {Maureen S.} and Catherine Gunther-Harrington and Stern, {Joshua A}",
year = "2018",
month = "9",
day = "1",
doi = "10.1111/jvim.15244",
language = "English (US)",
volume = "32",
pages = "1570--1578",
journal = "Journal of Veterinary Internal Medicine",
issn = "0891-6640",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Echocardiographic evaluation of velocity ratio, velocity time integral ratio, and pulmonary valve area in dogs with pulmonary valve stenosis

AU - Nishimura, Satoko

AU - Visser, Lance C

AU - Bélanger, Catherine

AU - Oldach, Maureen S.

AU - Gunther-Harrington, Catherine

AU - Stern, Joshua A

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Velocity ratio, velocity time integral (VTI) ratio, and pulmonary valve area indexed to body surface area (iPVA) are methods of assessment of pulmonary valve stenosis (PS) severity that are less dependent on blood flow. Studies evaluating these methods are limited. Objectives: To determine the effects of butorphanol, atenolol, and balloon valvuloplasty (BV) on velocity ratio, VTI ratio, iPVA, mean PG, and max PG. Animals: Twenty-seven dogs with PS (max PG >50 mm Hg). Methods: Prospective study. All dogs underwent an echocardiogram at baseline, 5-minutes after administration of butorphanol (0.2-0.25 mg/kg IV), and 2-to-4 weeks after atenolol (1-1.5 mg/kg q12h). Twenty-one of these were evaluated 24-hours after BV. Results: There were no significant differences (P >.05) amongst any of the methods of assessment of PS severity after butorphanol. After atenolol, mean (SD) of mean (57.0 [21.0] mm Hg) and max PG (93.1 [33.8] mm Hg) were significantly decreased (P ≤.047) compared with baseline (65.2 [26.2] mm Hg and 108 [44.4] mm Hg, respectively). After atenolol, there were no significant (P ≥.12) differences in velocity ratio (0.29 [0.09]), VTI ratio (0.18 [0.05]), or iPVA (0.43 [0.16] cm2/m2) compared with baseline (0.30 [0.09], 0.19 [0.09], 0.44 [0.17] cm2/m2, respectively). Conclusions and Clinical Importance: Atenolol might reduce mean and max PG but does not alter less flow-dependent methods of assessment of PS severity (velocity ratio, VTI ratio, and iPVA) in dogs with PS. Results support an integrative approach to assessment of PS severity that includes less flow-dependent methods, particularly in states of altered flow or right ventricular function.

AB - Background: Velocity ratio, velocity time integral (VTI) ratio, and pulmonary valve area indexed to body surface area (iPVA) are methods of assessment of pulmonary valve stenosis (PS) severity that are less dependent on blood flow. Studies evaluating these methods are limited. Objectives: To determine the effects of butorphanol, atenolol, and balloon valvuloplasty (BV) on velocity ratio, VTI ratio, iPVA, mean PG, and max PG. Animals: Twenty-seven dogs with PS (max PG >50 mm Hg). Methods: Prospective study. All dogs underwent an echocardiogram at baseline, 5-minutes after administration of butorphanol (0.2-0.25 mg/kg IV), and 2-to-4 weeks after atenolol (1-1.5 mg/kg q12h). Twenty-one of these were evaluated 24-hours after BV. Results: There were no significant differences (P >.05) amongst any of the methods of assessment of PS severity after butorphanol. After atenolol, mean (SD) of mean (57.0 [21.0] mm Hg) and max PG (93.1 [33.8] mm Hg) were significantly decreased (P ≤.047) compared with baseline (65.2 [26.2] mm Hg and 108 [44.4] mm Hg, respectively). After atenolol, there were no significant (P ≥.12) differences in velocity ratio (0.29 [0.09]), VTI ratio (0.18 [0.05]), or iPVA (0.43 [0.16] cm2/m2) compared with baseline (0.30 [0.09], 0.19 [0.09], 0.44 [0.17] cm2/m2, respectively). Conclusions and Clinical Importance: Atenolol might reduce mean and max PG but does not alter less flow-dependent methods of assessment of PS severity (velocity ratio, VTI ratio, and iPVA) in dogs with PS. Results support an integrative approach to assessment of PS severity that includes less flow-dependent methods, particularly in states of altered flow or right ventricular function.

KW - canine

KW - echocardiography

KW - effective orifice area

KW - pressure gradient

KW - pulmonic stenosis

KW - sedation

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U2 - 10.1111/jvim.15244

DO - 10.1111/jvim.15244

M3 - Article

C2 - 30079482

AN - SCOPUS:85052467771

VL - 32

SP - 1570

EP - 1578

JO - Journal of Veterinary Internal Medicine

JF - Journal of Veterinary Internal Medicine

SN - 0891-6640

IS - 5

ER -