Prognostic Value of Body Weight-Independent Tricuspid Annular Plane Systolic Excursion to Systolic Pulmonary Arterial Pressure Ratio in Canine Precapillary Pulmonary Hypertension: A Retrospective Study.

[en] BACKGROUND: The prognostic use of both the echocardiographic parameters tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (sPAP) in dogs with pulmonary hypertension (PH) has shown conflicting results. The ratio of TAPSE/sPAP, not yet described in dogs, is used for the evaluation and risk assessment in people with PH and is a validated surrogate for right ventricular to pulmonary artery coupling with lower values being associated with poor outcome. This study aimed to describe TAPSE/sPAP in dogs with precapillary PH (PCPH) due to various diseases. It demonstrates the correlation of this ratio with echocardiographic indices, its association with heart failure (HF) and its prognostic value.METHODS: Medical records and echocardiographic data from 95 client-owned dogs with estimated mild (n = 10), moderate (n = 31) or severe (n = 54) PCPH were retrospectively reviewed. Body weight-independent TAPSE/sPAP ratios were obtained, and short-term and overall survival until death from all causes or cardio-pulmonary death (CPD) were assessed.RESULTS: TAPSE/sPAP was lower in dogs with HF and correlated with other echocardiographic variables commonly altered in dogs with PCPH. Different TAPSE/sPAP ratios, such as nTAPSE/(sPAP(m/s)), were independent predictors of short-term CPD, as was having pulmonary thromboembolism. For overall survival only HF was a risk factor of CPD. The cut-off value of <1.05 for nTAPSE/(sPAP(m/s)) was associated with shorter survival for dogs dying from CPD.CONCLUSIONS: The TAPSE/sPAP ratio is a non-invasive echocardiographic parameter that provides prognostic information, especially in short-term survival, in dogs with PCPH and may aid in risk stratification.