Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease

Background: Pulmonary arterial wave reflection provides novel information about pulmonary artery hemodynamics in pulmonary hypertension (PH). PH is common in dogs with myxomatous mitral valve disease (MMVD), though research examining the relationship between pulmonary arterial wave reflection and MM...

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Autores principales:	Tomohiko Yoshida, Kazumi Shimada, Lina Hamabe, Tsuyoshi Uchide, Ryou Tanaka, Katsuhiro Matsuura
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	mitral valvuloplasty pulmonary artery wave reflection wave separation analysis pulmonary hypertension non-invasive methods of measurement Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/731c2bdfe784402a9e96a9a1b29edece
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spelling	oai:doaj.org-article:731c2bdfe784402a9e96a9a1b29edece2021-12-02T08:21:45ZMeasurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease2297-176910.3389/fvets.2021.773035https://doaj.org/article/731c2bdfe784402a9e96a9a1b29edece2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fvets.2021.773035/fullhttps://doaj.org/toc/2297-1769Background: Pulmonary arterial wave reflection provides novel information about pulmonary artery hemodynamics in pulmonary hypertension (PH). PH is common in dogs with myxomatous mitral valve disease (MMVD), though research examining the relationship between pulmonary arterial wave reflection and MMVD with PH is lacking.Hypothesis/Objective: This study investigated conventional echocardiographic parameters and pulmonary artery wave reflection parameters before and after mitral valvuloplasty in canine patients with PH due to MMVD. The parameters were backward pressure (Pb), forward pressure (Pf), and the reflection coefficient calculated as the ratio of peak Pb to peak Pf (RC).Animals: The study subjects were 10 client-owned dogs receiving mitral valvuloplasty for MMVD with PH.Methods: Conventional echocardiographic parameters and pulmonary artery wave reflection parameters were measured before and after mitral valvuloplasty. The relationships between pulmonary artery wave reflection parameters and echocardiographic parameters, estimation of pulmonary artery systolic pressure, and right atrium pressure (RAP) gained by catheter in mitral valvuloplasty were also investigated. Post-operative echocardiography and the measurement of pulmonary arterial wave reflection were performed 2 weeks after mitral valvuloplasty.Results: The parameters of normalized left ventricular internal diameter at end-diastole (LVIDDN), E velocity, and the estimation of pulmonary artery systolic pressure were significantly reduced post-operatively compared with baseline measurements (p < 0.05). Post-operative Pb decreased significantly compared with pre-operative measurements (8.8 ± 5.9 to 5.0 ± 3.2 mmHg, p = 0.037) as did RC (0.37 ± 0.15 to 0.22 ± 0.11, p < 0.01). A statistically significant positive correlation existed between wave reflection parameters and RAP, an estimation of pulmonary artery systolic pressure.Conclusions: Results demonstrate that mitral valvuloplasty can be used to treat secondary PH caused by MMVD, resulting in the improvement of post-operative echocardiographic and wave reflection parameters and a decrease in the right afterload. In some patients, some degree of vascular admittance mismatch persisted, despite the improvement of left atrial pressure. This may be indicative of residual pulmonary arterial disease, which may continue to adversely affect interactions between the right ventricle and the vasculature.Tomohiko YoshidaTomohiko YoshidaKazumi ShimadaLina HamabeTsuyoshi UchideRyou TanakaKatsuhiro MatsuuraKatsuhiro MatsuuraFrontiers Media S.A.articlemitral valvuloplastypulmonary artery wave reflectionwave separation analysispulmonary hypertensionnon-invasive methods of measurementVeterinary medicineSF600-1100ENFrontiers in Veterinary Science, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	mitral valvuloplasty pulmonary artery wave reflection wave separation analysis pulmonary hypertension non-invasive methods of measurement Veterinary medicine SF600-1100
spellingShingle	mitral valvuloplasty pulmonary artery wave reflection wave separation analysis pulmonary hypertension non-invasive methods of measurement Veterinary medicine SF600-1100 Tomohiko Yoshida Tomohiko Yoshida Kazumi Shimada Lina Hamabe Tsuyoshi Uchide Ryou Tanaka Katsuhiro Matsuura Katsuhiro Matsuura Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease
description	Background: Pulmonary arterial wave reflection provides novel information about pulmonary artery hemodynamics in pulmonary hypertension (PH). PH is common in dogs with myxomatous mitral valve disease (MMVD), though research examining the relationship between pulmonary arterial wave reflection and MMVD with PH is lacking.Hypothesis/Objective: This study investigated conventional echocardiographic parameters and pulmonary artery wave reflection parameters before and after mitral valvuloplasty in canine patients with PH due to MMVD. The parameters were backward pressure (Pb), forward pressure (Pf), and the reflection coefficient calculated as the ratio of peak Pb to peak Pf (RC).Animals: The study subjects were 10 client-owned dogs receiving mitral valvuloplasty for MMVD with PH.Methods: Conventional echocardiographic parameters and pulmonary artery wave reflection parameters were measured before and after mitral valvuloplasty. The relationships between pulmonary artery wave reflection parameters and echocardiographic parameters, estimation of pulmonary artery systolic pressure, and right atrium pressure (RAP) gained by catheter in mitral valvuloplasty were also investigated. Post-operative echocardiography and the measurement of pulmonary arterial wave reflection were performed 2 weeks after mitral valvuloplasty.Results: The parameters of normalized left ventricular internal diameter at end-diastole (LVIDDN), E velocity, and the estimation of pulmonary artery systolic pressure were significantly reduced post-operatively compared with baseline measurements (p < 0.05). Post-operative Pb decreased significantly compared with pre-operative measurements (8.8 ± 5.9 to 5.0 ± 3.2 mmHg, p = 0.037) as did RC (0.37 ± 0.15 to 0.22 ± 0.11, p < 0.01). A statistically significant positive correlation existed between wave reflection parameters and RAP, an estimation of pulmonary artery systolic pressure.Conclusions: Results demonstrate that mitral valvuloplasty can be used to treat secondary PH caused by MMVD, resulting in the improvement of post-operative echocardiographic and wave reflection parameters and a decrease in the right afterload. In some patients, some degree of vascular admittance mismatch persisted, despite the improvement of left atrial pressure. This may be indicative of residual pulmonary arterial disease, which may continue to adversely affect interactions between the right ventricle and the vasculature.
format	article
author	Tomohiko Yoshida Tomohiko Yoshida Kazumi Shimada Lina Hamabe Tsuyoshi Uchide Ryou Tanaka Katsuhiro Matsuura Katsuhiro Matsuura
author_facet	Tomohiko Yoshida Tomohiko Yoshida Kazumi Shimada Lina Hamabe Tsuyoshi Uchide Ryou Tanaka Katsuhiro Matsuura Katsuhiro Matsuura
author_sort	Tomohiko Yoshida
title	Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease
title_short	Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease
title_full	Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease
title_fullStr	Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease
title_full_unstemmed	Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease
title_sort	measurement of pulmonary artery wave reflection before and after mitral valvuloplasty in canine patients with pulmonary hypertension caused by myxomatous mitral valve disease
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/731c2bdfe784402a9e96a9a1b29edece
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Measurement of Pulmonary Artery Wave Reflection Before and After Mitral Valvuloplasty in Canine Patients With Pulmonary Hypertension Caused by Myxomatous Mitral Valve Disease

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