title: Accuracy of Doppler echocardiographic estimates of pulmonary artery pressures in a canine model of pulmonary hypertension.
abstract: OBJECTIVE
  To compare noninvasive estimates of pulmonary artery pressure (PAP) obtained via echocardiography (ECHO) to invasive measurements of PAP obtained during right heart catheterization (RHC) across a range of PAP. To examine the accuracy of estimating right atrial pressure via ECHO (RAPECHO) compared to RAP measured by RHC (RAPRHC), and determine if adding RAPECHO improves the accuracy of noninvasive PAP estimations.
  
  
  METHODS
  14 healthy female beagle dogs.
  
  
  METHODS
  Comparison of ECHO and RHC measures of PAP, both at normal PAP and increased PAP generated by microbead embolization.
  
  
  RESULTS
  Noninvasive estimates of PAP were moderately but significantly correlated (r of 0.68-0.78; p < 0.0006) with invasive measurements of PAP. Wide variance was noted for all estimations, with increased variance at higher PAP. The addition of RAPECHO improved correlation and bias in all cases. RAPRHC was significantly correlated with RAPECHO (r = 0.38; p = 0.04) as estimated by the ellipse area method. Median RAPRHC was significantly different between 3 subjective assessments of right atrial size (p = 0.037).
  
  
  CONCLUSIONS
  Spectral Doppler assessments of tricuspid and pulmonic regurgitation are imperfect methods for predicting PAP as measured by catheterization despite an overall moderate correlation between invasive and noninvasive values. Noninvasive measurements may be better utilized as part of a comprehensive assessment of PAP in canine patients. RAPRHC appears best estimated based on subjective assessment of RA size. Including estimated RAPECHO in estimates of PAP improves the correlation and relatedness between noninvasive and invasive measures of PAP, but notable variability in accuracy of estimations persists.
authors.affiliation: University of Wisconsin, School of Veterinary Medicine, Department of Medical Sciences (Cardiology), 2015 Linden Drive, Madison, WI 53706, USA.
authors.forename: Lydia C
authors.initials: LC
authors.lastname: Soydan
authors.affiliation: University of Wisconsin, School of Veterinary Medicine, Department of Medical Sciences (Cardiology), 2015 Linden Drive, Madison, WI 53706, USA. Electronic address: kellihanh@vetmed.wisc.edu.
authors.forename: Heidi B
authors.initials: HB
authors.lastname: Kellihan
authors.affiliation: University of Wisconsin, School of Medicine and Public Health, Department of Pediatrics and the John Rankin Laboratory of Pulmonary Medicine, 600 Highland Avenue, Madison, WI 53792, USA; University of Iowa, Department of Health and Human Physiology, 225 S. Grand Avenue, Iowa City, IA 52242, USA.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Bates
authors.affiliation: University of Wisconsin, School of Veterinary Medicine, Department of Medical Sciences (Cardiology), 2015 Linden Drive, Madison, WI 53706, USA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Stepien
authors.affiliation: University of Wisconsin, School of Medicine and Public Health, Department of Radiology, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Consigny
authors.affiliation: University of Wisconsin, College of Engineering, Department of Biomedical Engineering, 1550 Engineering Dr., Madison, WI 53706, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bellofiore
authors.affiliation: University of Wisconsin, School of Medicine and Public Health, Department of Radiology, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Francois
authors.affiliation: University of Wisconsin, College of Engineering, Department of Biomedical Engineering, 1550 Engineering Dr., Madison, WI 53706, USA.
authors.forename: Naomi C
authors.initials: NC
authors.lastname: Chesler
mesh_terms: D000818:Animals; D001795:Blood Pressure Determination; D006328:Cardiac Catheterization / Q000662:veterinary; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D015150:Echocardiography, Doppler / Q000592:standards / Q000662:veterinary*; D005260:Female; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000473:pathology / Q000662:veterinary*; D011651:Pulmonary Artery / Q000473:pathology*; D011859:Radiography
keywords: Dog; Pulmonic regurgitation; Right atrial pressure; Right heart catheterization; Tricuspid regurgitation