title: Pulmonary Vein-to-Pulmonary Artery Ratio is an Echocardiographic Index of Congestive Heart Failure in Dogs with Degenerative Mitral Valve Disease.
abstract: BACKGROUND
  Early recognition of left-sided congestive heart failure (CHF) in dogs with degenerative mitral valve disease (DMVD) is important because it influences medical therapy, timing of follow-up, and outcome.
  
  
  OBJECTIVE
  Pulmonary vein diameter-to-pulmonary artery diameter ratio (PV/PA) measured by echocardiography can predict CHF.
  
  
  METHODS
  Ninety-eight client-owned dogs, 37 controls, and 61 dogs with DMVD.
  
  
  METHODS
  Prospective clinical cohort study. History, physical examination and Doppler-echocardiography were performed. Dogs were classified as International Small Animal Cardiac Health Council class I, II or III. Congestive heart failure was identified in a subset of 56 dogs based on radiographic findings. The PV/PA was measured in bidimensional (2D) and M-mode by 2 investigators blinded to the radiologists' conclusions.
  
  
  RESULTS
  Interobserver coefficients of variation for PV/PA acquisition and measurement were <10%. The PV/PA in control dogs was approximately 1 and increased with class of heart failure. The presence of CHF could be best predicted by measuring PV/PA in 2D echocardiography (cut-off, 1.7; area under the curve, 0.98; CI, 0.97-0.98; P < .001) with a sensitivity of 96% and a specificity of 91%.
  
  
  CONCLUSIONS
  The PV/PA is a simple and reproducible echocardiographic variable that increases with class of heart failure and may help discriminate dogs in CHF from asymptomatic dogs with DMVD. Additional studies are required to determine whether PV/PA might provide additional information in the integrated interpretation of Doppler-echocardiographic indices of left ventricular filling pressures and could be used for rapid assessment of CHF in dogs in a critical care setting.
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
authors.forename: A-C
authors.initials: AC
authors.lastname: Merveille
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Bolen
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Krafft
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Roels
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.|Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Gomart
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
authors.forename: A-L
authors.initials: AL
authors.lastname: Etienne
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Clercx
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.|Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Mc Entee
mesh_terms: D000818:Animals; D016022:Case-Control Studies; D004283:Dog Diseases / Q000473:pathology*; D004285:Dogs; D004452:Echocardiography / Q000662:veterinary*; D006333:Heart Failure / Q000473:pathology / Q000662:veterinary*; D008944:Mitral Valve Insufficiency / Q000473:pathology / Q000662:veterinary*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Canine; Congestion; Diagnosis; Pulmonary vein