J Vet Sci.  2017 Mar;18(1):73-79. 10.4142/jvs.2017.18.1.73.

Pulsed-wave Doppler ultrasonographic evaluation of hepatic vein in dogs with tricuspid regurgitation

• Kim J
• Kim S
• Eom K

• KMID: 2412590
• DOI: http://doi.org/10.4142/jvs.2017.18.1.73

Abstract

This study was performed to identify the relationships between hepatic vein (HV) measurements, including flow velocity and waveform, using pulsed-wave (PW) Doppler ultrasonography, and the severity of tricuspid regurgitation (TR) in dogs. The study included 22 dogs with TR and 7 healthy dogs. The TR group was subdivided into 3 groups according to TR jet profile obtained by echocardiography. The hepatic venous waveform was obtained and classified into 3 types. A variety of HV measurements, including the maximal velocities of the atrial systolic, systolic (S), end ventricular systolic, and diastolic (D) waves and the ratio of the S- and D- wave velocities (S/D ratio), were acquired. TR severity was significantly correlated with the S- (r = −0.380, p = 0.042) and D- (r = 0.468, p = 0.011) wave velocities and the S/D ratio (r = −0.747, p < 0.001). Receiver operating characteristic curve analysis revealed the highest sensitivity and specificity for the S/D ratio (89% and 75%, respectively) at a threshold of 0.97 with excellent accuracy (AUC = 0.911, p < 0.001). In conclusion, PW Doppler ultrasonography of the HV can be used to identify the presence of significant TR and to classify TR severity in dogs.

Keyword

dogs; hepatic veins; pulsed-wave Doppler ultrasonography; tricuspid regurgitation

MeSH Terms

Animals
Dog Diseases/*diagnostic imaging/physiopathology
Dogs
Female
Hepatic Veins/*diagnostic imaging
Male
Tricuspid Valve Insufficiency/diagnostic imaging/physiopathology/*veterinary
Ultrasonography, Doppler, Pulsed/*veterinary

Figure

• 

  Fig. 1 Pulsed-wave Doppler waveform of the hepatic vein in a normal dog, with simultaneous electrocardiography recording. Four wave components are noted in the normal tetraphasic waveform. A, atrial systolic wave; S, systolic wave; V, ventricular systolic wave; D, diastolic wave.

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  Fig. 2 B-mode with a color Doppler image of the quadrate and right medial hepatic veins. The Doppler gate is placed within the quadrate hepatic vein with 1.5 mm of sample volume. Note the location of the two blood vessels and the gall bladder (GB), and the parallel relationship between the Doppler beam and the quadrate hepatic vein (QHV). RMHV, right medial hepatic vein.

• 

  Fig. 3 Three types of hepatic venous flow patterns in dogs with tricuspid regurgitation (TR). (A) Type 1 (normal systolic dominance) waveform with mild TR. (B and C) Type 2 (systolic blunting) waveform with moderate TR and the ventricular systolic (V)-waves of various sizes. (D) Type 3 (systolic reversed) waveform with severe TR. Note that the atrial systolic (A)-, systolic (S)-, and V-waves are fused and show a large retrograde pulse. D, diastolic wave.

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