J Vet Sci.  2016 Jun;17(2):243-251. 10.4142/jvs.2016.17.2.243.

Correlation between caudal pulmonary artery diameter to body surface area ratio and echocardiography-estimated systolic pulmonary arterial pressure in dogs

• Lee Y
• Choi W
• Lee D
• Chang J
• Kang JH
• Choi J
• Chang D

• KMID: 2413174
• DOI: http://doi.org/10.4142/jvs.2016.17.2.243

Abstract

Caudal pulmonary artery diameter (CPAD) to body surface area (BSA) ratios were measured in ventrodorsal thoracic radiographs to assess the correlation between CPAD to BSA ratios and systolic pulmonary arterial pressure (PAP) in dogs. Thoracic radiographs of 44 dogs with systolic pulmonary arterial hypertension (PAH) and 55 normal dogs were evaluated. Systolic PAP was estimated by Doppler echocardiography. CPADs were measured at their largest point at the level of tracheal bifurcation on ventrodorsal radiographs. Both right and left CPAD to BSA ratios were significantly higher in the PAH group than in the normal group (p < 0.0001). Linear regression analysis showed positive associations between PAP and right and left CPAD to BSA ratio (right, p = 0.0230; left, p = 0.0012). The receiver operating characteristic curve analysis revealed that the CPAD to BSA ratio had moderate diagnostic accuracy for detecting PAH. The operating point, sensitivity, specificity, and area under the curve were 28.35, 81.40%, 81.82%, and 0.870; respectively, for the right side and 26.92, 80.00%, 66.67%, and 0.822, respectively, for the left. The significant correlation of CPAD to BSA ratio with echocardiography-estimated systolic PAP supports its use in identifying PAH on survey thoracic radiographs in dogs.

Keyword

body surface area; caudal pulmonary artery; dog; echocardiography; pulmonary hypertension

MeSH Terms

Animals
Body Surface Area/*veterinary
Dog Diseases/*diagnostic imaging
Dogs
Echocardiography, Doppler/veterinary
Hypertension, Pulmonary/diagnostic imaging/*veterinary
Pulmonary Artery/*anatomy & histology
ROC Curve
Reference Values
Republic of Korea
Retrospective Studies
Sensitivity and Specificity

Figure

• 

  Fig. 1 Measurement of the left and right caudal pulmonary artery diameter. The maximum diameter (black arrows) of the right and left caudal lobe pulmonary arteries at the level of the first bifurcation of the trachea were measured on ventrodorsal thoracic radiographs. A, caudal pulmonary artery; B, caudal lobe main bronchus; V, caudal pulmonary vein.

• 

  Fig. 2 Box and whisker plots of the left (A) and right (B) caudal pulmonary artery diameter (CPAD) to body surface area (BSA) ratios in dogs with and without pulmonary arterial hypertension (PAH). Based on the Mann-Whitney U test, the left and right CPAD to BSA ratios were significantly higher in dogs in the PAH group than in the normal group (p < 0.0001). Box and whisker plots exhibit the entire range of data. The box encompasses the 25th–75th percentiles surrounding the median (indicated by the line within the box) and whiskers represent the upper and lower quartiles. A cross shows the mean value.

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  Fig. 3 Box and whisker plots of the left (A) and right (B) caudal pulmonary artery diameter (CPAD) to body surface area (BSA) ratios in normal dogs and dogs categorized according to severity of pulmonary arterial hypertension (PAH). Based on Dunn's multiple comparison test, the left and right CPAD to BSA ratios were significantly higher in dogs in the moderate and severe PAH groups than in the normal group. Box and whisker plots exhibit the entire range of data. The box encompasses the 25th–75th percentiles surrounding the median (indicated by the line within the box) and whiskers represent the upper and lower quartiles. A cross shows the mean value.

• 

  Fig. 4 Correlation between systolic pulmonary arterial pressure (PAP) and left (A) and right (B) caudal pulmonary artery diameter (CPAD) to body surface area (BSA) ratios. Scatter plots for systolic PAP and both CPAD to BSA ratios were drawn, and predicted linear regression lines were developed. Linear regression analysis showed positive associations between systolic PAP and both left and right CPAD to BSA ratios in the pulmonary arterial hypertension group (p = 0.0012, p = 0.0230, respectively). However, goodness of fit was low in both left and right CPAD to BSA ratios (R2 = 0.2447, R2 = 0.1197, respectively).

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  Fig. 5 Receiver operating characteristic curves of the left (A) and right (B) caudal pulmonary artery diameter (CPAD) to body surface area (BSA) ratio. The left and right areas under the curves were 0.822 and 0.870, respectively. The left and right CPAD to BSA ratios had good diagnostic accuracy for detecting pulmonary arterial hypertension. The area under the curve was used as the following scales: excellent, 0.90–1.0; good, 0.80–0.90; fair, 0.70–0.80; poor, 0.60–0.70; and fail, 0.50–0.60.

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