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Background  Noninvasive diagnosis of pulmonary hypertension ( PH ) primarily relies upon Doppler echocardiography of tricuspid regurgitation ( TR ). However,  TR  might be absent or difficult to measure.    Hypothesis/Objectives  To determine the diagnostic value of right pulmonary artery distensibility ( RPAD ) index for prediction of Doppler‐derived estimates of pulmonary artery ( PA ) pressure compared to other indices of  PH  in dogs.    Animals  Sixty‐nine client‐owned dogs with  TR .    Methods  Prospective observational study. Dogs were allocated to groups according to  TR  pressure gradient ( TRPG ):  TRPG  <36 mmHg (control, n = 22),  TRPG  36–50 (n = 16),  TRPG  50–75 (n = 14) and  TRPG  >75 mmHg (n = 17). Right pulmonary artery distensibility index, acceleration time to peak  PA  flow ( AT ),  AT : ejection time of  PA  flow ( AT : ET ) and main  PA  size: aorta size ( MPA :Ao) were calculated in each dog.    Results  Right pulmonary artery distensibility index demonstrated the strongest correlation ( r  = −0.90;  P  < .0001) to  TRPG  followed by  MPA :Ao ( r  = 0.78;  P  < .0001),  AT  ( r  = −0.69;  P  < .0001) and  AT : ET  ( r  = −0.68;  P  < .0001).  RPAD  index possessed the most accurate cutoff (<29.5%; Sensitivity [Sn] 0.84, Specificity [Sp] 0.95) to predict  TRPG  >50 mmHg compared to  AT  (<53.9 ms; Sn 0.74, Sp 0.87),  AT : ET  (<0.30; Sn 0.61, Sp 0.97) and  MPA :Ao (>1.04; Sn 0.94, Sp 0.74). All intra‐ and interobserver measurement variabilities exhibited coefficients of variation ≤13%.    Conclusions and Clinical Importance  Right pulmonary artery distensibility index is an accurate predictor of  TRPG  and should be particularly useful if  TR  is absent or difficult to measure.

journal of veterinary internal medicine

Diagnostic Value of Right Pulmonary Artery Distensibility Index in Dogs with Pulmonary Hypertension: Comparison with Doppler Echocardiographic Estimates of Pulmonary Arterial Pressure