Open AccessDiagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation
Author(s) -
Boegli Julia,
Schwarzwald Colin C.,
Mitchell Katharyn J.
Publication year - 2019
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.15494
Subject(s) - warmblood , medicine , horse , receiver operating characteristic , cardiology , confidence interval , mitral regurgitation , area under the curve , nuclear medicine , paleontology , biology
Background Noninvasive blood pressures (NIBP) and pulse pressures (PP) have not been published in horses with aortic and mitral regurgitation (AR or MR). Objectives To investigate NIBP and PP in healthy Warmblood horses and horses with AR and MR and propose PP cutoffs to identify and stage AR severity. Animals Seventy‐three Warmblood horses (healthy, 10; AR, 31; MR, 32). Methods Retrospective study. All horses had NIBP and an echocardiogram recorded. Cases were categorized based on severity of regurgitation. Pulse pressures were compared among healthy, MR, and AR groups and among AR severity groups. Cutoffs were determined by receiver operating characteristic curve analyses. Results Horses with AR had higher PP than horses with MR (mean difference [95% confidence interval (CI)], +17 [9‐26] mm Hg, P < .001) and controls (+17 [5‐30] mm Hg; P =.004). Horses with severe AR had higher PP compared those with mild (+38 [20‐54] mm Hg; P < 0.001) and moderate AR (+33 [18‐47] mm Hg; P < .001). The PP cutoffs to distinguish AR from MR and controls were 38 mm Hg (sensitivity [Sn], 100%; specificity [Sp], 19%) for maximal Sn and 61 mm Hg (Sn, 43%; Sp, 100%) for maximal Sp. The PP cutoffs to distinguish severe AR from mild and moderate AR were 57 mm Hg (Sn, 100%; Sp, 70%) for maximal Sn and 77 mm Hg (Sn, 75%; Sp, 100%) for maximal Sp. Conclusions and Clinical Importance Horses with AR have increased PP. Noninvasive PP measurements interpreted with provided cutoffs may aid clinicians in diagnosing and staging severity of AR in horses.