Right Ventricle Strain Assessed by 2-Dimensional Speckle Tracking Echocardiography (2D-STE) to Evaluate Pulmonary Hypertension in Dogs with Dirofilaria immitis

Abstract

Echocardiographic assessment of the right ventricle is helpful for analysing the pathophysiology of heartworm disease and detecting pulmonary hypertension (PH) in dogs. In veterinary cardiology, the study of myocardial deformation using two-dimensional speckle tracking (2D-STE) echocardiography has become increasingly acknowledged as useful for quantifying right ventricular function. The aim of this study was to evaluate the usefulness of myocardial deformation strain of the right ventricular free wall (FWS), global deformation strain of the right ventricle, including the interventricular septum (GS), and tissue motion annular displacement of the tricuspid valve (TMAD) in a cohort of dogs with heartworm (Dirofilaria immitis) disease and to determine cut-off values for detecting the presence of PH. Out of the 93 dogs tested, 71% were diagnosed with heartworm infection. PH was identified in 41% of the infected dogs following the American College of Veterinary Internal Medicine (ACVIM) guidelines, based on the peak tricuspid regurgitation velocity to calculate the tricuspid regurgitation pressure gradient (TRPG), while other routine measurements were used, including the right pulmonary artery distensibility index (RPADi). The 2D-STE mode measurements were determined using Right Ventricular Automated Function Imaging (RV AFI®) software. The statistical analysis showed significant differences in the studied parameters among dogs with and without PH. Additionally, sensitivity (sen) and specificity (sp) cut-off values were obtained (GS ≥ −21.25%, sen 96%, sp 86.4%; FWS ≥ −21.95%, sen 92.56%, sp 95.5%; TMAD ≤ 0.85 cm, sen 70.4%, sp 83.3%). These results demonstrated that GS, FWS, and TMAD could be used as supplementary and alternative variables to conventional echocardiographic measurements when detecting PH in dogs with heartworm disease.

Simple Summary: The development of new echocardiographic techniques, such as two-dimensional speckle tracking echocardiography and assessment of longitudinal myocardial deformation, may be new alternative tools to analyse the presence and severity of pulmonary hypertension in heartworm disease. A total of 93 dogs were used, of which 71% were diagnosed with heartworm infection and 41% were found to have PH. The measurements evaluated were obtained using Right Ventricular Automated Function Imaging (RV AFI®) software. The results showed significant differences between animals with and without pulmonary hypertension. Cut-off values with high sensitivity and specificity were also obtained for the detection of pulmonary hypertension in the animals analysed. Echocardiographic measurements for functional assessment of the right ventricle using myocardial longitudinal strain have demonstrated their usefulness in heartworm-infected dogs.