Abstract：
BACKGROUND: Hemodynamic classification of pulmonary hypertension (PH) has important clinical implications. However, only a few echocardiographic variables have been used to hemodynamically classify PH in dogs.
OBJECTIVE: To evaluate the echocardiographic pulmonary to left atrial ratio index (ePLAR) in dogs with PH.
METHODS: Forty-six dogs with intermediate to high probability of PH.
METHODS: Cross-sectional study. Variables were compared between dogs with precapillary PH [PrePH (n = 24)] vs postcapillary PH [PostPH (n = 22)], and with combined PH [CombPH (n = 14)] vs isolated PH [IsoPH (n = 8)] using the t-, Mann-Whitney, Pearson\'s Chi, or Fisher\'s exact test. The receiver operating characteristic curve and Youden index were used to identify the optimal ePLAR cutoff value to differentiate among the groups, intraclass correlation coefficients (ICC) were used to determine the reliability of measurements.
RESULTS: The mean (SD) ePLAR of the PrePH was higher than that of the PostPH group [0.36 (0.13) vs 0.26 (0.09), respectively; P = .005]. The median (interquartile range) ePLAR of the CombPH was higher than that of the IsoPH subgroup [0.29 (0.24-0.38), vs 0.20 (0.16-0.23), respectively; P = .001]. The best cutoff value of ePLAR for identifying IsoPH was <0.245 [AUC at cutoff point = 0.86; sensitivity (95% confidence interval [CI]) = 0.71 (0.47-0.95); specificity (95% CI) = 1 (0.76-1)]. The ICC analysis indicated a high degree of reliability.
CONCLUSIONS: ePLAR can be considered a valid noninvasive variable to hemodynamically classify PH in dogs with an intermediate to high probability of PH. Assessment of ePLAR can be useful in the therapeutic management of PH in dogs.
OBJECTIVE: To evaluate the echocardiographic pulmonary to left atrial ratio index (ePLAR) in dogs with PH.
METHODS: Forty-six dogs with intermediate to high probability of PH.
METHODS: Cross-sectional study. Variables were compared between dogs with precapillary PH [PrePH (n = 24)] vs postcapillary PH [PostPH (n = 22)], and with combined PH [CombPH (n = 14)] vs isolated PH [IsoPH (n = 8)] using the t-, Mann-Whitney, Pearson\'s Chi, or Fisher\'s exact test. The receiver operating characteristic curve and Youden index were used to identify the optimal ePLAR cutoff value to differentiate among the groups, intraclass correlation coefficients (ICC) were used to determine the reliability of measurements.
RESULTS: The mean (SD) ePLAR of the PrePH was higher than that of the PostPH group [0.36 (0.13) vs 0.26 (0.09), respectively; P = .005]. The median (interquartile range) ePLAR of the CombPH was higher than that of the IsoPH subgroup [0.29 (0.24-0.38), vs 0.20 (0.16-0.23), respectively; P = .001]. The best cutoff value of ePLAR for identifying IsoPH was <0.245 [AUC at cutoff point = 0.86; sensitivity (95% confidence interval [CI]) = 0.71 (0.47-0.95); specificity (95% CI) = 1 (0.76-1)]. The ICC analysis indicated a high degree of reliability.
CONCLUSIONS: ePLAR can be considered a valid noninvasive variable to hemodynamically classify PH in dogs with an intermediate to high probability of PH. Assessment of ePLAR can be useful in the therapeutic management of PH in dogs.
摘要：
背景：肺动脉高压（PH）的血流动力学分类具有重要的临床意义。然而,只有少数超声心动图变量已用于对狗的PH进行血液动力学分类。
目的：评估PH犬的超声心动图肺与左心房比值指数（ePLAR）。
方法：46只PH概率中等到高的狗。
方法：横断面研究。比较了毛细血管前PH[PrePH（n=24）]与毛细血管后PH[PostPH（n=22）]的狗之间的变量，并且使用t-，组合PH[CombPH（n=14）]与分离PH[IsoPH（n=8）]，Mann-Whitney,皮尔森的志，或者费希尔的精确检验。受试者工作特征曲线和Youden指数用于确定最佳ePLAR截止值，以区分各组，使用组内相关系数(ICC)来确定测量的可靠性.
结果：前PH组的平均值（SD）高于后PH组[0.36（0.13）对0.26（0.09），分别为；P=0.005]。CombPH的中位数（四分位距）ePLAR高于IsoPH亚组[0.29（0.24-0.38），vs.0.20（0.16-0.23），分别为；P=.001]。用于鉴定IsoPH的ePLAR的最佳截断值为<0.245[截止点AUC=0.86;灵敏度(95%置信区间[CI])=0.71(0.47-0.95);特异性(95%CI)=1(0.76-1)]。ICC分析表明具有高度的可靠性。
结论：ePLAR可以被认为是一种有效的非侵入性变量，可以对狗的PH进行血液动力学分类，其中PH的概率为中等到高。ePLAR的评估可用于狗的PH的治疗管理。
目的：评估PH犬的超声心动图肺与左心房比值指数（ePLAR）。
方法：46只PH概率中等到高的狗。
方法：横断面研究。比较了毛细血管前PH[PrePH（n=24）]与毛细血管后PH[PostPH（n=22）]的狗之间的变量，并且使用t-，组合PH[CombPH（n=14）]与分离PH[IsoPH（n=8）]，Mann-Whitney,皮尔森的志，或者费希尔的精确检验。受试者工作特征曲线和Youden指数用于确定最佳ePLAR截止值，以区分各组，使用组内相关系数(ICC)来确定测量的可靠性.
结果：前PH组的平均值（SD）高于后PH组[0.36（0.13）对0.26（0.09），分别为；P=0.005]。CombPH的中位数（四分位距）ePLAR高于IsoPH亚组[0.29（0.24-0.38），vs.0.20（0.16-0.23），分别为；P=.001]。用于鉴定IsoPH的ePLAR的最佳截断值为<0.245[截止点AUC=0.86;灵敏度(95%置信区间[CI])=0.71(0.47-0.95);特异性(95%CI)=1(0.76-1)]。ICC分析表明具有高度的可靠性。
结论：ePLAR可以被认为是一种有效的非侵入性变量，可以对狗的PH进行血液动力学分类，其中PH的概率为中等到高。ePLAR的评估可用于狗的PH的治疗管理。
