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pulmonary findings and clinical status. The aim of this study was to evaluate the
risk for developing PAH in symptomatic dogs naturally infected with
L. infantum
living in an endemic area by means of doppler echocardiography. In particular, in
the absence of a regurgitant flow across the tricuspid and/or pulmonic valve,
indirect-PAH markers were evaluated, including the AT, AT/ET, right ventricular
Tei index, and pulmonary velocity profiles.
20.2 Materials and Methods
Dogs of different ages, sexes, and breeds referred at the Veterinary Teaching
Hospital of the University of Bari (Italy) with a diagnosis of
L. infantum
infection
as determined by microscopic detection of amastigotes on lymph-nodal smears
were selected for this study. A clinical examination was performed on each dog,
and blood samples were collected during routine laboratory exams. A conventional
echocardiographic and Doppler examination was performed on all selected
animals. An Esaote Mylab 30 ultrasonic diagnostic apparatus (Medmark-Esaote,
Italia) equipped with a 2.5-3.5 MHz cardiologic probe was used. All ultrasono-
graphic examinations were registered and the presence of two-dimensional findings
of PAH as well as the presence and velocity of tricuspid and/or pulmonary valve
regurgitant jets for systolic and diastolic pulmonary arterial pressure estimation
were reported.
In the absence of echocardiographic findings indicative of moderate to severe
PAH and in the absence of discernable tricuspid and/or pulmonary valve regurgitant
jets, the AT index was determined and the AT/ET ratio was calculated to estimate
pulmonary artery pressure. Furthermore, the Tei index was calculated and the
pulmonary artery Doppler flow pattern profile was evaluated and classified as
previously described (Johnson et al.
1999
). The pulmonary flow velocity profile
and the AT and ET measurements were recorded from the standard right parasternal
short axis view at the basal level. AT and ET values were measured from the onset
of pulsed Doppler flow to peak flow velocity and from the onset to the end of the
pulsed Doppler flow, respectively. The Tei index was calculated using the formula
(
I
ET)/ET, where
I
is the interval between cessation and the onset of tricuspid
inflow and was assessed using the left apical four-chamber view.
20.3 Results
Preliminary results were obtained from 10 symptomatic dogs with diagnoses of
leishmaniasis without previous treatment histories. Two dogs showed a left systolic
murmur at cardiac auscultation, and the echocardiographic exam permitted a
diagnosis of degenerative mitral valve disease. Neither two-dimensional echocar-
diographic findings of PAH (i.e., enlarged right ventricle, flattened interventricular
