Usefulness of the Indexed Effective Orifice Area in the Assessment of Subaortic Stenosis in the Dog

Abstract

To evaluate the usefulness of the Doppler-derived effective orifice area (EOA) in assessing the hemodynamic severity of subaortic stenosis (SAS) in dogs, 2-dimensional and Doppler echocardiographic examinations were performed in 16 dogs with SAS, 22 normal adult dogs, and 22 normal puppies. The EOA was calculated by the continuity equation using the stroke volume determined in the right ventricular outflow tract. The EOA was significantly lower (P < .001 ) in the SAS dogs (0.76+/-0.45 cm2) and in the normal puppies (1.58+/-1.00 cm2) than in the normal adult dogs (2.34+/-0.78 cm2). The EOA indexed for body surface area (IEOA) was significantly lower (0.89+/-0.48 cm2/m2) in SAS dogs than in the normal puppies (2.42+/-0.85 cm2/m2) or adults (2.22+/-0.76 cm2/m2). The normal dogs (adults and puppies) had an IEOA of > or =1.25 cm2/m2. Among the demographic and echocardiographic parameters measured in this study, only the indexed EOA was significantly associated (P = .03) with the occurrence of adverse events (eg, syncope, episodic weakness, ventricular arrhythmias). This study demonstrates the usefulness and feasibility of the indexed EOA as measured by Doppler echocardiography for noninvasive assessment of SAS severity in dogs.