Comparison of peak flow velocity through the left ventricular outflow tract and effective orifice area indexed to body surface area in Golden Retriever puppies to predict development of subaortic stenosis in adult dogs.

Abstract

Objective — To evaluate the usefulness of Doppler-derived peak flow velocity through the left ventricular outflow tract (LVOT Vmax) and effective orifice area indexed to body surface area (EOAi) in puppies to predict development of subaortic stenosis (SAS) in the same dogs as adults. Design — Prospective, longitudinal, observational study. Animals — 38 Golden Retrievers. Procedures — Cardiac auscultation and echocardiography were performed on 2- to 6-monthold puppies, then repeated at 12 to 18 months. Subaortic stenosis was diagnosed when LVOT Vmax was = 2.3 m/s in adult dogs with left basilar systolic murmurs. Results—All puppies with EOAi < 1.46 cm2/m2 had SAS as adults. All adults with EOAi <1.29 cm2/m2 had SAS. An LVOT Vmax > 2.3 m/s in puppyhood was 63% sensitive and 100% specific for SAS in adulthood. In puppies, LVOT Vmax was more strongly associated with a future diagnosis of SAS (area under the curve [AUC], 0.89) than was EOAi (AUC, 0.80). In puppies, the combination of LVOT Vmax and EOAi yielded slightly higher sensitivity (69%) and specificity (100%) for adult SAS than did LVOT Vmax alone. In unaffected and affected dogs, LVOT Vmax increased significantly from puppyhood to adulthood but EOAi did not. Conclusions and Clinical Relevance — In Golden Retriever puppies, LVOT Vmax > 2.3 m/s and EOAi < 1.46 cm2/m2 were both associated with a diagnosis of SAS at adulthood. The combination of these 2 criteria may result in higher sensitivity for SAS screening. Unlike LVOT Vmax, EOAi did not change during growth in either unaffected Golden Retrievers or those with SAS. (J Am Vet Med Assoc 2014;245:1367–1374