Pulsed-wave Doppler ultrasonographic evaluation of hepatic vein in dogs with tricuspid regurgitation

This study was performed to identify the relationships between hepatic vein (HV) measurements, including flow velocity and waveform, using pulsed-wave (PW) Doppler ultrasonography, and the severity of tricuspid regurgitation (TR) in dogs. The study included 22 dogs with TR and 7 healthy dogs. The TR group was subdivided into 3 groups according to TR jet profile obtained by echocardiography. The hepatic venous waveform was obtained and classified into 3 types. A variety of HV measurements, including the maximal velocities of the atrial systolic, systolic (S), end ventricular systolic, and diastolic (D) waves and the ratio of the S- and D- wave velocities (S/D ratio), were acquired. TR severity was significantly correlated with the S- (r = -0.380, p = 0.042) and D- (r = 0.468, p = 0.011) wave velocities and the S/D ratio (r = -0.747, p ＜ 0.001). Receiver operating characteristic curve analysis revealed the highest sensitivity and specificity for the S/D ratio (89% and 75%, respectively) at a threshold of 0.97 with excellent accuracy (AUC = 0.911, p ＜ 0.001). In conclusion, PW Doppler ultrasonography of the HV can be used to identify the presence of significant TR and to classify TR severity in dogs.