Evaluation of Pulse Pressure as a Hemodynamic Marker of Cardiac Disease in Dogs and Horses Undergoing Pre-Anesthetic Assessment.
Abstract: Pulse pressure (PP) reflects ventricular stroke volume and arterial compliance, but its utility as a marker of cardiac disease in animals is not well established. This study evaluated the association between PP and echocardiographically confirmed cardiac abnormalities in dogs and horses and assessed its potential in pre-anesthetic evaluation. Clinical and echocardiography examination of 20 dogs and 20 horses was sufficient for inter-group comparisons and assignments to a Cardiac group (echocardiographically confirmed cardiac disease) or a Control group (healthy animals). Non-invasive oscillometric blood pressure was measured, and PP was calculated. Animals with cardiac abnormalities showed significantly higher PP but not mean arterial blood pressure (MAP) compared with healthy subjects. In horses, PP was approximately 22 mmHg higher in the Cardiac group ( = 0.042), while in dogs, the increase was 25 mmHg ( < 0.001). Regression analysis confirmed cardiac status as an independent predictor of elevated PP ( = 0.001) with excellent and good discriminatory performance between healthy and diseased dogs (AUC = 0.90; 95% CI: 0.77-1.00) and healthy and diseased horses (AUC = 0.81; 95% CI: 0.61-1.00), respectively. These results suggest that PP may serve as a sensitive and practical hemodynamic indicator of underlying cardiac disease.
Publication Date: 2026-02-12 PubMed ID: 41751029PubMed Central: PMC12937357DOI: 10.3390/ani16040569Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Cite This Article
APA
Lutvikadic I, Preldzic D, Floriano D, Hopster K.
(2026).
Evaluation of Pulse Pressure as a Hemodynamic Marker of Cardiac Disease in Dogs and Horses Undergoing Pre-Anesthetic Assessment.
Animals (Basel), 16(4), 569.
https://doi.org/10.3390/ani16040569 Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Rd., Kennett Square, PA 19348, USA.
- Department of Clinical Science, Veterinary Faculty, University of Sarajevo, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina.
- Department of Clinical Science, Veterinary Faculty, University of Sarajevo, Zmaja od Bosne 90, 71000 Sarajevo, Bosnia and Herzegovina.
- Department of Clinical Studies and Advanced Medicine, Matthew J. Ryan Hospital, School of Veterinary Medicine, University of Pennsylvania, 2900 Spruce St., Philadelphia, PA 19104, USA.
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Rd., Kennett Square, PA 19348, USA.
Conflict of Interest Statement
The authors declare no conflicts of interest.
References
This article includes 32 references
- Brodbelt D.C., Flaherty D., Pettifer G.R. Anesthetic Risk and Informed Consent. In: Grimm K.A., Lamont L.A., Tranquilli W.J., Greene S.A., Robertson S.A., editors. Veterinary Anesthesia and Analgesia. 5th ed. John Wiley & Sons, Inc.; Hoboken, NJ, USA: 2015. pp. 11–22.
- Thomas J.A., Lerche P. Anesthesia and Analgesia for Veterinary Technicians. 5th ed. Elsevier; St. Louis, MO, USA: 2017. Patient preparation; pp. 7–51.
- Mitchell K., Barletta M., Quandt J., Shepard M., Kleine S., Hofmeister E. Effect of routine pre-anesthetic laboratory screening on pre-operative anesthesia-related decision-making in healthy dogs. Can. Vet. J. 2018;59:773–778.
- Ateca L.B., Reineke E.L., Drobatz K.J. Evaluation of the relationship between peripheral pulse palpation and Doppler systolic blood pressure in dogs presenting to an emergency service. J. Vet. Emerg. Crit. Care. 2018;28:226–231. doi: 10.1111/vec.12718.
- Stepien R.L., Gregg S.R. Clinical comparison of three methods to measure blood pressure in nonsedated dogs. J. Am. Vet. Med. Assoc. 1999;215:1623–1628. doi: 10.2460/javma.1999.215.11.1623.
- Muir W.W. Cardiovascular Physiology. In: Lamont L., Grimm K., Robertson S., Love L., Schroeder C., editors. Veterinary Anesthesia and Analgesia. 6th ed. Wiley-Blackwell, Inc.; Hoboken, NJ, USA: 2024. pp. 615–660.
- Odette O. Blood Pressure Monitoring. In: Lamont L., Grimm K., Robertson S., Love L., Schroeder C., editors. Veterinary Anesthesia and Analgesia. 6th ed. Wiley-Blackwell, Inc.; Hoboken, NJ, USA: 2024. pp. 197–208.
- Boegli J., Schwarzwald C.C., Mitchell K.J. Diagnostic value of noninvasive pulse pressure measurements in Warmblood horses with aortic regurgitation. J. Vet. Intern. Med. 2019;33:1446–1455. doi: 10.1111/jvim.15494.
- Suvarna J. Watson’s water hammer pulse. J. Postgrad. Med. 2008;54:163–165. doi: 10.4103/0022-3859.40791.
- Maurer G. Aortic regurgitation. Heart. 2006;92:994–1000. doi: 10.1136/hrt.2004.042614.
- Folts J., Rowe G. Coronary and hemodynamic effects of temporary acute aortic insufficiency in intact anesthetized dogs. Circ. Res. 1974;35:238–246. doi: 10.1161/01.RES.35.2.238.
- Avolio A.P., Kuznetsova T., Heyndrickx G.R., Kerkhof P.L.M., Li J.K. Arterial Flow, Pulse Pressure and Pulse Wave Velocity in Men and Women at Various Ages. Adv. Exp. Med. Biol. 2018;1065:153–168. doi: 10.1007/978-3-319-77932-4_10.
- Bonow R., Rosing D., Mcintosh C., Jones M., Maron B.J., Lan K.K., Lakatos E., Bacharach S.L., Green M.V., Epstein S.E. The natural history of asymptomatic patients with aortic regurgitation and normal left ventricular function. Circulation. 1983;68:509–517. doi: 10.1161/01.CIR.68.3.509.
- Franklin S., Khan S., Wong N., Larson M.G., Levy D. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham heart study. Circulation. 1999;100:354–360. doi: 10.1161/01.CIR.100.4.354.
- Blacher J., Staessen J.A., Girerd X., Gasowski J., Thijs L., Liu L., Wang J.G., Fagard R.H., Safar M.E. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch. Intern. Med. 2000;160:1085–1089. doi: 10.1001/archinte.160.8.1085.
- Homan T.D., Bordes S.J., Cichowski E. Physiology, Pulse Pressure. StatPearls; Treasure Island, FL, USA: 2023. [(accessed on 28 December 2025)]. Available online: https://www.ncbi.nlm.nih.gov/books/NBK482408/
- Blacher J., Evans A., Arveiler D., Amouyel P., Ferrières J., Bingham A., Yarnell J., Haas B., Montaye M., Ruidavets J.B., et al. PRIME Study Group. Residual Cardiovascular Risk in Treated Hypertension and Hyperlipidaemia: The PRIME study. J. Hum. Hypertens. 2010;24:19–26. doi: 10.1038/jhh.2009.34.
- Moyá-Amengual A., Ruiz-García A., Pallarés-Carratalá V., Serrano-Cumplido A., Prieto-Díaz M.Á., Segura-Fragoso A., Cinza-Sanjurjo S. The Researchers of the IBERICAN Study. Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study. Front. Cardiovasc. Med. 2023;10:1090458. doi: 10.3389/fcvm.2023.1090458.
- Melgarejo J.D., Thijs L., Wei D.M., Bursztyn M., Yang W.Y., Li Y., Asayama K., Hansen T.W., Kikuya M., Ohkubo T., et al. Relative and Absolute Risk to Guide the Management of Pulse Pressure, an Age-Related Cardiovascular Risk Factor. Am. J. Hypertens. 2021;34:929–938. doi: 10.1093/ajh/hpab048.
- Fielding C.L., Stolba D.N. Pulse pressure variation and systolic pressure variation in horses undergoing general anesthesia. J. Vet. Emerg. Crit. Care. 2012;22:372–375. doi: 10.1111/j.1476-4431.2012.00746.x.
- Fantoni D.T., Ida K.K., Gimenes A.M., Mantovani M.M., Castro J.R., Patrício G.C.F., Ambrósio A.M., Otsuki D.A. Pulse pressure variation as a guide for volume expansion in dogs undergoing orthopedic surgery. Vet. Anaesth. Analg. 2017;44:710–718. doi: 10.1016/j.vaa.2016.11.011.
- Kim D., Son W.G., Shin D., Kim J., Lee I. Effect of the respiratory rate on the pulse pressure variation induced by hemorrhage in anesthetized dogs. J. Vet. Sci. 2022;23:e68. doi: 10.4142/jvs.22090.
- Dalmagro T.L., Teixeira-Neto F.J., Celeita-Rodrígez N., Garofalo N.A., López-Castañeda B., do Nascimento-Junior P. Comparison between pulse pressure variation and systolic pressure variation measured from a peripheral artery for accurately predicting fluid responsiveness in mechanically ventilated dogs. Vet. Anaesth. Analg. 2021;48:501–508. doi: 10.1016/j.vaa.2021.01.009.
- Boysen S.R., Gommeren K. Assessment of Volume Status and Fluid Responsiveness in Small Animals. Front. Vet. Sci. 2021;28:630643. doi: 10.3389/fvets.2021.630643.
- Araos J., Kenny J.S., Rousseau-Blass F., Pang D.S. Dynamic prediction of fluid responsiveness during positive pressure ventilation: A review of the physiology underlying heart-lung interactions and a critical interpretation. Vet. Anaesth. Analg. 2020;47:3–14. doi: 10.1016/j.vaa.2019.08.004.
- Boon J.A. Veterinary Echocardiography. 2nd ed. Wiley-Blackwell; Chichester, UK: 2011. The two-dimensional echocardiographic exam; pp. 54–138.
- de Madron E. Normal Views: 2D, TM, Spectral, and Color Doppler. In: de Madron E., Chetboul V., Bussadori C., editors. Clinical Echocardiography of the Dog and Cat. Elsevier Masson; St. Louis, MO, USA: 2015. pp. 3–19.
- Cornell C.C., Kittleson M.D., Torre P.D., Häggström J., Lombard C.W., Pedersen H.D., Vollmar A., Wey A. Allometric Scaling of M-mode Cardiac Measurements in Normal Adult Dogs. J. Vet. Intern. Med. 2004;18:311–321. doi: 10.1111/j.1939-1676.2004.tb02551.x.
- Tang K.S., Medeiros E.D., Shah A.D. Wide pulse pressure: A clinical review. J. Clin. Hypertens. 2020;22:1960–1967. doi: 10.1111/jch.14051.
- Brown S.A. Hypertension, Heart Failure, and Shock. In: Reece W.O., editor. Dukes’ Physiology of Domestic Animals. 13th ed. Wiley Blackwell; Ames, IA, USA: 2015. pp. 429–442.
- Bonagura J.D., Stepien R.L. Vascular Diseases. In: Birchard S.J., Sherding R.G., editors. Saunders Manual of Small Animal Practice. 3rd ed. Saunders Elsevier; St. Louis, MO, USA: 2006. pp. 1574–1588.
- Thomas J.A., Lerche P. Anesthesia and Analgesia for Veterinary Technicians. 5th ed. Elsevier; St. Louis, MO, USA: 2017. Anesthetic Problems and Emergencies; pp. 362–403.
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
