Pulmonary hypertension in dogs with myxomatous mitral valve disease.

PH complicating MMVD worsens prognosis; early detection and individualized management optimize outcomes.

Pulmonary hypertension (PH) represents a significant and increasingly recognized complication in dogs with myxomatous mitral valve disease (MMVD), substantially impacting morbidity and mortality rates. The development of secondary PH in MMVD patients manifests clinically with exercise intolerance, syncope, and respiratory distress, and correlates directly with reduced survival times. Echocardiography remains the primary diagnostic modality, utilizing Doppler-derived tricuspid regurgitation velocity estimates, though sensitivity and accuracy limitations persist. Current therapeutic approaches prioritize management of underlying MMVD and heart failure through control of left atrial pressure using conventional agents including diuretics, ACE inhibitors, and pimobendan. Pulmonary vasodilators such as sildenafil have been employed with variable and inconsistently documented clinical benefits. Prognosis depends on both valve disease severity and degree of pulmonary vascular involvement. Recognizing the complex interplay between MMVD and PH is essential for timely diagnosis, individualized treatment planning, and optimizing clinical outcomes in veterinary cardiology practice.

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