# Evaluation of Pulse Pressure as a Hemodynamic Marker of Cardiac Disease in Dogs and Horses Undergoing Pre-Anesthetic Assessment

## TL;DR

This study shows that pulse pressure can detect hidden heart disease in dogs and horses before anesthesia, improving safety.

## Contribution

The study demonstrates that pulse pressure is a practical, non-invasive marker for cardiac disease in veterinary pre-anesthetic assessments.

## Key findings

- Animals with cardiac disease had significantly higher pulse pressure compared to healthy animals.
- Pulse pressure showed strong discriminatory performance between healthy and diseased dogs and horses.
- Pulse pressure can be measured easily and used to prompt further cardiac evaluation in veterinary patients.

## Abstract

Careful cardiovascular assessment before anesthesia is important for reducing anesthetic risk in veterinary patients. Pulse pressure, defined as the difference between systolic and diastolic blood pressure, reflects how much blood the heart ejects with each beat and how elastic the arteries are. Despite its physiological relevance, pulse pressure is rarely used as a screening parameter in routine veterinary practice. In this study, pulse pressure was evaluated as a potential indicator of cardiac disease in dogs and horses undergoing pre-anesthetic assessment. Animals with echocardiographically confirmed cardiac abnormalities showed consistently higher pulse pressure values compared with clinically healthy animals, while mean arterial pressure remained similar between groups. These findings suggest that changes in pulse pressure may occur even when overall blood pressure appears normal. Because pulse pressure can be obtained easily from standard non-invasive blood pressure measurements in conscious animals, it represents a practical and low-cost addition to routine pre-anesthetic evaluation. Identifying unexpectedly increased pulse pressure in apparently healthy animals may prompt further cardiac investigation or encourage more cautious anesthetic planning. Overall, this study supports the use of pulse pressure as a simple, non-invasive tool to help detect occult cardiac disease and improve anesthetic safety in veterinary patients.

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 (p = 0.042), while in dogs, the increase was 25 mmHg (p < 0.001). Regression analysis confirmed cardiac status as an independent predictor of elevated PP (p = 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.