The Combined Prognostic Potential of Serum High‐Sensitivity Cardiac Troponin I and N‐Terminal pro‐B‐Type Natriuretic Peptide Concentrations in Dogs with Degenerative Mitral Valve Disease

Journal of Veterinary Internal Medicine

M.J. Hezzell²  A. Boswood²  Y.-M. Chang¹  W. Moonarmart²  K. Souttar¹ 

[1] Department of Veterinary Basic Sciences, The Royal Veterinary College, London, UK;Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hertfordshire, UK

关键词: Biomarkers;    Cardiology;    Monitoring;    Risk stratification;    Valvular disease;   

DOI  :  10.1111/j.1939-1676.2012.00894.x

来源: Wiley

【 摘 要 】

Abstract

Background

Identification of factors associated with decreased survival in dogs with degenerative mitral valve disease (DMVD) will allow more accurate prognosis. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is negatively associated with survival in dogs with DMVD. In human patients, multimarker strategies provide superior risk stratification compared with single markers.

Hypothesis

High-sensitivity cardiac troponin I (hscTnI) and other clinical variables will be associated with survival time in dogs with DMVD. Measuring hscTnI and NT-proBNP in combination will be prognostically superior to measurement of either marker alone. The rate of change of these markers will vary according to cause of death.

Animals

Client-owned dogs (n = 202) with DMVD of varying severity and age-matched healthy control dogs (n = 30) recruited from first opinion private practice.

Methods

Prospective cohort study relating clinical variables at enrollment in dogs with DMVD to survival time (all-cause, cardiac, and noncardiac mortality). Multivariable Cox regression analysis was used to identify factors associated with survival. Measurements were obtained approximately every 6 months. Repeated measures models were constructed to assess changes over time.

Results

hscTnI, LVEDDN, heart rate, and age were independently associated with decreased survival time (all-cause mortality). Survival times were shortest in dogs in which both serum hscTnI and NT-proBNP were increased. hscTnI and NT-proBNP increased more rapidly in dogs that died of cardiac disease.

Conclusions and Clinical Importance

Serum hscTnI has prognostic value in dogs with DMVD. Measurement of NT-proBNP and hscTnI is prognostically superior to measuring either alone. Serial measurement strategies provide additional prognostic information.

【 授权许可】

Unknown   
Copyright © 2012 by the American College of Veterinary Internal Medicine