Prospective Evaluation of NT‐proBNP Assay to Detect Occult Dilated Cardiomyopathy and Predict Survival in Doberman Pinschers

Journal of Veterinary Internal Medicine

G.E. Singletary⁴  N.A. Morris³  M. Lynne O'Sullivan²  S.G. Gordon¹ 

[1] Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX;Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada;Mass Veterinary Cardiology Services Inc., West Springfield, MA;Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA

关键词: Blood tests;    BNP;    Diagnostics;    Heart disease;    Natriuretic peptides;   

DOI  :  10.1111/j.1939-1676.2012.1000.x

来源: Wiley

【 摘 要 】

Abstract

Background

Occult (asymptomatic) dilated cardiomyopathy (ODCM) is highly prevalent in Doberman Pinschers.

Hypothesis/Objectives

Assess ability of NT-proBNP assay to detect ODCM and predict death.

Animals

155 asymptomatic Dobermans presenting for ODCM screening.

Methods

Echocardiography, 24-hour Holter, and NT-proBNP assay were performed prospectively. Diagnosis was based on increased left ventricular end-systolic dimension, >50 ventricular premature complexes (VPCs), or both on Holter. Utility was evaluated using receiver-operating characteristic curves. Effect of age, weight, sex, disease status, VPCs, and NT-proBNP on survival was analyzed using Kaplan-Meier and Cox-proportional hazard analysis.

Results

Seventy-three (47.1%) Dobermans were diagnosed with ODCM, including 31, 17, and 25 that met Holter, echocardiographic, or both criteria, respectively. Sensitivity of NT-proBNP > 457 pmol/L to detect these groups was 45.2, 76.5, and 96.0%, respectively. Combination of NT-proBNP and Holter to detect ODCM yielded sensitivity of 94.5%, specificity of 87.8%, and accuracy of 91.0%. Follow-up data were available for 78 Dobermans. The median survival time of Dobermans with > 50 VPCs (469 days), NT-proBNP > 900 pmol/L (284 days), or ODCM (474 days) was significantly (P < .0001) shorter than those with < 50 VPCs (1743 days), NT-proBNP < 900 pmol/L (1743 days), or without disease (1743 days). NT-proBNP concentration and disease status were independently predictive of all-cause mortality.

Conclusions and Clinical Importance

The combination of NT-proBNP assay and Holter detected ODCM with high accuracy. NT-proBNP and disease status were independently associated with survival. NT-proBNP assay identified Dobermans with high probability of increased LVIDs consistent with ODCM, and can facilitate pursuit of confirmatory diagnostic testing, such as echocardiography, in suspected Dobermans.

【 授权许可】

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