Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Journal of Veterinary Internal Medicine

P.R. Fox⁶  M.A. Oyama⁵  M.J. Hezzell⁵  J.E. Rush⁴  T.P. Nguyenba⁸  T.C. DeFrancesco¹⁰  L.B. Lehmkuhl⁸  H.B. Kellihan¹  B. Bulmer²  S.G. Gordon⁹  S.M. Cunningham⁴  J. MacGregor⁷  R.L. Stepien¹  B. Lefbom^3,6  D. Adin⁸ 

[1]University Wisconsin, Madison, WI

[2]Oregon State College of Veterinary Medicine, Corvalis, OR

[3]Chesapeake Veterinary Cardiology Associates, Springfield, VA

[4]Tufts University Cummings School of Veterinary Medicine, North Grafton, MA

[5]University of Pennsylvania, Philadelphia, PA

[6]The Animal Medical Center, New York, NY

[7]InTown Veterinary Group, Woburn, MA

[8]MedVet Medical & Cancer Center for Pets, Worthington, OH

[9]Texas A&M University, College Station, TX

[10]North Carolina State University, Raleigh, NC

关键词: Biomarkers;    Canine;    Heart disease;    Respiratory distress;   

DOI  :  10.1111/jvim.12472

来源: Wiley

【 摘 要 】

Abstract

Background

Cardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).

Hypothesis/Objectives

Determine the utility of plasma N-terminal pro-brain natriuretic peptide concentration [NT-proBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity.

Animals

Client-owned dogs (n = 291).

Methods

Multicenter, cross-sectional, prospective investigation. Medical history, physical examination, echocardiography, and thoracic radiography classified 113 asymptomatic dogs (group 1, n = 39 without HD; group 2, n = 74 with HD), and 178 with respiratory distress (group 3, n = 104 respiratory disease, either with or without concurrent HD; group 4, n = 74 with congestive heart failure [CHF]). HD severity was graded using International Small Animal Cardiac Health Council (ISACHC) and ACVIM Consensus (ACVIM-HD) schemes without knowledge of [NT-proBNP] results. Receiver-operating characteristic curve analysis assessed the capacity of [NT-proBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NT-proBNP] and HD severity.

Results

Plasma [NT-proBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769–8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672–2,704 pmol/L; P < .0001). A cut-off >2,447 pmol/L discriminated CHF from noncardiac respiratory distress (81.1% sensitivity; 73.1% specificity; area under curve, 0.84). A multivariate model comprising left atrial to aortic ratio, heart rate, left ventricular diameter, end-systole, and ACVIM-HD scheme most accurately associated average plasma [NT-proBNP] with HD severity.

Conclusions and Clinical Importance

Plasma [NT-proBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NT-BNP] increased significantly as a function of HD severity using the ACVIM-HD classification scheme.

【 授权许可】

Unknown   
Copyright © 2014 by the American College of Veterinary Internal Medicine