1. 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.
- Author
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Fox, P.R., Oyama, M.A., Hezzell, M.J., Rush, J.E., Nguyenba, T.P., DeFrancesco, T.C., Lehmkuhl, L.B., Kellihan, H.B., Bulmer, B., Gordon, S.G., Cunningham, S.M., MacGregor, J., Stepien, R.L., Lefbom, B., Adin, D., and Lamb, K.
- Subjects
NATRIURETIC peptides ,DOG diseases ,HEART failure ,RESPIRATORY distress syndrome ,ENZYME-linked immunosorbent assay ,BIOMARKERS - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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