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 |
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Authors: | PR Fox MA Oyama MJ Hezzell JE Rush TP Nguyenba TC DeFrancesco LB Lehmkuhl HB Kellihan B Bulmer SG Gordon SM Cunningham J MacGregor RL Stepien B Lefbom D Adin K Lamb |
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Institution: | 1. The Animal Medical Center, New York, NY;2. University of Pennsylvania, Philadelphia, PA;3. Tufts University Cummings School of Veterinary Medicine, North Grafton, MA;4. MedVet Medical & Cancer Center for Pets, Worthington, OH;5. North Carolina State University, Raleigh, NC;6. University Wisconsin, Madison, WI;7. Oregon State College of Veterinary Medicine, Corvalis, OR;8. Texas A&M University, College Station, TX;9. InTown Veterinary Group, Woburn, MA;10. Chesapeake Veterinary Cardiology Associates, Springfield, VA;11. Lamb Statistical Consulting, West St. Paul, MN |
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Abstract: | BackgroundCardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).Hypothesis/ObjectivesDetermine 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.AnimalsClient‐owned dogs (n = 291).MethodsMulticenter, 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.ResultsPlasma 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 ImportancePlasma 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. |
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Keywords: | Biomarkers Canine Heart disease Respiratory distress |
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