Prospective evaluation of the combined value of physical examination and biomarker variables in screening for preclinical dilated cardiomyopathy in Doberman Pinschers |
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| Affiliation: | 1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA;2. College of Veterinary Medicine, University of Florida, Gainesville, FL, USA;3. Companion Animal Cardiac Care, College Station, TX 77845, USA;4. Morris Veterinary Cardiology, Inc South Deerfield, MA 01373, USA;5. Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7045 Uppsala, 7507, Sweden;6. Wasaga Beach, ONT, Canada;1. CVCA Cardiac Care for Pets (Vienna), 140 Park Street SE, Vienna, VA 22180, USA;2. CVCA Cardiac Care for Pets (Towson), 1209 Cromwell Bridge Rd, Towson, MD 21286, USA;3. CVCA Cardiac Care for Pets (Annapolis), 808 Bestgate Road, Annapolis, MD 21401, USA;1. Department of Veterinary Medical Sciences, Alma Mater Studiorum – University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell''Emilia, Italy;2. Freelance Veterinary Cardiologist, Bologna, Italy;3. Clinica Veterinaria Sasso Marconi, viale Verde 7, 40037, Sasso Marconi, Italy;4. Clinica Veterinaria San Sebastiano, via Boari 22, 04026, Minturno, Italy;5. Department of Veterinary Sciences, University of Parma, Strada del Taglio 10, 43126 Parma, Italy;1. Corresponding Address Kardiovet GmbH, Eystrasse 74, Kirchberg, Switzerland;2. Department for Companion Animals and Horses, University of Veterinary Medicine, Veterinärplatz, Vienna, Austria;3. Centre Hospitalier Vétérinaire des Cordeliers, 35 Avenue Du Maréchal Joffre, 77100 Meaux, France;4. Tierärztliche Gemeinschaftspraxis, An Den Wurthen 26, 17489 Greifswald, Germany;5. Medisch Centrum voor Dieren, Isolatorweg 45, 1014 AS Amsterdam, the Netherlands;6. Small Animal Teaching Hospital, Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Cheshire CH64 7TE, UK;7. Tierklinik Bockenheim, Juliusstrasse 12, 60487 Frankfurt, Germany;8. Ross University School of Veterinary Medicine, Basseterre, St. Kitts West Indies, St. Kitts and Nevis;9. Kleintierspezialisten Dres. Schmerbach & Höpfner, Wittestr. 30, 13509 Berlin, Germany;10. Tiergesundheitszentrum Obere Hard, Überweisungspraxis für Innere Medizin und Kardiologie, Oberer Hardweg 16, 75181 Pforzheim, Germany;11. Barton Veterinary Hospital and Surgery, CVS (UK) Ltd, 34 New Dover Road, Canterbury, Kent CT1 3BH, UK;12. North Downs Specialist Referrals, The Friesian Building 3 & 4, The Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, Surrey RH1 4QP, UK;13. Clinique Vétérinaire Aquivet, 19 Avenue de La Forêt, Parc d''activités Mermoz, 33320 Eysines, France;14. Clinique Vétérinaire Armonia, Rue Serge Mauroit, 38090 Villefontaine, France;15. Aalborg Dyrehospital, Fredrikstadvej 10, 9200 Aalborg SV, Denmark;p. Kleintierzentrum Walluf, Am Klingenweg 21, 65396 Walluf, Germany;q. Tierärztliche Klinik Oberhaching, Bajuwarenring 10, 82041 Oberhaching, Germany;r. Oncovet Clinique Vétérinaire de Référés, Avenue Paul Langevin, 59650 Villeneuve d''Ascq, France;s. Ivy Court, Willington Rd, Etwall, Derbyshire DE65 6JG, UK;t. Anderson Moores Veterinary Specialists, The Granary, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire SO21 2LL, UK;u. Clinic of Small Animal Medicine, Ludwig-Maximilians University, Veterinärstrasse 13, 80539 Munich, Germany;v. Clinique Vétérinaire Foch, 38 Avenue du Maréchal Foch, 34500 Beziers, France;w. Boehringer Ingelheim Vetmedica GmbH Binger Strasse 173, 55216 Ingelheim Am Rhein, Germany;1. Clinica Veterinaria Malpensa, AniCura, Viale Marconi, 27, 21017, Samarate, VA, Italy;2. Ospedale Veterinario I Portoni Rossi, AniCura, Via Roma 57, 40069, Zola Predosa, BO, Italy;3. Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra, 50, 40064, Ozzano Dell''Emilia, BO, Italy;4. Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road, 14853, Ithaca, NY, USA |
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| Abstract: | IntroductionScreening to assess likelihood of preclinical dilated cardiomyopathy (PC-DCM) prior to advanced diagnostic tests in Doberman Pinschers (DP) is desirable.ObjectiveTo investigate the combined value of physical examination (PE), N-terminal pro B-type natriuretic peptide (NTproBNP) and cardiac troponin I (cTnI) for identifying PC-DCM in DP.Animals, materials and methodsAll dogs underwent: PE, echocardiogram, 3-min ECG and cardiac biomarker measurement. Asymptomatic DP (414) were classified based on 3-min ECG and echocardiogram as: No-DCM/MMVD or myxomatous mitral valve disease (MMVD), PC-DCM based on echocardiogram (PC-DCM-Echo), PC-DCM based on arrhythmias with a normal echocardiogram (PC-DCM-ECG), equivocal DCM (EQ-DCM), and MMVD. Receiver operator characteristic curves and prediction models were derived.ResultsHeart murmurs and arrhythmias were rare and gallop sounds were absent in No-DCM/MMVD DP. Dogs ≥ four years old and males had higher probabilities of PC-DCM-Echo. Prediction models incorporating PE variables with NTproBNP had an area under the curve (AUC) of 0.940 for distinguishing between PC-DCM-Echo and all other groups, which was similar to the AUC for NTproBNP (0.939) or cTnI (0.932) alone. Discrimination between No-DCM/MMVD and all other groups was similar for NTproBNP (0.781) and cTnI (0.742) as individual tests, however, models combining PE variables and NTproBNP increased the AUC to 0.812. An NTproBNP cut-off of ≥548 pmol/L, was 100% sensitive and 77.3% specific for detecting PC-DCM-Echo.ConclusionsBoth NTproBNP and cTnI had good utility as sole tests to discriminate PC-DCM-Echo DP from all others. Models differentiating No-DCM/MMVD DP from all other DP were improved by using PE and NTproBNP together. |
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| Keywords: | NTproBNP Occult Asymptomatic PDK4 Troponin |
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