1 research outputs found
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
BACKGROUND: Cardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD). HYPOTHESIS/OBJECTIVES: Determine the utility of plasma Nâterminal proâbrain natriuretic peptide concentration [NTâproBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity. ANIMALS: Clientâowned dogs (n = 291). METHODS: Multicenter, crossâsectional, 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 (ACVIMâHD) schemes without knowledge of [NTâproBNP] results. Receiverâoperating characteristic curve analysis assessed the capacity of [NTâproBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NTâproBNP] and HD severity. RESULTS: Plasma [NTâproBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769â8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672â2,704 pmol/L; P < .0001). A cutâoff >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, endâsystole, and ACVIMâHD scheme most accurately associated average plasma [NTâproBNP] with HD severity. CONCLUSIONS AND CLINICAL IMPORTANCE: Plasma [NTâproBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NTâBNP] increased significantly as a function of HD severity using the ACVIMâHD classification scheme