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Atrial natriuretic peptide vs. N ‐terminal‐pro‐atrial natriuretic peptide for the detection of left atrial dilatation in horses
Author(s) -
Vekens N.,
Decloedt A.,
Clercq D.,
Ven S.,
Sys S.,
Loon G.
Publication year - 2016
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12362
Subject(s) - atrial natriuretic peptide , natriuretic peptide , interquartile range , medicine , cardiology , horse , atrial fibrillation , mitral regurgitation , endocrinology , heart failure , biology , paleontology
Summary Reasons for performing study Studies on the use of atrial natriuretic peptide ( ANP ) as a biomarker for left atrial dilatation in horses have produced variable results. Few have been performed, and the results may have been influenced by ANP instability, differences in sampling protocol and changes in the assay over time. N ‐Terminal pro ANP ( NT ‐pro ANP ) is a more stable molecule and might be a good alternative for clinical use. Objectives To compare ANP and NT ‐pro ANP in terms of the detection of left atrial dilatation and to determine the influence of sample storage at temperatures of ‐80 and ‐20° C . Study design Prospective clinical study. Methods Atrial natriuretic peptide and NT ‐pro ANP concentrations were compared between healthy horses ( Group 1 , n = 20), horses with mitral valve regurgitation and a normal atrial size ( Group 2 , n = 11) and horses with mitral valve regurgitation associated with left atrial dilatation ( Group 3 , n = 16). The ANP concentration was measured with an equine enzyme‐linked immunosorbent assay and the NT ‐pro ANP concentration with an enzyme‐linked immunosorbent assay developed for use in human patients. Samples were stored at ‐20 and ‐80° C and analysed within 7 months. Results The NT ‐pro ANP concentrations were not significantly different between the groups. Horses in Group 3 had a significantly higher ANP concentration (median 366 pg/ml; interquartile range [ IQR ] 74–2000 pg/ml) compared with horses in Group 1 (median 31 pg/ml; IQR 31–333 pg/ml) or Group 2 (median 31 pg/ml; IQR 31–1152 pg/ml; P = 0.02). The ANP cut‐off value for detection of left atrial dilatation was 52 pg/ml (sensitivity 81%; specificity 84%) for sample storage at ‐80° C , and 44 pg/ml (sensitivity 69%; specificity 84%) for storage at ‐20° C . A larger decrease in ANP (45 ± 126 pg/ml) than in NT ‐pro ANP (10 ± 31 pg/ml) was found associated with sample storage at ‐20 instead of ‐80° C . Conclusions Atrial natriuretic peptide, but not NT ‐pro ANP , can be used to detect left atrial dilatation in horses. Atrial natriuretic peptide is less stable than NT ‐pro ANP when samples are stored at ‐20° C . Atrial natriuretic peptide is a more suitable biomarker of left atrial dilatation in horses than NT ‐pro ANP .