Open AccessMulticenter Evaluation of Plasma N‐Terminal Probrain Natriuretic Peptide ( NT ‐pro BNP ) as a Biochemical Screening Test for Asymptomatic (occult) Cardiomyopathy in Cats
Author(s) -
Fox P.R.,
Rush J.E.,
Reynolds C.A.,
DeFrancesco T.C.,
Keene B.W.,
Atkins C.E.,
Gordon S.G.,
Schober K.E.,
Bonagura J.D.,
Stepien R.L.,
Kellihan H.B.,
MacDonald K.A.,
Lehmkuhl L.B.,
Nguyenba T.P.,
Sydney Moise N.,
Lefbom B.K.,
Hogan D.F.,
Oyama M.A.
Publication year - 2011
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2011.00776.x
Subject(s) - medicine , natriuretic peptide , asymptomatic , cardiology , interquartile range , cardiomyopathy , receiver operating characteristic , cats , hypertrophic cardiomyopathy , heart failure , endocrinology
Background: B ‐type natriuretic peptide concentrations reliably distinguish between cardiac and respiratory causes of dyspnea, but its utility to detect asymptomatic cats with occult cardiomyopathy ( OCM ) is unresolved. Hypothesis/Objectives: Determine whether plasma N terminal probrain natriuretic peptide ( NT ‐pro BNP ) concentration can discriminate asymptomatic cats with OCM from normal cats, and whether NT ‐pro BNP concentration correlates with clinical, biochemical, and echocardiographic parameters. Animals: One hundred and fourteen normal, healthy cats; 113 OCM cats. Methods: Prospective, multicenter, case‐controlled study. NT ‐pro BNP was prospectively measured and cardiac status was determined from history, physical examination, and M ‐mode/ 2D / Doppler echocardiography. Optimal cut‐off values were derived using receiver operating characteristic ( ROC ) curve analysis. Results: NT ‐pro BNP was higher (median, interquartile range [25th and 75th percentiles]) in (1) OCM (186 pmol/L; 79, 478 pmol/L) versus normal (24 pmol/L; 24, 32 pmol/L) ( P < .001); and (2) hypertrophic obstructive cardiomyopathy (396 pmol/L; 205, 685 pmol/L) versus hypertrophic cardiomyopathy (112 pmol/L; 48, 318 pmol/L) ( P < .001). In OCM, NT ‐pro BNP correlated (1) positively with LVPW d (ρ = 0.23; P = .01), LA /Ao ratio (ρ = 0.31; P < .001), LV s (ρ = 0.33; P < .001), and troponin‐I (ρ = 0.64; P < .001), and (2) negatively with % FS (ρ = −0.27; P = .004). Area under ROC curve was 0.92; >46 pmol/L cut‐off distinguished normal from OCM (91.2% specificity, 85.8% sensitivity); >99 pmol/L cut‐off was 100% specific, 70.8% sensitive. Conclusions and Clinical Importance: Plasma NT ‐pro BNP concentration reliably discriminated normal from OCM cats, and was associated with several echocardiographic markers of disease severity. Further studies are needed to assess test performance in unselected, general feline populations, and evaluate relationships between NT ‐pro BNP concentrations and disease progression.