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Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats.
J Vet Cardiol. 2009 May; 11 Suppl 1:S51-61.JV

Abstract

BACKGROUND

Circulating plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration facilitates emergency diagnosis of congestive heart failure (CHF) in people. Its utility to discriminate between dyspneic cats with CHF vs. primary respiratory disease requires further assessment. Our objectives were to determine if NT-proBNP (1) differentiates dyspneic cats with CHF vs. primary respiratory disease; (2) increases with renal insufficiency; (3) correlates with left atrial dimension, radiographic cardiomegaly, and estimated left ventricular filling pressure (E/E(a)).

METHODS

NT-proBNP was measured in 167 dyspneic cats (66 primary respiratory disease, 101 CHF) to evaluate (1) relationship with clinical parameters; (2) ability to distinguish CHF from primary respiratory disease; (3) optimal cut-off values using receiver operating characteristic (ROC) curve analysis.

RESULTS

NT-proBNP (1) was higher (median and inter-quartile [25th-75th] percentile) in CHF (754 pmol/L; 437, 1035 pmol/L) vs. primary respiratory disease (76.5 pmol/L; 24, 180 pmol/L) cohorts (P<0.001); (2) positively correlated in CHF cats with increased inter-ventricular septal end-diastolic thickness (rho=0.266; P=0.007) and LV free wall thickness (rho=0.218; P=0.027), but not with radiographic heart size, left atrial size, left ventricular dimensions, E/E(a) ratio, BUN, creatinine, or thyroxine; (3) distinguished dyspneic CHF cats from primary respiratory disease at 265 pmol/L cut-off value with 90.2% sensitivity, 87.9% specificity, 92% positive predictive value, and 85.3% negative predictive value (area under ROC curve, 0.94).

CONCLUSIONS

NT-proBNP accurately discriminated CHF from respiratory disease causes of dyspnea.

Authors+Show Affiliations

Caspary Institute, The Animal Medical Center, 510 East 62nd Street, New York, NY 10065, USA. philip.fox@amcny.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19394287

Citation

Fox, Philip R., et al. "Utility of Plasma N-terminal Pro-brain Natriuretic Peptide (NT-proBNP) to Distinguish Between Congestive Heart Failure and Non-cardiac Causes of Acute Dyspnea in Cats." Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology, vol. 11 Suppl 1, 2009, pp. S51-61.
Fox PR, Oyama MA, Reynolds C, et al. Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats. J Vet Cardiol. 2009;11 Suppl 1:S51-61.
Fox, P. R., Oyama, M. A., Reynolds, C., Rush, J. E., DeFrancesco, T. C., Keene, B. W., Atkins, C. E., Macdonald, K. A., Schober, K. E., Bonagura, J. D., Stepien, R. L., Kellihan, H. B., Nguyenba, T. P., Lehmkuhl, L. B., Lefbom, B. K., Moise, N. S., & Hogan, D. F. (2009). Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats. Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology, 11 Suppl 1, S51-61. https://doi.org/10.1016/j.jvc.2008.12.001
Fox PR, et al. Utility of Plasma N-terminal Pro-brain Natriuretic Peptide (NT-proBNP) to Distinguish Between Congestive Heart Failure and Non-cardiac Causes of Acute Dyspnea in Cats. J Vet Cardiol. 2009;11 Suppl 1:S51-61. PubMed PMID: 19394287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats. AU - Fox,Philip R, AU - Oyama,Mark A, AU - Reynolds,Caryn, AU - Rush,John E, AU - DeFrancesco,Terri C, AU - Keene,Bruce W, AU - Atkins,Clark E, AU - Macdonald,Kristin A, AU - Schober,Karsten E, AU - Bonagura,John D, AU - Stepien,Rebecca L, AU - Kellihan,Heidi B, AU - Nguyenba,Thaibinh P, AU - Lehmkuhl,Linda B, AU - Lefbom,Bonnie K, AU - Moise,N Sydney, AU - Hogan,Daniel F, Y1 - 2009/04/24/ PY - 2008/10/16/received PY - 2008/11/25/revised PY - 2008/12/03/accepted PY - 2009/4/28/entrez PY - 2009/4/28/pubmed PY - 2009/6/26/medline SP - S51 EP - 61 JF - Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology JO - J Vet Cardiol VL - 11 Suppl 1 N2 - BACKGROUND: Circulating plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration facilitates emergency diagnosis of congestive heart failure (CHF) in people. Its utility to discriminate between dyspneic cats with CHF vs. primary respiratory disease requires further assessment. Our objectives were to determine if NT-proBNP (1) differentiates dyspneic cats with CHF vs. primary respiratory disease; (2) increases with renal insufficiency; (3) correlates with left atrial dimension, radiographic cardiomegaly, and estimated left ventricular filling pressure (E/E(a)). METHODS: NT-proBNP was measured in 167 dyspneic cats (66 primary respiratory disease, 101 CHF) to evaluate (1) relationship with clinical parameters; (2) ability to distinguish CHF from primary respiratory disease; (3) optimal cut-off values using receiver operating characteristic (ROC) curve analysis. RESULTS: NT-proBNP (1) was higher (median and inter-quartile [25th-75th] percentile) in CHF (754 pmol/L; 437, 1035 pmol/L) vs. primary respiratory disease (76.5 pmol/L; 24, 180 pmol/L) cohorts (P<0.001); (2) positively correlated in CHF cats with increased inter-ventricular septal end-diastolic thickness (rho=0.266; P=0.007) and LV free wall thickness (rho=0.218; P=0.027), but not with radiographic heart size, left atrial size, left ventricular dimensions, E/E(a) ratio, BUN, creatinine, or thyroxine; (3) distinguished dyspneic CHF cats from primary respiratory disease at 265 pmol/L cut-off value with 90.2% sensitivity, 87.9% specificity, 92% positive predictive value, and 85.3% negative predictive value (area under ROC curve, 0.94). CONCLUSIONS: NT-proBNP accurately discriminated CHF from respiratory disease causes of dyspnea. SN - 1875-0834 UR - https://www.unboundmedicine.com/medline/citation/19394287/Utility_of_plasma_N_terminal_pro_brain_natriuretic_peptide__NT_proBNP__to_distinguish_between_congestive_heart_failure_and_non_cardiac_causes_of_acute_dyspnea_in_cats_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1760-2734(09)00002-2 DB - PRIME DP - Unbound Medicine ER -