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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.
J Vet Intern Med. 2015 Jan; 29(1):171-9.JV

Abstract

BACKGROUND

Cardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).

HYPOTHESIS/OBJECTIVES

Determine the utility of plasma N-terminal pro-brain natriuretic peptide concentration [NT-proBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity.

ANIMALS

Client-owned dogs (n = 291).

METHODS

Multicenter, cross-sectional, 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 (ACVIM-HD) schemes without knowledge of [NT-proBNP] results. Receiver-operating characteristic curve analysis assessed the capacity of [NT-proBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NT-proBNP] and HD severity.

RESULTS

Plasma [NT-proBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769-8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672-2,704 pmol/L; P < .0001). A cut-off >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, end-systole, and ACVIM-HD scheme most accurately associated average plasma [NT-proBNP] with HD severity.

CONCLUSIONS AND CLINICAL IMPORTANCE

Plasma [NT-proBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NT-BNP] increased significantly as a function of HD severity using the ACVIM-HD classification scheme.

Authors+Show Affiliations

The Animal Medical Center, New York, NY.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25308881

Citation

Fox, P R., et al. "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." Journal of Veterinary Internal Medicine, vol. 29, no. 1, 2015, pp. 171-9.
Fox PR, Oyama MA, Hezzell MJ, et al. 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. J Vet Intern Med. 2015;29(1):171-9.
Fox, P. R., Oyama, M. A., Hezzell, M. J., Rush, J. E., Nguyenba, T. P., DeFrancesco, T. C., Lehmkuhl, L. B., Kellihan, H. B., Bulmer, B., Gordon, S. G., Cunningham, S. M., MacGregor, J., Stepien, R. L., Lefbom, B., Adin, D., & Lamb, K. (2015). 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. Journal of Veterinary Internal Medicine, 29(1), 171-9. https://doi.org/10.1111/jvim.12472
Fox PR, et al. 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. J Vet Intern Med. 2015;29(1):171-9. PubMed PMID: 25308881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Fox,P R, AU - Oyama,M A, AU - Hezzell,M J, AU - Rush,J E, AU - Nguyenba,T P, AU - DeFrancesco,T C, AU - Lehmkuhl,L B, AU - Kellihan,H B, AU - Bulmer,B, AU - Gordon,S G, AU - Cunningham,S M, AU - MacGregor,J, AU - Stepien,R L, AU - Lefbom,B, AU - Adin,D, AU - Lamb,K, Y1 - 2014/10/10/ PY - 2014/05/27/received PY - 2014/08/03/revised PY - 2014/08/28/accepted PY - 2014/10/14/entrez PY - 2014/10/14/pubmed PY - 2015/10/6/medline KW - Biomarkers KW - Canine KW - Heart disease KW - Respiratory distress SP - 171 EP - 9 JF - Journal of veterinary internal medicine JO - J Vet Intern Med VL - 29 IS - 1 N2 - BACKGROUND: Cardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD). HYPOTHESIS/OBJECTIVES: Determine the utility of plasma N-terminal pro-brain natriuretic peptide concentration [NT-proBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity. ANIMALS: Client-owned dogs (n = 291). METHODS: Multicenter, cross-sectional, 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 (ACVIM-HD) schemes without knowledge of [NT-proBNP] results. Receiver-operating characteristic curve analysis assessed the capacity of [NT-proBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NT-proBNP] and HD severity. RESULTS: Plasma [NT-proBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769-8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672-2,704 pmol/L; P < .0001). A cut-off >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, end-systole, and ACVIM-HD scheme most accurately associated average plasma [NT-proBNP] with HD severity. CONCLUSIONS AND CLINICAL IMPORTANCE: Plasma [NT-proBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NT-BNP] increased significantly as a function of HD severity using the ACVIM-HD classification scheme. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/25308881/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_ L2 - https://doi.org/10.1111/jvim.12472 DB - PRIME DP - Unbound Medicine ER -