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.

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Authors+Show Affiliations

Fox PR
Caspary Institute, The Animal Medical Center, 510 East 62nd Street, New York, NY 10065, USA. philip.fox@amcny.org
Oyama MA
No affiliation info available
Reynolds C
No affiliation info available
Rush JE
No affiliation info available
DeFrancesco TC
No affiliation info available
Keene BW
No affiliation info available
Atkins CE
No affiliation info available
Macdonald KA
No affiliation info available
Schober KE
No affiliation info available
Bonagura JD
No affiliation info available
Stepien RL
No affiliation info available
Kellihan HB
No affiliation info available
Nguyenba TP
No affiliation info available
Lehmkuhl LB
No affiliation info available
Lefbom BK
No affiliation info available
Moise NS
No affiliation info available
Hogan DF
No affiliation info available

MeSH

AnimalsBiomarkersCase-Control StudiesCat DiseasesCatsDiagnosis, DifferentialDyspneaFemaleHeart FailureMaleNatriuretic Peptide, BrainPeptide FragmentsPredictive Value of TestsProspective StudiesROC CurveRenal InsufficiencyRespiration Disorders

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19394287