Document Detail

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.
MedLine Citation:
PMID:  19394287     Owner:  NLM     Status:  MEDLINE    
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.
Philip R Fox; Mark A Oyama; Caryn Reynolds; John E Rush; Terri C DeFrancesco; Bruce W Keene; Clark E Atkins; Kristin A Macdonald; Karsten E Schober; John D Bonagura; Rebecca L Stepien; Heidi B Kellihan; Thaibinh P Nguyenba; Linda B Lehmkuhl; Bonnie K Lefbom; N Sydney Moise; Daniel F Hogan
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-04-24
Journal Detail:
Title:  Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology     Volume:  11 Suppl 1     ISSN:  1875-0834     ISO Abbreviation:  J Vet Cardiol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101163270     Medline TA:  J Vet Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S51-61     Citation Subset:  IM    
Caspary Institute, The Animal Medical Center, 510 East 62nd Street, New York, NY 10065, USA.
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MeSH Terms
Biological Markers / blood
Case-Control Studies
Cat Diseases / blood*,  diagnosis
Diagnosis, Differential
Dyspnea / blood,  diagnosis,  etiology,  veterinary
Heart Failure / blood,  complications,  diagnosis,  veterinary*
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Prospective Studies
ROC Curve
Renal Insufficiency / blood,  complications,  diagnosis,  veterinary*
Respiration Disorders / blood,  complications,  diagnosis,  veterinary*
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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