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

P R Fox, M A Oyama, M J Hezzell, J E Rush, T P Nguyenba, T C DeFrancesco, L B Lehmkuhl, H B Kellihan, B Bulmer, S G Gordon, S M Cunningham, J MacGregor, R L Stepien, B Lefbom, D Adin, K Lamb

Research output: Contribution to journalArticle (Academic Journal)peer-review

23 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)171-9
Number of pages9
JournalJournal of Veterinary Internal Medicine
Volume29
Issue number1
DOIs
Publication statusPublished - Jan 2015

Keywords

  • Animals
  • Cross-Sectional Studies
  • Dog Diseases
  • Dogs
  • Dyspnea
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Heart Failure
  • Male
  • Natriuretic Peptide, Brain
  • Peptide Fragments

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