The combined prognostic potential of serum high-sensitivity cardiac troponin I and N-terminal pro-B-type natriuretic peptide concentrations in dogs with degenerative mitral valve disease

M J Hezzell, A Boswood, Y-M Chang, W Moonarmart, K Souttar, J Elliott

Research output: Contribution to journalArticle (Academic Journal)

63 Citations (Scopus)

Abstract

BACKGROUND: Identification of factors associated with decreased survival in dogs with degenerative mitral valve disease (DMVD) will allow more accurate prognosis. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is negatively associated with survival in dogs with DMVD. In human patients, multimarker strategies provide superior risk stratification compared with single markers.

HYPOTHESIS: High-sensitivity cardiac troponin I (hscTnI) and other clinical variables will be associated with survival time in dogs with DMVD. Measuring hscTnI and NT-proBNP in combination will be prognostically superior to measurement of either marker alone. The rate of change of these markers will vary according to cause of death.

ANIMALS: Client-owned dogs (n = 202) with DMVD of varying severity and age-matched healthy control dogs (n = 30) recruited from first opinion private practice.

METHODS: Prospective cohort study relating clinical variables at enrollment in dogs with DMVD to survival time (all-cause, cardiac, and noncardiac mortality). Multivariable Cox regression analysis was used to identify factors associated with survival. Measurements were obtained approximately every 6 months. Repeated measures models were constructed to assess changes over time.

RESULTS: hscTnI, LVEDDN, heart rate, and age were independently associated with decreased survival time (all-cause mortality). Survival times were shortest in dogs in which both serum hscTnI and NT-proBNP were increased. hscTnI and NT-proBNP increased more rapidly in dogs that died of cardiac disease.

CONCLUSIONS AND CLINICAL IMPORTANCE: Serum hscTnI has prognostic value in dogs with DMVD. Measurement of NT-proBNP and hscTnI is prognostically superior to measuring either alone. Serial measurement strategies provide additional prognostic information.

Original languageEnglish
Pages (from-to)302-11
Number of pages10
JournalJournal of Veterinary Internal Medicine
Volume26
Issue number2
DOIs
Publication statusPublished - 1 Mar 2012

Keywords

  • Animals
  • Cohort Studies
  • Dog Diseases
  • Dogs
  • Echocardiography, Doppler
  • Heart Valve Diseases
  • Mitral Valve
  • Natriuretic Peptide, Brain
  • Peptide Fragments
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Survival Analysis
  • Troponin I

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