Assessment of a bedside test for N-terminal pro B-type natriuretic peptide (NT-proBNP) to differentiate cardiac from non-cardiac causes of pleural effusion in cats

Wurtinger, Gabriel; Henrich, Estelle; Hildebrandt, Nicolai; Wiedemann, Nicola; Schneider, Matthias; Hassdenteufel, Esther

doi:10.1186/s12917-017-1319-6

Cited by 13 publications

(13 citation statements)

References 30 publications

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“…The moderate to high rate of false positives in the pleural fluid tests suggests that blood samples are preferred over pleural fluid samples for POC NT‐proBNP testing, and corroborates previous studies suggesting that the POC NT‐proBNP test appears to be most helpful in ruling out (rather than ruling in) CHF in cats with respiratory distress . However, diluting pleural fluid 1 : 1 with saline may increase the specificity of POC NT‐proBNP performed on PLEFF samples but this dilution technique was not used in our study. The advantage of the POC NT‐proBNP is its relatively low cost (as compared with an ultrasound unit), as well as the speed and ease of performing the test and interpreting results.…”

Section: Discussionsupporting

confidence: 85%

Evaluation of point‐of‐care thoracic ultrasound and NT‐proBNP for the diagnosis of congestive heart failure in cats with respiratory distress

Ward

Lisciandro²,

Ware

et al. 2018

Veterinary Internal Medicne

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BackgroundThe diagnosis of congestive heart failure (CHF) in cats is challenging. Point‐of‐care (POC) thoracic ultrasound and NT‐proBNP testing are emerging tools that may aid in diagnosis.Hypothesis/ObjectivesTo assess the diagnostic accuracy of POC lung ultrasound (LUS), focused cardiac ultrasound (FCU), and NT‐proBNP in predicting a final diagnosis of CHF.AnimalsFifty‐one cats in respiratory distress.MethodsBlood NT‐proBNP, LUS, and FCU evaluating left atrial (LA) size and presence of pericardial effusion (PCEFF) were performed in all cats. Lung ultrasound findings including pleural effusion (PLEFF), number of B‐lines, and sub‐pleural abnormalities were noted. Medical records were evaluated for final diagnosis.ResultsThirty‐three of 51 (65%) cats were diagnosed with CHF. Lung ultrasound and blood NT‐proBNP were significant predictors of CHF in a multivariate model. The LUS criterion that maximized accuracy for CHF diagnosis was presence of >1 site strongly positive for B‐lines (>3 B‐lines per site), resulting in sensitivity of 78.8%, specificity of 83.3%, and area under the curve (AUC) of 0.833. Subjective LA enlargement was 97.0% sensitive and 100% specific for CHF (AUC 0.985). Presence of PCEFF also was 100% specific, but only 60.6% sensitive, for CHF (AUC 0.803). A positive blood NT‐proBNP test was 93.9% sensitive and 72.2% specific for the diagnosis of CHF (AUC 0.831).Conclusions and Clinical ImportancePoint‐of‐care diagnostic techniques of LUS, FCU, and NT‐proBNP are useful to diagnose CHF in cats with respiratory distress.

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Section: Discussionsupporting

confidence: 85%

Evaluation of point‐of‐care thoracic ultrasound and NT‐proBNP for the diagnosis of congestive heart failure in cats with respiratory distress

Ward

Lisciandro²,

Ware

et al. 2018

Veterinary Internal Medicne

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“…The quantitative feline‐specific NT‐proBNP assay using plasma or pleural fluid has good diagnostic accuracy for discriminating between cats with cardiac and noncardiac causes of respiratory distress (LOE high), but it is not recommended for guiding therapeutic decision‐making in cats with respiratory distress because of the delay in receiving test results from an external laboratory. Instead, a point‐of‐care NT‐proBNP assay provides rapid results while maintaining reasonable diagnostic accuracy in discriminating between cardiac and noncardiac causes of respiratory distress, and should be considered when point‐of‐care ultrasound examination is not available (LOE medium) . The point‐of‐care assay can be used on plasma or pleural fluid, the latter diluted 1:1 with saline for greater specificity …”

Section: Diagnosismentioning

confidence: 99%

“…Instead, a point‐of‐care NT‐proBNP assay provides rapid results while maintaining reasonable diagnostic accuracy in discriminating between cardiac and noncardiac causes of respiratory distress, and should be considered when point‐of‐care ultrasound examination is not available (LOE medium) . The point‐of‐care assay can be used on plasma or pleural fluid, the latter diluted 1:1 with saline for greater specificity …”

Section: Diagnosismentioning

confidence: 99%

ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats

Fuentes

Abbott

Chetboul

et al. 2020

Veterinary Internal Medicne

172

236

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Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide the veterinary community with up-to-date information on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the process. The statements are derived from evidence-based medicine whenever possible and the panel offers interpretive comments when such evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership that may be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited before publication. The authors are solely responsible for the content of the statements. AbstractCardiomyopathies are a heterogeneous group of myocardial disorders of mostly unknown etiology, and they occur commonly in cats. In some cats, they are welltolerated and are associated with normal life expectancy, but in other cats they can result in congestive heart failure, arterial thromboembolism or sudden death.Cardiomyopathy classification in cats can be challenging, and in this consensus statement we outline a classification system based on cardiac structure and function (phenotype). We also introduce a staging system for cardiomyopathy that includes subdivision of cats with subclinical cardiomyopathy into those at low risk

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“…A study has shown that a point-of-care test measuring NT-proBNP in diluted pleural effusion (1:1 pleural effusion to 0.9% saline solution) was suitable to distinguish cardiogenic causes from non-cardiogenic causes of pleural effusion. However, this method was not performed in pleural fluid samples in this study [22].…”

Section: Discussionmentioning

confidence: 89%

Evaluation of pleural fluid parameters related to cardiac diseases in cats

et al. 2021

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Background and Aim: Cardiac disease is common in cats, and concurrent pleural effusion can worsen the prognosis. However, the definitive diagnosis of feline cardiac disease by echocardiography is limited in some areas. This study was designed to determine the indicators from fluid analysis obtained from pleural effusion to help diagnose cardiac disease in cats. Materials and Methods: A retrospective study was conducted. Data of 61 cats with pleural effusion were retrieved. The cats were divided into two groups: Cardiac disease (n=34) and non-cardiac disease (n=27) groups. Sex, neuter status, breed, age, weight, physical findings, fluid analysis results, radiographic findings, echocardiographic findings, and the presence of other diseases or conditions were recorded. Results: The Chi-square test showed the relationship between cardiac disease and the presence of abnormal heart sounds (p=0.0003), the N-terminal pro-B-type natriuretic peptide-positive result from serum samples (p=0.046), the presence of arterial thromboembolism (p<0.00001), and the presence of radiographic evidence of cardiomegaly and pulmonary edema (p=0.0002 and 0.001, respectively). The Mann–Whitney U-test showed a significant difference in protein concentration and specific gravity between the cardiac and non-cardiac disease groups (p=0.012 and 0.009, respectively). The decision tree classification method showed that protein concentrations of ≤3 g/dL were related to cardiac disease (sensitivity, 41.2% and specificity, 92.6%). Conclusion: The protein concentration in the pleural fluid may be used to distinguish cardiac and non-cardiac diseases in cats.

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Assessment of a bedside test for N-terminal pro B-type natriuretic peptide (NT-proBNP) to differentiate cardiac from non-cardiac causes of pleural effusion in cats

Cited by 13 publications

References 30 publications

Evaluation of point‐of‐care thoracic ultrasound and NT‐proBNP for the diagnosis of congestive heart failure in cats with respiratory distress

Evaluation of point‐of‐care thoracic ultrasound and NT‐proBNP for the diagnosis of congestive heart failure in cats with respiratory distress

ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats

Evaluation of pleural fluid parameters related to cardiac diseases in cats

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