Cardiac Troponin I in Doberman Pinschers with Cardiomyopathy

BackgroundCardiac troponin I (cTnI) is useful for assessing hypertrophic cardiomyopathy (HCM) in cats.ObjectiveTo measure plasma cTnI concentrations in healthy cats and evaluate the clinical utility of cTnI in determining the severity of HCM.AnimalsClinically healthy cats (n = 88) and cats with HCM (n = 93).MethodsMulticenter prospective study. Cats with HCM, including hypertrophic obstructive cardiomyopathy at various stages, were diagnosed using echocardiography. Plasma cTnI concentrations were analyzed by a commercial laboratory. Receiver‐operating characteristic curve analysis was used to evaluate the accuracy of plasma cTnI concentrations to detect HCM.ResultsThe median cTnI concentration was 0.027 ng/mL (interquartile range, 0.012‐0.048 ng/mL) in healthy cats. Concentrations were significantly higher in diseased cats than in healthy controls, and concentrations were significantly higher in cats with heart failure than in asymptomatic cats. A plasma cTnI concentration of 0.163 ng/mL had a sensitivity of 62.0% and specificity of 100% when used to distinguish normal cats from asymptomatic HCM cats without left atrial dilatation. A cutoff of 0.234 ng/mL had high sensitivity (95.0%) and specificity (77.8%) for assessing heart failure. The areas under the receiver‐operating characteristic curves were 0.85 and 0.93, respectively.Conclusions and Clinical ImportanceIncreased cTnI concentrations reflect the severity of HCM. If other causes of cardiac injury are ruled out, plasma cTnI concentration may be useful for predicting the severity of HCM in cats.

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of cardiac troponin I in cats with hypertrophic cardiomyopathy

Hori

Iguchi²,

Heishima

et al. 2018

“…Several studies in human and veterinary medicine have demonstrated that serum cardiac troponin concentrations are increased in various cardiac and noncardiac diseases 4, 19, 30, 33, 38, 44, 45…”

Section: Discussionmentioning

confidence: 99%

“…Based on this information, we did not exclude dogs with renal failure. The study should include all feasible medical ICU patients, excluding those with cardiac disease, but renal failure as well as age29, 30, 48 and extensive physical strain should be kept in mind as differentials for increased cTnI concentrations 49…”

Section: Discussionmentioning

confidence: 99%

Serum Cardiac Troponin I Concentrations in Dogs with Systemic Inflammatory Response Syndrome

Hamacher¹,

Dörfelt²,

Müller³

et al. 2015

Self Cite

BackgroundMyocardial injury can be detected by cardiac troponin I (cTnI) concentration, which appears to be a predictor of short‐term death in critically ill patients. It is unknown if the best prognostic indicator of short‐term survival is cTnI measurement at admission or at later time points.Hypothesis/ObjectivesMeasuring cTnI with a high‐sensitivity (HS) test at different time points after admission may be a better short‐term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS).AnimalsProspective, observational clinical study of 60 dogs with SIRS.MethodsCardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3, and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28‐day mortality were assessed by receiver operating characteristic curve analysis.ResultsForty‐one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; P = .004) and at the peak time point (median, 0.23 ng/mL; P = .01) compared to 19 nonsurvivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score.Conclusions and Clinical ImportanceIncreased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow‐up measurement of cTnI concentration provides no additional prognostic information for short‐term mortality.

“…The reasons for this finding remain unclear, but might involve interday variability in arrhythmia severity, the relatively low number of ventricular arrhythmias present in any individual dog, and the fact that blood sampling for NT‐proBNP assay was not performed simultaneously using Holter examination. Alternate biomarkers of cellular damage, electrical dysfunction, or arrhythmias, such as cardiac troponin, might be superior or complementary to NT‐proBNP assay in detecting H‐ODCM …”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of NT‐proBNP Assay to Detect Occult Dilated Cardiomyopathy and Predict Survival in Doberman Pinschers

Singletary

Morris²,

O’Sullivan

et al. 2012

Background: Occult (asymptomatic) dilated cardiomyopathy (ODCM) is highly prevalent in Doberman Pinschers. Hypothesis/Objectives: Assess ability of NT-proBNP assay to detect ODCM and predict death. Animals: 155 asymptomatic Dobermans presenting for ODCM screening. Methods: Echocardiography, 24-hour Holter, and NT-proBNP assay were performed prospectively. Diagnosis was based on increased left ventricular end-systolic dimension, >50 ventricular premature complexes (VPCs), or both on Holter. Utility was evaluated using receiver-operating characteristic curves. Effect of age, weight, sex, disease status, VPCs, and NT-proBNP on survival was analyzed using Kaplan-Meier and Cox-proportional hazard analysis.Results: Seventy-three (47.1%) Dobermans were diagnosed with ODCM, including 31, 17, and 25 that met Holter, echocardiographic, or both criteria, respectively. Sensitivity of NT-proBNP > 457 pmol/L to detect these groups was 45.2, 76.5, and 96.0%, respectively. Combination of NT-proBNP and Holter to detect ODCM yielded sensitivity of 94.5%, specificity of 87.8%, and accuracy of 91.0%. Follow-up data were available for 78 Dobermans. The median survival time of Dobermans with > 50 VPCs (469 days), NT-proBNP > 900 pmol/L (284 days), or ODCM (474 days) was significantly (P < .0001) shorter than those with < 50 VPCs (1743 days), NT-proBNP < 900 pmol/L (1743 days), or without disease (1743 days). NT-proBNP concentration and disease status were independently predictive of all-cause mortality.Conclusions and Clinical Importance: The combination of NT-proBNP assay and Holter detected ODCM with high accuracy. NT-proBNP and disease status were independently associated with survival. NT-proBNP assay identified Dobermans with high probability of increased LVIDs consistent with ODCM, and can facilitate pursuit of confirmatory diagnostic testing, such as echocardiography, in suspected Dobermans.