Investigation into the use of plasma NT-proBNP concentration to screen for feline hypertrophic cardiomyopathy

Hsu, Adonia; Kittleson, Mark D.; Paling, Anna

doi:10.1016/j.jvc.2009.02.005

Cited by 44 publications

(63 citation statements)

References 25 publications

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“…As feline plasma NT‐proBNP concentrations can be markedly increased in cats with heart failure, the correlation between left ventricular hypertrophy and BNP concentrations requires further analysis. Others have investigated Maine Coon cats with inherited HCM, reporting that NT‐proBNP distinguished severe, but not mild left ventricular hypertrophy . However, the applicability of data from a closed, inbred colony to the greater, worldwide, feline population has been questioned .…”

Section: Discussionmentioning

confidence: 56%

Multicenter Evaluation of Plasma N‐Terminal Probrain Natriuretic Peptide (NT‐pro BNP) as a Biochemical Screening Test for Asymptomatic (occult) Cardiomyopathy in Cats

Fox

Rush

Reynolds

et al. 2011

Veterinary Internal Medicne

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Background: B-type natriuretic peptide concentrations reliably distinguish between cardiac and respiratory causes of dyspnea, but its utility to detect asymptomatic cats with occult cardiomyopathy (OCM) is unresolved.Hypothesis/Objectives: Determine whether plasma N terminal probrain natriuretic peptide (NT-proBNP) concentration can discriminate asymptomatic cats with OCM from normal cats, and whether NT-proBNP concentration correlates with clinical, biochemical, and echocardiographic parameters.Animals: One hundred and fourteen normal, healthy cats; 113 OCM cats. Methods: Prospective, multicenter, case-controlled study. NT-proBNP was prospectively measured and cardiac status was determined from history, physical examination, and M-mode/2D/Doppler echocardiography. Optimal cut-off values were derived using receiver operating characteristic (ROC) curve analysis.Results: NT-proBNP was higher (median, interquartile range [25th and 75th percentiles]) in (1) OCM (186 pmol/L; 79, 478 pmol/L) versus normal (24 pmol/L; 24, 32 pmol/L) (P < .001); and (2) hypertrophic obstructive cardiomyopathy (396 pmol/L; 205, 685 pmol/L) versus hypertrophic cardiomyopathy (112 pmol/L; 48, 318 pmol/L) (P < .001). In OCM, NT-proBNP correlated (1) positively with LVPWd (ρ = 0.23; P = .01), LA/Ao ratio (ρ = 0.31; P < .001), LVs (ρ = 0.33; P < .001), and troponin-I (ρ = 0.64; P < .001), and (2) negatively with %FS (ρ = À0.27; P = .004). Area under ROC curve was 0.92; >46 pmol/L cut-off distinguished normal from OCM (91.2% specificity, 85.8% sensitivity); >99 pmol/L cut-off was 100% specific, 70.8% sensitive.Conclusions and Clinical Importance: Plasma NT-proBNP concentration reliably discriminated normal from OCM cats, and was associated with several echocardiographic markers of disease severity. Further studies are needed to assess test performance in unselected, general feline populations, and evaluate relationships between NT-proBNP concentrations and disease progression.

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Section: Discussionmentioning

confidence: 56%

Multicenter Evaluation of Plasma N‐Terminal Probrain Natriuretic Peptide (NT‐pro BNP) as a Biochemical Screening Test for Asymptomatic (occult) Cardiomyopathy in Cats

Fox

Rush

Reynolds

et al. 2011

Veterinary Internal Medicne

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“…Severe HCM was defined as severe concentric hypertrophy of the left ventricle, not by the clinical condition of the cats or the size of the left atrium. The degree of concentric hypertrophy was considered severe when thickness of either LVPWd or IVSd was ≥7 mm or marked thickening of the papillary muscles was present 22 . None of the cats had evidence of dynamic left ventricular outflow tract obstruction caused by SAM of the mitral valve.…”

Section: Methodsmentioning

confidence: 99%

“…None of the cats had evidence of dynamic left ventricular outflow tract obstruction caused by SAM of the mitral valve. All cats had been genetically screened for the A31P mutation in the MYBPC3 gene 22 . Genotype was classified as either heterozygous or wild type.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Atenolol on NT‐proBNP and Troponin in Asymptomatic Cats with Severe Left Ventricular Hypertrophy because of Hypertrophic Cardiomyopathy: A Pilot Study

Jung

Kittleson

2011

Veterinary Internal Medicne

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Background: Atenolol often is used empirically in cats with hypertrophic cardiomyopathy (HCM) before the onset of heart failure, although evidence of efficacy is lacking. Cardiac biomarkers play a critical role in the early detection of subclinical cardiac disease, in the prediction of long-term prognosis, and in monitoring the response to therapy in humans.Hypothesis: Circulating concentrations of the biomarkers N-terminal pro-B type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) will decrease after chronic administration of atenolol PO to cats with severe HCM but no signs of heart failure.Animals: Six Maine Coon or Maine Coon cross cats with severe HCM. Methods: Cats were treated with atenolol (12.5 mg PO q12 h) for 30 days. No cat had left ventricular dynamic outflow tract obstruction caused by systolic anterior motion of the mitral valve. The concentrations of NT-proBNP and cTnI were assayed before and on the last day of drug administration.Results: There was no statistically significant change in NT-proBNP (median before, 394 pmol/L; range, 71-1,500 pmol/L; median after, 439 pmol/L; range, 24-1,500 pmol/L; P 5 .63) or in cTnI (median before, 0.24 ng/mL; range, 0.10-0.97 ng/mL; median after, 0.28 ng/mL; range, 0.09-1.0 ng/mL; P 5 .69) after administration of atenolol.Conclusions: Atenolol administration did not decrease NT-proBNP or cTnI concentrations in cats with severe left ventricular hypertrophy caused by hypertrophic cardiomyopathy. These results suggest that atenolol did not decrease myocardial ischemia and myocyte death in these cats. A larger clinical trial is warranted to verify these findings.

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“…Recently, determination of the plasma NT-proBNP concentration in cats became possible, and the usefulness of this marker in cats with heart disease has been studied [5,8]. However, there have been no studies on the diagnostic importance of the plasma NT-proBNP concentration in asymptomatic cats with cardiac enlargement to our knowledge.…”

mentioning

confidence: 99%

The Diagnostic Significance of the Plasma N-Terminal Pro-B-Type Natriuretic Peptide Concentration in Asymptomatic Cats with Cardiac Enlargement

Tominaga

Miyagawa

Toda

et al. 2011

The Journal of Veterinary Medical Science

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ABSTRACT. We evaluated the diagnostic significance of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration in asymptomatic cats with cardiac enlargement. The plasma NT-proBNP concentration was measured in 21 clinically healthy control cats, and 67 asymptomatic cats with cardiac enlargement defined as end-diastolic interventricular septum thickness (IVSd) and/or diastolic left ventricular posterior wall thickness (LVPWd) >0.6 cm, vertebla heart scale (VHS) >7.8, and/or left atria/aorta ratio (LA/Ao) >1.5. The plasma NT-proBNP concentration in the asymptomatic cats with cardiac enlargement (median: 662.0, range: 24.0-2,449.0 pmol/l) was significantly higher than that in the controls (24.0, 24.0-95.0 pmol/l, P<0.001). The plasma NT-proBNP concentration was significantly correlated with the VHS, LA/Ao, IVSd and LVPWd (r=0.578, P<0.001; r=0.462, P<0.001; r=0.563, P<0.001; and r=0.764, P<0.001, respectively). Receiver operating characteristic analysis showed a cut-off value of 95.0 pmol/l for the detection of asymptomatic cats with cardiac enlargement, sensitivity and specificity of 88.1 and 100%, respectively, and an area under the curve of 0.971. These results suggest that the determination of the plasma NT-proBNP concentration can be a useful screening test for asymptomatic cats with cardiac enlargement.

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Investigation into the use of plasma NT-proBNP concentration to screen for feline hypertrophic cardiomyopathy

Cited by 44 publications

References 25 publications

Multicenter Evaluation of Plasma N‐Terminal Probrain Natriuretic Peptide (NT‐pro BNP) as a Biochemical Screening Test for Asymptomatic (occult) Cardiomyopathy in Cats

Multicenter Evaluation of Plasma N‐Terminal Probrain Natriuretic Peptide (NT‐pro BNP) as a Biochemical Screening Test for Asymptomatic (occult) Cardiomyopathy in Cats

The Effect of Atenolol on NT‐proBNP and Troponin in Asymptomatic Cats with Severe Left Ventricular Hypertrophy because of Hypertrophic Cardiomyopathy: A Pilot Study

The Diagnostic Significance of the Plasma N-Terminal Pro-B-Type Natriuretic Peptide Concentration in Asymptomatic Cats with Cardiac Enlargement

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