Relationship between different natriuretic peptides and severity of naturally acquired mitral regurgitation in dogs with chronic myxomatous valve disease

Häggström, Jens; Hansson, Kerstin; Kvart, Clarence; Pedersen, Henrik D.; Vuolteenaho, Olli; Olsson, Kerstin

doi:10.1016/s1760-2734(06)70002-9

Cited by 74 publications

(79 citation statements)

References 37 publications

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“…Increased plasma NP concentrations have been identified in dogs with dilated cardiomyopathy (DCM) 2, 3, 4, 5, 6, 7. Furthermore, NP concentrations have been shown to increase with increasing disease severity in dogs with myxomatous mitral valve disease (MMVD),3, 8, 9, 10, 11 and NT‐proBNP has been suggested to be predictive of outcome in dogs with MMVD 9, 12, 13, 14, 15, 16. Natriuretic peptides also have been found useful to distinguish CHF from respiratory disease 12, 17, 18, 19, 20.…”

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“…Natriuretic peptides also have been found useful to distinguish CHF from respiratory disease 12, 17, 18, 19, 20. However, in several studies of dogs, considerable overlap between investigated groups has been identified 2, 3, 8, 9, 11, 17, 18, 19…”

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“…NT‐proANP is further cleaved into 3 segments; proANP 1‐30, 31‐67, and 68‐98 24. All segments can be analyzed,3, 4, 6, 8, 17, 18, 25 but the N‐terminal segments have been found to have longer half‐lives and may, therefore, be better suited as diagnostic tools 11, 26, 27, 28, 29. Furthermore, midregional proANP, such as proANP 31‐67, has been shown to have high biological stability, potentially because of a lower risk of fragmentation compared to proANP 1‐98 27…”

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Breed Differences in Natriuretic Peptides in Healthy Dogs

Sjöstrand

Wess

Ljungvall

et al. 2014

Veterinary Internal Medicne

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BackgroundMeasurement of plasma concentration of natriuretic peptides (NPs) is suggested to be of value in diagnosis of cardiac disease in dogs, but many factors other than cardiac status may influence their concentrations. Dog breed potentially is 1 such factor.ObjectiveTo investigate breed variation in plasma concentrations of pro‐atrial natriuretic peptide 31‐67 (proANP 31‐67) and N‐terminal B‐type natriuretic peptide (NT‐proBNP) in healthy dogs.Animals535 healthy, privately owned dogs of 9 breeds were examined at 5 centers as part of the European Union (EU) LUPA project.MethodsAbsence of cardiovascular disease or other clinically relevant organ‐related or systemic disease was ensured by thorough clinical investigation. Plasma concentrations of proANP 31‐67 and NT‐proBNP were measured by commercially available ELISA assays.ResultsOverall significant breed differences were found in proANP 31‐67 (P < .0001) and NT‐proBNP (P < .0001) concentrations. Pair‐wise comparisons between breeds differed in approximately 50% of comparisons for proANP 31‐67 as well as NT‐proBNP concentrations, both when including all centers and within each center. Interquartile range was large for many breeds, especially for NT‐proBNP. Among included breeds, Labrador Retrievers and Newfoundlands had highest median NT‐proBNP concentrations with concentrations 3 times as high as those of Dachshunds. German Shepherds and Cavalier King Charles Spaniels had the highest median proANP 31‐67 concentrations, twice the median concentration in Doberman Pinschers.Conclusions and Clinical ImportanceConsiderable interbreed variation in plasma NP concentrations was found in healthy dogs. Intrabreed variation was large in several breeds, especially for NT‐proBNP. Additional studies are needed to establish breed‐specific reference ranges.

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Breed Differences in Natriuretic Peptides in Healthy Dogs

Sjöstrand

Wess

Ljungvall

et al. 2014

Veterinary Internal Medicne

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“…Measurement of natriuretic peptides including canine N‐terminal pro‐brain natriuretic peptide concentration ([NT‐proBNP]) provides insights to distinguish cardiac from noncardiac respiratory distress,3, 4, 5, 6, 7, 8 assess heart disease (HD) severity,7, 9, 10, 11 predict onset of CHF,11 provide prognostic information in myxomatous mitral valve disease (MMVD),10, 11, 12, 13, 14 and dilated cardiomyopathy (DCM),15, 16 and help with treatment decisions 17…”

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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

Fox

Oyama

Hezzell

et al. 2014

Veterinary Internal Medicne

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BackgroundCardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).Hypothesis/ObjectivesDetermine 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.AnimalsClient‐owned dogs (n = 291).MethodsMulticenter, 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.ResultsPlasma [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 ImportancePlasma [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.

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“…In dogs, several studies have investigated the plasma concentration of BNP [1,2,7,12], but studies on NT-proBNP are limited. In the present study, the authors evaluated the clinical significance of the plasma NT-proBNP concentration in dogs with mitral valve insufficiency with respect to the severity of heart failure, the intensity of cardiac murmurs, cardiac size and left atrial enlargement.…”

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Evaluation of Plasma N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) Concentrations in Dogs with Mitral Valve Insufficiency

Takemura

Toda

Miyagawa

et al. 2009

The Journal of Veterinary Medical Science

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ABSTRACT. The diagnostic significance of the plasma concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) was evaluated in 72 dogs with mitral valve insufficiency and 36 control dogs. In the controls, the plasma NT-proBNP concentration was 163.9  114.7 (SD) pmol/l. The values in those with International Small Animal Cardiac Health Council (ISACHC) functional classification of heart failure class Ia, Ib, II and IIIa mitral valve insufficiency were 302.8  257.1 (n=21), 634.2  642.5 (n=23), 1,277.9  756.2 (n=18) and 1,908.9  538.8 (n=10) pmol/l, respectively; those in the class Ib or severer groups were significantly higher than that in the controls. In dogs in which the intensity of cardiac murmurs was Levine 3, 4, 5 and 6, plasma NT-proBNP concentrations were 647.6  577.3 (n=27), 1,184.7  841.0 (n=18), 1,532.4  784.2 (n=10) and 1,461.8  932.2 (n=4) pmol/l, respectively, and were significantly higher than that in the controls. The plasma NT-proBNP concentration was significantly correlated with the cardiac size (VHS) and LA/Ao (r=0.611, n=89, p<0.01; and r=0.705, n=91, p<0.01, respectively). When dogs with ISACHC class II or IIIa were regarded as heart failure, the cut-off value was 713.5 pmol/l, and the sensitivity and specificity were 0.913 and 0.857, respectively. These findings could indicate that plasma NT-proBNP concentration was significantly associated with the severity of heart failure due to mitral valve insufficiency in dogs. Further investigation is required to determine factors other than heart failure affecting plasma NT-proBNP concentration.KEY WORDS: canine, mitral valve insufficiency, NT-pro BNP.

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Relationship between different natriuretic peptides and severity of naturally acquired mitral regurgitation in dogs with chronic myxomatous valve disease

Cited by 74 publications

References 37 publications

Breed Differences in Natriuretic Peptides in Healthy Dogs

Breed Differences in Natriuretic Peptides in Healthy Dogs

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

Evaluation of Plasma N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) Concentrations in Dogs with Mitral Valve Insufficiency

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