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

Abstract

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.

Investigation of an N‐Terminal Prohormone of Brain Natriuretic Peptide Point‐of‐Care ELISA in Clinically Normal Cats and Cats With Cardiac Disease

“…The second‐generation quantitative plate ELISA used in our study had sensitivity and specificity (84.6 and 100%) similar to previously reported values (sensitivity, 71–92%; specificity, 78–100%) for both the first‐ and second‐generation quantitative assays . The POC ELISA had a lower sensitivity (65.4%) and higher specificity (100%) than previously reported (83.4 and 82.6%) .…”

“…Several studies have investigated the ability of this assay to distinguish echocardiographically normal cats from those with subclinical cardiomyopathy. These studies have shown that NT‐proBNP concentration can distinguish healthy cats from those with subclinical disease (sensitivity, 70.9–92.4%; specificity, 93.9–100%) . Plasma NT‐proBNP concentrations >100 pmol/L indicate that morphologic cardiac changes may be present and further cardiac evaluation is warranted.…”

Associations among echocardiography, cardiac biomarkers, insulin metabolism, morphology, and inflammation in cats with asymptomatic hypertrophic cardiomyopathy

“…Body morphology or larger stature may simply lead to larger hearts . However, in our study, cardiac markers NTproBNP and cTnI were significantly increased and associated with the echocardiographic measures of HCM, as described previously for NTproBNP . This finding suggests that the cats in these studies suffered from cardiac pathology, with cardiomyocyte stretch and injury, and a thus physiological variation of heart size was less likely.…”

“…Cats with LA remodeling or generalized hypertrophy did not have significantly increased blood concentrations of insulin, IGF‐1, or glucose, but cats with LA remodeling had significantly increased NTproBNP and cTnI concentrations. Increased concentration of NTproBNP previously have been reported to be associated with LA remodeling, and NTproBNP is higher in severe HCM . Serum concentration of cTnI also is higher in severe HCM and is described to be higher in cats >10 years of age, possibly reflecting a subclinical age‐related decrease in cardiac function .…”

Atrial natriuretic peptide vs.N‐terminal‐pro‐atrial natriuretic peptide for the detection of left atrial dilatation in horses

“…Natriuretic peptides (NPs) are a family of cardioprotective hormones that cause natriuresis, diuresis and vasodilatation in the case of cardiac overload [1]. The NP family consists of 2 main members, namely atrial NP (ANP) and B-type NP (BNP), of which the diagnostic value has already been extensively proved in human and small animal veterinary medicine [2][3][4][5][6][7][8][9][10][11][12]. In human medical practice, NPs are useful for diagnosis of congestive heart failure and are often used for rapid diagnosis of acute dyspnoea.…”