Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats

Fox, Philip R.; Oyama, Mark A.; Reynolds, Caryn; Rush, John E.; DeFrancesco, Teresa C.; Keene, Bruce W.; Atkins, Clark E.; MacDonald, Kristin A.; Schober, Karsten E.; Bonagura, John D.; Stepien, Rebecca L.; Kellihan, Heidi B.; Nguyenba, Thaibinh P.; Lehmkuhl, Linda B.; Lefbom, Bonnie K.; Moı̈se, N. Sydney; Hogan, Daniel F.

doi:10.1016/j.jvc.2008.12.001

Cited by 87 publications

(96 citation statements)

References 51 publications

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“…Single‐time measurement of NT‐proBNP has a wide array of clinical applications in veterinary medicine, including the prediction of first onset CHF in dogs with degenerative mitral valve disease,9 prognostication in dogs with acquired cardiac disease,10 differentiation between cardiac and noncardiac causes of respiratory signs in cats11 and dogs,12, 13, 14 detection of occult cardiomyopathy in cats15, 16 and screening for occult dilated cardiomyopathy (DCM) in Doberman pinschers 17, 18. In addition, changes in NT‐proBNP concentrations have been investigated in 1 study in dogs with degenerative mitral valve disease and CHF, although changes were not associated with survival, dogs with NT‐proBNP concentrations <965 pmol/L at the time of re‐evaluation had a longer survival time 19…”

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confidence: 99%

Association between Survival Time and Changes inNT‐proBNPin Cats Treated for Congestive Heart Failure

Pierce

Freeman

Cunningham

et al. 2017

Veterinary Internal Medicne

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BackgroundReductions in N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations after treatment have been associated with improved survival in people with congestive heart failure (CHF), but have not been reported in cats with CHF.ObjectivesTo evaluate changes in NT‐proBNP concentrations in cats with CHF after treatment and determine whether serial NT‐proBNP measurements provide prognostic information.AnimalsThirty‐one client‐owned cats.MethodsProspective, observational study in cats with new onset CHF secondary to cardiomyopathy. Concentrations of NT‐proBNP were measured within 4 hours of admission to the hospital, on the day of discharge, and at re‐evaluation 7–10 days later.ResultsMedian NT‐proBNP concentrations decreased significantly from admission (1,713 pmol/L [range, 160–3,784 pmol/L]) to discharge (902 pmol/L [range, 147–3,223 pmol/L]); P = .005) and from admission to re‐evaluation (1,124 pmol/L [range, 111–2,727 pmol/L]; P = .024). Median survival time was 109 days (range, 1–709 days), with 5 cats still alive at the time of analysis. Cats with a larger percent decrease in NT‐proBNP from admission to discharge had a longer survival time (P = .048). Cats with evidence of active CHF at the time of re‐evaluation (P = .010) and cats whose owners had difficulty administering medications (P = .045) had shorter survival times.Conclusions and clinical importanceCats with a larger percent decrease in NT‐proBNP during hospitalization and no evidence of CHF at the time of re‐evaluation had longer survival times. Additional studies are needed to determine whether NT‐proBNP can help guide treatment in cats with CHF.

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confidence: 99%

Association between Survival Time and Changes inNT‐proBNPin Cats Treated for Congestive Heart Failure

Pierce

Freeman

Cunningham

et al. 2017

Veterinary Internal Medicne

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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.…”

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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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“…These antibodies target epitopes directed to the N-terminal portion of NTproBNP. NT-proBNP stability studies suggest that the N-terminal epitopes are more stable than those in the firstgeneration assay 7,8 where declines in the median NTproBNP concentration were observed over time in the absence of a protease inhibitor tube. 6 The second-generation feline NT-proBNP immunoassay accurately measures levels of NT-proBNP, which are often elevated in cats with cardiac disease, and the use of this test can improve diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Analytical validation of an immunoassay for the quantification of N-terminal pro–B-type natriuretic peptide in feline blood

et al. 2015

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The measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), a biomarker for heart stress detectable in blood, has been shown to have clinical utility in cats with heart disease. A second-generation feline enzyme-linked immunosorbent assay (Cardiopet® proBNP, IDEXX Laboratories Inc., Westbrook, Maine) was developed to measure NT-proBNP in routine feline plasma or serum samples with improved analyte stability. Results of the analytical validation for the second-generation assay are presented. Analytic sensitivity was 10 pmol/l. Accuracy of 103.5% was determined via serial dilutions of 6 plasma samples. Coefficients of variation for intra-assay, interassay, and total precision were in the ranges of 1.6-6.3%, 4.3-8.8%, and 10.1-15.1%, respectively. Repeatability across 2 lots for both serum and plasma had an average coefficient of determination (r(2)) of 0.99 and slope of 1.11. Stability of the analyte was found to be high. In serum samples held at 4°C for 24-72 hr, the mean percent recovery from time zero was ≥99%. In serum samples held at 25°C for 24 hr, the mean percent recovery from time zero was 91.9%, and for 48 hr, 85.6%. A method comparison of the first- and second-generation assays with a clinically characterized population of cats revealed no difference in the tests' ability to differentiate levels of NT-proBNP between normal cats and cats with occult cardiomyopathy (P < 0.001). Results from our study validate that the second-generation feline Cardiopet proBNP assay can measure NT-proBNP in routine feline plasma and serum samples with accuracy and precision.

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Utility of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats

Cited by 87 publications

References 51 publications

Association between Survival Time and Changes inNT‐proBNPin Cats Treated for Congestive Heart Failure

Association between Survival Time and Changes inNT‐proBNPin Cats Treated for Congestive Heart Failure

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

Analytical validation of an immunoassay for the quantification of N-terminal pro–B-type natriuretic peptide in feline blood

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