N-terminal-pro brain natriuretic peptides in dogs and cats: A technical and clinical review

Abstract

Biomarkers are quantitative indicators of biological processes performed by an organ or system. In recent years, natriuretic peptides (NPs) have emerged as important tools in the diagnosis and therapeutic monitoring of heart diseases. Research has shown that serum and plasma levels of N-terminal pro brain NP (NT-proBNP) in dogs and cats are the only biomarkers that afford to diagnose and monitor congestive processes and, indirectly, the myocardial function of small animals. The present review discusses the peer-reviewed specialized literature about NT-proBNP and presents and compares the potential clinical applications of this NP in veterinary medicine of small animals, considering diagnosis, follow-up, and prognosis of myocardial or systemic diseases. The relevance of NT-proBNP is associated with sample stability, easy determination in laboratory, sensitivity, accuracy, and the possibility to analyze myocardial function. These advantages are specially important when NT-proBNP is compared with other cardiac biomarkers, mostly those that indicate the integrity of the myocardial cell. Fast NT-proBNP assays are marketed today and may be used in association with complementary tests. Together, these methods are an important source of information in differential diagnosis of heart and lung diseases as well in the early diagnosis of cardiopathy in dogs and cats, proving valuable tools in treatment and prognosis.

Clinical use of submaximal treadmill exercise testing and assessments of cardiac biomarkers NT-proBNP and cTnI in dogs with presymptomatic mitral regurgitation

“…NT-proBNP concentrations vary immensely between breeds and also show a great intrabreed variation [ 19 , 23 ]. The same is not true for cTnI levels [ 46 ].…”

“…The cardiac biomarkers NT-proBNP and cardiac troponin I (cTnI) are promising parameters for canine cardiology, yet they are mostly used for research purposes, as solid characterisations for the use in a clinical setting are lacking [ 19 , 20 ]. Resting values are subject to day-to-day variability and are influenced by age or breed and circadian rhythms [ 21 – 24 ].…”

Canine Traditional Laboratory Tests and Cardiac Biomarkers

“…The reference intervals of cardiac biomarkers (as for all laboratory tests) may vary depending on the type of test used, sensitivity, and working conditions; therefore, it is hard to define a unique value of these. Some reviews have provided reference intervals for the various tests available ( 67 , 68 , 79 , 101 ).…”

Biomarcadores Cardíacos E Sua Aplicabilidade Clínica Em Cães E Gatos

“…Após a sua ação, o ANP e BNP são retirados da circulação por dois mecanismos principais: pelo receptor de peptídeos natriuréticos tipo C, que resulta na depuração por internalização dos peptídeos natriuréticos e posterior degradação lisossomal, ou através da enzima neutralizadora de endopeptídeos que quebra os peptídeos natriuréticos em fragmentos inativos. Os receptores apresentam maior afinidade pelo ANP, o que pode estar relacionado ao aumento do tempo de meiavida do BNP na circulação (HEZZEL et al, 2015;LIMA;FERREIRA, 2017).…”

“…Na medicina veterinária, a mensuração do NT-proBNP é recomendada, e têm sido validada, para auxiliar na identificação de doenças cardíacas ocultas, na diferenciação das dispneias de origem respiratória e de ICC (FOX et al, 2015;KANNO et al, 2016;LIMA;FERREIRA, 2017), na cardiomiopatia hipertrófica (CMH) em felinos (FREITAS et al, 2015;HEISHIMA et al, 2018), na cardiomiopatia dilatada (CMD) (WESS et al, 2017) e como valor prognóstico nas doenças degenerativas valvares (FOX et al, 2015;RUAUX et al, 2015;WINTER et al, 2017). No Quadro 1, apresentam-se os níveis séricos de NT-proBNP encontrados em cães e gatos, segundo recomendações do laboratório IDEXX (IDEXX LABORATORIES, 2013).…”