Prospective Evaluation of <scp>NT</scp>‐pro<scp>BNP</scp> Assay to Detect Occult Dilated Cardiomyopathy and Predict Survival in <scp>D</scp>oberman Pinschers

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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confidence: 99%

Breed Differences in Natriuretic Peptides in Healthy Dogs

Sjöstrand

Wess

Ljungvall

et al. 2014

“…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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confidence: 99%

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

Self Cite

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.

“…Several other authors also investigated the predictive value of different variables for assessing the SCD risk of Doberman Pinschers suffering from DCM. However, most of the previously existing studies determined a combination of CHF and SCD as terminal point, drew on a rather small population, did not compile cut‐off values, or the control group was not based on Doberman Pinschers with DCM …”

Section: Discussionmentioning

confidence: 99%

Predictors of Sudden Cardiac Death in Doberman Pinschers with Dilated Cardiomyopathy

Klüser

Holler

Simak

et al. 2016

BackgroundDoberman Pinschers with dilated cardiomyopathy (DCM) are at high risk of sudden cardiac death (SCD). Risk factors for SCD are poorly defined.AimTo assess cardiac biomarkers, Holter‐ECG, echocardiographic variables and canine characteristics in a group of Doberman Pinschers with DCM dying of SCD and in a DCM control group to identify factors predicting SCD.Methods/AnimalsA longitudinal prospective study was performed in 95 Doberman Pinschers with DCM. Forty‐one dogs died within 3 months after the last cardiac examination (SCD‐group) and were compared to 54 Doberman Pinschers with DCM surviving 1 year after inclusion. Holter‐ECG, echocardiography, measurement of N‐terminal prohormone of brain‐natriuretic peptide (NT‐proBNP), and cardiac Troponin I (cTnI) concentrations were recorded for all dogs.ResultsVolume overload of the left ventricle (left ventricular end‐diastolic volume (LVEDV/BSA) > 91.3 mL/m²) was the single best variable to predict SCD. The probability of SCD increases 8.5‐fold (CI 0.95 = 0.8–35.3) for every 50 mL/m²‐unit increment in LVEDV/BSA. Ejection fraction (EF), left ventricular end‐systolic volume (LVESV/BSA) and NT‐proBNP were highly correlated with LVEDV/BSA (r = −0.63, 0.96, 0.86, respectively). Generated conditional inference trees (CTREEs) revealed that the presence of ventricular tachycardia (VT), increased concentration of cTnI, and the fastest rate (FR) of ventricular premature complexes (VPC) ≥260 beats per minute (bpm) are additional important variables to predict SCD.ConclusionConditional inference trees provided in this study might be useful for risk assessment of SCD in Doberman Pinschers with DCM.