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Evaluation of the association between plasma concentration of N-terminal proatrial natriuretic peptide and outcome in cats with cardiomyopathy

Tanja M. ZimmeringSmall Animal Hospital, University of Veterinary Medicine, 30173 Hannover, Germany

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Stephan HungerbühlerSmall Animal Hospital, University of Veterinary Medicine, 30173 Hannover, Germany

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Felix MenesesSmall Animal Hospital, University of Veterinary Medicine, 30173 Hannover, Germany

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Abstract

Objective—To determine whether plasma N-terminal proatrial natriuretic peptide (NT-proANP) concentration could predict the outcome (survival duration) of cats with cardiomyopathy (CM).

Design—Case-control study.

Animals—51 cats with CM (25 with and 26 without congestive heart failure [CHF]) and 17 healthy cats.

Procedures—Cats were thoroughly examined and assigned to 1 of 3 groups (control, CM with CHF, and CM alone). Plasma NT-proANP concentrations were measured by use of a human proANP(1-98) ELISA. Survival durations were compared between CM groups.

Results—Plasma NT-proANP concentrations differed significantly among the 3 groups, and survival durations differed significantly between the 2 CM groups. Median (range) NT-proANP concentration was 413 fmol/mL (52 to 940 fmol/mL) in the control group, 1,254 fmol/mL (167 to 2,818 fmol/mL) in the CM alone group, and 3,208 fmol/mL (1,189 to 15,462 fmol/mL) in the CM with CHF group. At a cutoff of 517 fmol/mL, NT-proANP concentration had a sensitivity of 90% and specificity of 82% for detecting CM. Multivariate analysis revealed that only the variable left atrium-to-aortic diameter ratio was a significant predictor of survival duration.

Conclusions and Clinical Relevance—Plasma NT-proANP concentration may have potential as a testing marker for distinguishing healthy cats from cats with CM. It may also be useful for distinguishing CM cats with CHF from those without CHF The value of NT-proANP concentration as a predictor of survival duration was not supported in this study and requires further evaluation. (J Am Vet Med Assoc 2010;237:665-672)

Abstract

Objective—To determine whether plasma N-terminal proatrial natriuretic peptide (NT-proANP) concentration could predict the outcome (survival duration) of cats with cardiomyopathy (CM).

Design—Case-control study.

Animals—51 cats with CM (25 with and 26 without congestive heart failure [CHF]) and 17 healthy cats.

Procedures—Cats were thoroughly examined and assigned to 1 of 3 groups (control, CM with CHF, and CM alone). Plasma NT-proANP concentrations were measured by use of a human proANP(1-98) ELISA. Survival durations were compared between CM groups.

Results—Plasma NT-proANP concentrations differed significantly among the 3 groups, and survival durations differed significantly between the 2 CM groups. Median (range) NT-proANP concentration was 413 fmol/mL (52 to 940 fmol/mL) in the control group, 1,254 fmol/mL (167 to 2,818 fmol/mL) in the CM alone group, and 3,208 fmol/mL (1,189 to 15,462 fmol/mL) in the CM with CHF group. At a cutoff of 517 fmol/mL, NT-proANP concentration had a sensitivity of 90% and specificity of 82% for detecting CM. Multivariate analysis revealed that only the variable left atrium-to-aortic diameter ratio was a significant predictor of survival duration.

Conclusions and Clinical Relevance—Plasma NT-proANP concentration may have potential as a testing marker for distinguishing healthy cats from cats with CM. It may also be useful for distinguishing CM cats with CHF from those without CHF The value of NT-proANP concentration as a predictor of survival duration was not supported in this study and requires further evaluation. (J Am Vet Med Assoc 2010;237:665-672)

Contributor Notes

Presented in abstract form at the 18th Annual Congress of the European College of Veterinary Internal Medicine, Gent, Belgium, September 2008.

Address correspondence to Dr. Zimmering (tanja.zimmering@tiho-hannover.de).