Objective—To evaluate plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in a large, diverse population of dogs with and without cardiac disease and to define the upper reference limit for the biomarker in this species.
Design—Cross-sectional single center study.
Procedures—Dogs underwent blood sample collection, physical examination, ECG, and echocardiographic and thoracic radiographic evaluations. Cardiac status was graded by use of a 9-grade cardiac disease classification system and a simplified 4-stage cardiac scoring system. Vertebral heart score (VHS) was assessed in 280 dogs. Associations of plasma NT-proBNP concentrations with multiple variables were evaluated via univariate and multivariate linear regression analysis. Sensitivity and specificity of NT-proBNP concentrations and of VHS to discriminate between dogs with and without clinical signs of cardiac disease were evaluated via receiver-operating characteristic curve analysis.
Results—974 dogs had cardiac disease, 37 had noncardiac-related disease, and 123 were healthy. Plasma NT-proBNP concentrations correlated with cardiac grade and stage; VHS was also associated with cardiac grade. At a cutoff of 874 pmol/L, sensitivity and specificity of NT-proBNP concentration to detect clinical signs of cardiac disease were 70% and 83%, respectively; for VHS, sensitivity and specificity were 56% and 85%, respectively, at a cutoff of 11.5. Mean NT-proBNP concentration was significantly increased in dogs with cardiac-related dyspnea or coughing, compared with dogs in which these signs were noncardiac related.
Conclusions and Clinical Relevance—Results suggested that 900 pmol/L is the upper reference limit of plasma NT-proBNP concentration in dogs. This biomarker may be a useful tool for staging of cardiac disease and identifying cardiac-related coughing or dyspnea in this species.
Objective—To determine signalment, clinical signs,
diagnostic findings, treatment, and outcome for cats
with atrial fibrillation (AF).
Procedure—Medical records of cats that met criteria
for a diagnosis of AF (ECG consisting of at least 2
leads, clear absence of P waves, supraventricular
rhythm, and convincingly irregularly irregular rhythm)
and had undergone echocardiography were reviewed.
Results—There were 41 males (37 castrated) and 9
females (7 spayed). Forty-one were of mixed breeding;
9 were purebred. Mean ± SD age was 10.2 ± 3.7 years.
The most common chief complaints were dyspnea,
aortic thromboembolism, and lethargy. In 11 cats, AF
was an incidental finding. Mean ± SD ventricular rate
was 223 ± 36 beats/min. The most common echocardiographic
abnormalities were restrictive or unclassified
cardiomyopathy (n = 19), concentric left ventricular
hypertrophy (18), and dilated cardiomyopathy (6). Mean
± SD left atrial-to-aortic diameter ratio (n = 39) was 2.55
± 0.80. The most common thoracic radiographic findings
were cardiomegaly, pleural effusion, and pulmonary
edema. Median survival time (n = 24) was 165
days (range, 0 to 1,095 days). Eight of 24 cats lived for
≥ 1 year after a diagnosis of AF was made.
Conclusions and Clinical Relevance—Results suggest
that AF occurs primarily in older adult male cats
with structural heart disease severe enough to lead to
atrial enlargement. Atrial fibrillation in these cats was
most commonly first detected when signs of decompensated
cardiac disease were evident, but also was
commonly identified as an incidental finding. (J Am
Vet Med Assoc 2004;225:256–260)