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酶联免疫吸附测定法检测B型利钠肽在诊断伴有咳嗽或呼吸困难的犬充血性心力衰竭中的前瞻性临床评估。

Prospective clinical evaluation of an ELISA B-type natriuretic peptide assay in the diagnosis of congestive heart failure in dogs presenting with cough or dyspnea.

作者信息

DeFrancesco Teresa C, Rush John E, Rozanski Elizabeth A, Hansen Bernard D, Keene Bruce W, Moore Dominic T, Atkins Clarke E

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.

出版信息

J Vet Intern Med. 2007 Mar-Apr;21(2):243-50. doi: 10.1892/0891-6640(2007)21[243:pceoae]2.0.co;2.

Abstract

BACKGROUND

B-type natriuretic peptide (BNP) is increased in dogs with congestive heart failure (CHF).

HYPOTHESIS

The purpose of this study was to evaluate the clinical utility of a novel canine-specific enzyme-linked immunosorbent assay of BNP for the diagnosis of CHF in dogs presenting with either cough or dyspnea.

ANIMALS

Three hundred and thirty dogs from 2 large university teaching hospitals.

METHODS

We prospectively measured plasma BNP concentrations in 3 groups of dogs: (1) normal adult dogs (n = 75), (2) dogs with asymptomatic heart disease (n = 76), and (3) dogs with cough or dyspnea (n = 179). The final diagnosis of dogs with cough or dyspnea and the severity of CHF (International Small Animal Cardiac Health Council Heart Failure Classification [ISACHC]) were determined by medical record review by a study cardiologist who was blinded to the results of the BNP assay.

RESULTS

Dogs with CHF had a higher median BNP concentration (24.6 pg/mL) than dogs with noncardiac causes of cough or dyspnea (2.6 pg/mL) (P < .0001). The area under the curve was 0.91 for the receiver operating curve analysis of the diagnostic accuracy of the BNP measurement to differentiate CHF from other causes of cough or dyspnea. The median BNP concentrations in dogs were 3.0 pg/mL with ISACHC I, 17.8 pg/mL with ISACHC II, and 30.5 pg/mL with ISACHC III. (P < .0001)

CONCLUSION AND CLINICAL IMPORTANCE

Measurement of BNP is useful in establishing or in excluding the diagnosis of CHF in dogs with cough or dyspnea. B-type natriuretic peptide concentrations rose significantly as a function of severity of CHF.

摘要

背景

B型利钠肽(BNP)在患有充血性心力衰竭(CHF)的犬中升高。

假设

本研究的目的是评估一种新型的犬特异性BNP酶联免疫吸附测定法在诊断出现咳嗽或呼吸困难的犬CHF中的临床实用性。

动物

来自2家大型大学教学医院的330只犬。

方法

我们前瞻性地测量了3组犬的血浆BNP浓度:(1)正常成年犬(n = 75),(2)无症状心脏病犬(n = 76),以及(3)咳嗽或呼吸困难犬(n = 179)。对咳嗽或呼吸困难犬的最终诊断以及CHF的严重程度(国际小动物心脏健康委员会心力衰竭分级[ISACHC])由一位对BNP测定结果不知情的研究心脏病专家通过病历审查确定。

结果

患有CHF的犬的BNP浓度中位数(24.6 pg/mL)高于因非心脏原因引起咳嗽或呼吸困难的犬(2.6 pg/mL)(P <.0001)。BNP测量用于区分CHF与其他咳嗽或呼吸困难原因的诊断准确性的受试者操作曲线分析的曲线下面积为0.91。ISACHC I级犬的BNP浓度中位数为3.0 pg/mL,ISACHC II级犬为17.8 pg/mL,ISACHC III级犬为30.5 pg/mL。(P <.0001)

结论及临床意义

测量BNP有助于对咳嗽或呼吸困难的犬建立或排除CHF诊断。B型利钠肽浓度随着CHF严重程度的增加而显著升高。

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