Fine Deborah M, DeClue Amy E, Reinero Carol R
Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.
J Am Vet Med Assoc. 2008 Jun 1;232(11):1674-9. doi: 10.2460/javma.232.11.1674.
To evaluate assessment of circulating amino terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration as a means to discriminate between congestive heart failure and primary pulmonary disease in dogs.
Prospective case series.
46 dogs with signs of respiratory distress or coughing.
All dogs underwent physical and thoracic radiographic examinations. Dogs with evidence of heart disease (eg, murmur, arrhythmia, or large cardiac silhouette detected by radiography) also underwent echocardiography. Dogs with no evidence of heart disease or failure were included if they underwent bronchoalveolar lavage (with cytologic examination and bacterial culture of the lavage fluid). Blood samples for NT-proBNP assay were obtained within 12 hours of the diagnosis of heart failure or prior to bronchoalveolar lavage in dogs with primary pulmonary disease. Circulating concentrations of NT-proBNP were compared between groups and correlated with radiographic and echocardiographic measures of cardiac size.
Congestive heart failure and primary pulmonary disease were diagnosed in 25 and 21 dogs, respectively. Dogs with congestive heart failure had significantly higher median serum or plasma NT-proBNP concentration (2,554 pmol/L; interquartile [25% to 75%] range, 1,651.5 to 3,475.5 pmol/L) than dogs with primary pulmonary disease (357 pmol/L; interquartile range, 192.5 to 565.5 pmol/L). Radiographic vertebral heart score and echocardiographic left atrial-to-aortic diameter ratio were not correlated with NT-proBNP concentration. Left ventricular end-diastolic diameter (measured echocardiographically) and NT-proBNP concentration were weakly correlated.
Serum or plasma NT-proBNP concentration assessment may be useful for discrimination of congestive heart failure from primary pulmonary disease in dogs with respiratory distress or cough.
评估循环氨基末端脑钠肽前体（NT-proBNP）浓度作为区分犬充血性心力衰竭和原发性肺部疾病的一种方法。
前瞻性病例系列研究。
46只出现呼吸窘迫或咳嗽症状的犬。
所有犬均接受体格检查和胸部X光检查。有心脏病证据（如通过X光检查发现杂音、心律失常或心脏轮廓增大）的犬还接受了超声心动图检查。无心脏病或心力衰竭证据但接受支气管肺泡灌洗（对灌洗液进行细胞学检查和细菌培养）的犬也被纳入研究。在诊断心力衰竭后12小时内或对原发性肺部疾病的犬进行支气管肺泡灌洗前采集用于NT-proBNP检测的血样。比较各组间NT-proBNP的循环浓度，并将其与心脏大小的X光和超声心动图测量值相关联。
分别在25只和21只犬中诊断出充血性心力衰竭和原发性肺部疾病。充血性心力衰竭的犬血清或血浆NT-proBNP浓度中位数（2,554 pmol/L；四分位数间距[25%至75%]范围，1,651.5至3,475.5 pmol/L）显著高于原发性肺部疾病的犬（357 pmol/L；四分位数间距，192.5至565.5 pmol/L）。X光椎体心脏评分和超声心动图左心房与主动脉直径比与NT-proBNP浓度无关。左心室舒张末期直径（通过超声心动图测量）与NT-proBNP浓度呈弱相关。
血清或血浆NT-proBNP浓度评估可能有助于区分有呼吸窘迫或咳嗽症状的犬的充血性心力衰竭和原发性肺部疾病。
