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评估血清N末端B型利钠肽原浓度在鉴别犬因充血性心力衰竭与原发性呼吸道疾病导致呼吸体征中的作用。

Assessment of serum N-terminal pro-B-type natriuretic peptide concentration for differentiation of congestive heart failure from primary respiratory tract disease as the cause of respiratory signs in dogs.

作者信息

Oyama Mark A, Rush John E, Rozanski Elizabeth A, Fox Philip R, Reynolds Caryn A, Gordon Sonya G, Bulmer Barret J, Lefbom Bonnie K, Brown Bill A, Lehmkuhl Linda B, Prosek Robert, Lesser Michael B, Kraus Marc S, Bossbaly Maribeth J, Rapoport Gregg S, Boileau Jean-Sebastien

机构信息

Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

J Am Vet Med Assoc. 2009 Dec 1;235(11):1319-25. doi: 10.2460/javma.235.11.1319.

Abstract

OBJECTIVE

To determine whether serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration is useful in discriminating between cardiac and noncardiac (ie, primary respiratory tract disease) causes of respiratory signs (ie, coughing, stertor, stridor, excessive panting, increased respiratory effort, tachypnea, or overt respiratory distress) in dogs.

DESIGN

Multicenter cross-sectional study.

ANIMALS

P 115 dogs with respiratory signs.

PROCEDURES

Dogs with respiratory signs were solicited for study. Physical examination, thoracic radiography, and echocardiography were used to determine whether respiratory signs were the result of cardiac (ie, congestive heart failure) or noncardiac (ie, primary respiratory tract disease) causes. Serum samples for NT-proBNP assay were obtained at time of admission for each dog. Receiver-operating characteristic curves were constructed to determine the ability of serum NT-proBNP concentration to discriminate between cardiac and noncardiac causes of respiratory signs.

RESULTS

Serum NT-proBNP concentration was significantly higher in dogs with cardiac versus noncardiac causes of respiratory signs. In dogs with primary respiratory tract disease, serum NT-proBNP concentration was significantly higher in those with concurrent pulmonary hypertension than in those without. A serum NT-proBNP cutoff concentration > 1,158 pmol/L discriminated between dogs with congestive heart failure and dogs with primary respiratory tract disease with a sensitivity of 85.5% and a specificity of 81.3%.

CONCLUSIONS AND CLINICAL RELEVANCE

Measuring serum NT-proBNP concentration in dogs with respiratory signs helps to differentiate between congestive heart failure and primary respiratory tract disease as an underlying cause.

摘要

目的

确定血清N末端B型利钠肽原(NT-proBNP)浓度是否有助于鉴别犬类呼吸体征(即咳嗽、鼾音、喘鸣、过度喘气、呼吸用力增加、呼吸急促或明显呼吸窘迫)的心脏性病因和非心脏性病因(即原发性呼吸道疾病)。

设计

多中心横断面研究。

动物

115只出现呼吸体征的犬。

方法

招募出现呼吸体征的犬进行研究。通过体格检查、胸部X光摄影和超声心动图来确定呼吸体征是由心脏性病因(即充血性心力衰竭)还是非心脏性病因(即原发性呼吸道疾病)引起的。在每只犬入院时采集血清样本用于NT-proBNP检测。构建受试者操作特征曲线以确定血清NT-proBNP浓度区分呼吸体征的心脏性病因和非心脏性病因的能力。

结果

呼吸体征由心脏性病因引起的犬,其血清NT-proBNP浓度显著高于由非心脏性病因引起的犬。在患有原发性呼吸道疾病的犬中,并发肺动脉高压的犬血清NT-proBNP浓度显著高于未并发肺动脉高压的犬。血清NT-proBNP临界浓度>1158 pmol/L时,区分充血性心力衰竭犬和原发性呼吸道疾病犬的灵敏度为85.5%,特异度为81.3%。

结论及临床意义

检测出现呼吸体征犬的血清NT-proBNP浓度有助于鉴别潜在病因是充血性心力衰竭还是原发性呼吸道疾病。

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