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评估猫心肌病患者血浆N末端前脑钠肽浓度与预后之间的关联。

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

作者信息

Zimmering Tanja M, Hungerbühler Stephan, Meneses Felix, Nolte Ingo, Simon Daniela

机构信息

Small Animal Hospital, University of Veterinary Medicine, Hannover, Germany.

出版信息

J Am Vet Med Assoc. 2010 Sep 15;237(6):665-72. doi: 10.2460/javma.237.6.665.

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.

摘要

目的

确定血浆N端前心钠素(NT-proANP)浓度是否可预测猫心肌病(CM)的预后(生存时长)。

设计

病例对照研究。

动物

51只患有CM的猫(25只伴有充血性心力衰竭[CHF],26只不伴有CHF)以及17只健康猫。

步骤

对猫进行全面检查,并分为3组之一(对照组、伴有CHF的CM组和单纯CM组)。使用人proANP(1-98) ELISA法测量血浆NT-proANP浓度。比较CM组之间的生存时长。

结果

3组之间血浆NT-proANP浓度差异显著,2个CM组之间的生存时长差异显著。对照组NT-proANP浓度中位数(范围)为413 fmol/mL(52至940 fmol/mL),单纯CM组为1254 fmol/mL(167至2818 fmol/mL),伴有CHF的CM组为3208 fmol/mL(1189至15462 fmol/mL)。NT-proANP浓度在截断值为517 fmol/mL时,检测CM的灵敏度为90%,特异性为82%。多变量分析显示,只有左心房与主动脉直径比值这一变量是生存时长的显著预测指标。

结论及临床意义

血浆NT-proANP浓度可能有潜力作为区分健康猫与患有CM的猫的检测标志物。它也可能有助于区分伴有CHF的CM猫和不伴有CHF的CM猫。本研究不支持NT-proANP浓度作为生存时长预测指标的价值,需要进一步评估。

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