Animal Medical Center, New York, NY, USA.
J Vet Intern Med. 2011 Sep-Oct;25(5):1010-6. doi: 10.1111/j.1939-1676.2011.00776.x. Epub 2011 Aug 30.
B-type natriuretic peptide concentrations reliably distinguish between cardiac and respiratory causes of dyspnea, but its utility to detect asymptomatic cats with occult cardiomyopathy (OCM) is unresolved.
HYPOTHESIS/OBJECTIVES: Determine whether plasma N terminal probrain natriuretic peptide (NT-proBNP) concentration can discriminate asymptomatic cats with OCM from normal cats, and whether NT-proBNP concentration correlates with clinical, biochemical, and echocardiographic parameters.
One hundred and fourteen normal, healthy cats; 113 OCM cats.
Prospective, multicenter, case-controlled study. NT-proBNP was prospectively measured and cardiac status was determined from history, physical examination, and M-mode/2D/Doppler echocardiography. Optimal cut-off values were derived using receiver operating characteristic (ROC) curve analysis.
NT-proBNP was higher (median, interquartile range [25th and 75th percentiles]) in (1) OCM (186 pmol/L; 79, 478 pmol/L) versus normal (24 pmol/L; 24, 32 pmol/L) (P < .001); and (2) hypertrophic obstructive cardiomyopathy (396 pmol/L; 205, 685 pmol/L) versus hypertrophic cardiomyopathy (112 pmol/L; 48, 318 pmol/L) (P < .001). In OCM, NT-proBNP correlated (1) positively with LVPWd (ρ = 0.23; P = .01), LA/Ao ratio (ρ = 0.31; P < .001), LVs (ρ = 0.33; P < .001), and troponin-I (ρ = 0.64; P < .001), and (2) negatively with %FS (ρ = -0.27; P = .004). Area under ROC curve was 0.92; >46 pmol/L cut-off distinguished normal from OCM (91.2% specificity, 85.8% sensitivity); >99 pmol/L cut-off was 100% specific, 70.8% sensitive.
Plasma NT-proBNP concentration reliably discriminated normal from OCM cats, and was associated with several echocardiographic markers of disease severity. Further studies are needed to assess test performance in unselected, general feline populations, and evaluate relationships between NT-proBNP concentrations and disease progression.
B 型利钠肽浓度可靠地区分呼吸困难的心脏和呼吸原因，但它用于检测无症状的隐匿性心肌病（OCM）猫的能力尚未确定。
假设/目的：确定血浆 N 末端脑利钠肽前体（NT-proBNP）浓度是否可以区分无症状的 OCM 猫与正常猫，并确定 NT-proBNP 浓度是否与临床、生化和超声心动图参数相关。
114 只正常、健康的猫；113 只 OCM 猫。
前瞻性、多中心、病例对照研究。前瞻性测量 NT-proBNP，并通过病史、体格检查和 M 型/2D/多普勒超声心动图确定心脏状态。使用接收者操作特征（ROC）曲线分析得出最佳截断值。
（1）OCM（186 pmol/L；79，478 pmol/L）与正常（24 pmol/L；24，32 pmol/L）相比，NT-proBNP 更高（中位数，四分位距[第 25 和 75 百分位数]）（P<.001）；和（2）肥厚型梗阻性心肌病（396 pmol/L；205，685 pmol/L）与肥厚型心肌病（112 pmol/L；48，318 pmol/L）相比（P<.001）。在 OCM 中，NT-proBNP 与 LVPWd（ρ=0.23；P=0.01）、LA/Ao 比值（ρ=0.31；P<.001）、LVs（ρ=0.33；P<.001）和肌钙蛋白-I（ρ=0.64；P<.001）呈正相关，与 %FS（ρ=-0.27；P=0.004）呈负相关。ROC 曲线下面积为 0.92；>46 pmol/L 截断值区分正常与 OCM（91.2%特异性，85.8%敏感性）；>99 pmol/L 截断值为 100%特异，70.8%敏感。
血浆 NT-proBNP 浓度可靠地区分正常与 OCM 猫，与疾病严重程度的多个超声心动图标志物相关。需要进一步研究来评估在未选择的普通猫群中的检测性能，并评估 NT-proBNP 浓度与疾病进展之间的关系。
