Borgeat K, Sherwood K, Payne J R, Luis Fuentes V, Connolly D J
Royal Veterinary College, Hatfield, UK; Highcroft Veterinary Referrals, Bristol, UK.
J Vet Intern Med. 2014 Nov-Dec;28(6):1731-7. doi: 10.1111/jvim.12459. Epub 2014 Oct 15.
The use of cardiac biomarkers to assist in the diagnosis of occult and symptomatic hypertrophic cardiomyopathy (HCM) in cats has been established. There is limited data describing their prognostic utility in cats with HCM.
Circulating concentrations of N-terminal B-type natriuretic peptide (NTproBNP) and cardiac troponin I (cTnI) predict cardiac death in cats with HCM.
Forty-one cats diagnosed with HCM at a veterinary teaching hospital, between February 2010 and May 2011.
Prospective investigational study. Plasma samples were collected from cats diagnosed with HCM and concentrations of NTproBNP and cTnI were analyzed at a commercial laboratory. Echocardiographic measurements from the day of blood sampling were recorded. Long-term outcome data were obtained. Associations with time to cardiac death were analyzed using Cox proportional hazards models.
When controlling for the presence/absence of heart failure and echocardiographic measures of left atrial size and function, cTnI > 0.7 ng/mL was independently associated with time to cardiac death. In univariable analysis, NTproBNP > 250 pmol/L was associated with cardiac death (P = .023), but this did not remain significant (P = .951) when controlling for the effect of clinical signs or left atrial size/function.
Plasma concentration of cTnI (cutoff >0.7 ng/mL) is a predictor of cardiac death in cats with HCM that is independent of the presence of heart failure or left atrial dilatation.
心脏生物标志物在辅助诊断猫隐匿性和症状性肥厚型心肌病(HCM)中的应用已得到确立。关于其在猫HCM中的预后效用的数据有限。
N末端B型利钠肽(NTproBNP)和心肌肌钙蛋白I(cTnI)的循环浓度可预测猫HCM的心脏死亡。
2010年2月至2011年5月间,在一家兽医教学医院诊断为HCM的41只猫。
前瞻性研究。从诊断为HCM的猫中采集血浆样本,并在一家商业实验室分析NTproBNP和cTnI的浓度。记录采血当天的超声心动图测量值。获取长期预后数据。使用Cox比例风险模型分析与心脏死亡时间的关联。
在控制心力衰竭的存在与否以及左心房大小和功能的超声心动图测量值时,cTnI>0.7 ng/mL与心脏死亡时间独立相关。在单变量分析中,NTproBNP>250 pmol/L与心脏死亡相关(P = 0.023),但在控制临床体征或左心房大小/功能的影响时,这一相关性不再显著(P = 0.951)。
cTnI的血浆浓度(临界值>0.7 ng/mL)是猫HCM心脏死亡的预测指标,独立于心力衰竭或左心房扩张的存在。