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自发性心包积液继发心脏压塞的犬心包穿刺前后血浆N末端脑钠肽前体浓度

Plasma N-terminal pro-brain natriuretic peptide concentrations before and after pericardiocentesis in dogs with cardiac tamponade secondary to spontaneous pericardial effusion.

作者信息

Baumwart R D, Hanzlicek A S, Lyon S D, Lee P M

机构信息

Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States.

Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States.

出版信息

J Vet Cardiol. 2017 Oct;19(5):416-420. doi: 10.1016/j.jvc.2017.08.007. Epub 2017 Oct 4.

Abstract

OBJECTIVE

To determine if concentrations of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) are increased in dogs with cardiac tamponade and if there is a significant increase in plasma NT-proBNP after pericardiocentesis.

ANIMALS

Ten client-owned dogs with spontaneous cardiac tamponade.

METHODS

Prospective clinical study. Cardiac tamponade was suspected from physical examination and confirmed with echocardiography. Blood was collected and plasma NT-proBNP concentrations were measured before and 30-60 min following pericardiocentesis and resolution of cardiac tamponade. Within-subject changes in plasma NT-proBNP were compared by the Wilcoxon signed-rank test.

RESULTS

The plasma NT-proBNP concentrations measured within the reference interval in seven of 10 dogs before pericardiocentesis and in six of 10 dogs following pericardiocentesis. Following pericardiocentesis, there was a statistically significant increase in median NT-proBNP concentration (733 pmol/L, range 250-3,297) compared with the values measured before (643 pmol/L, range 250-3,210, P = 0.004). The NT-proBNP concentration increased in 90% of the dogs following pericardiocentesis.

CONCLUSIONS

An upper reference limit of 900 pmol/L for plasma NT-proBNP is insensitive for the diagnosis of pericardial effusion and cardiac tamponade in dogs. Plasma NT-proBNP concentration commonly increases following pericardiocentesis, perhaps related to improved ventricular filling and stretch.

摘要

目的

确定心包填塞犬的血浆N末端脑钠肽前体(NT-proBNP)浓度是否升高,以及心包穿刺术后血浆NT-proBNP是否显著升高。

动物

10只客户拥有的自发性心包填塞犬。

方法

前瞻性临床研究。通过体格检查怀疑有心包填塞,并经超声心动图确诊。在进行心包穿刺术和心包填塞解除前及术后30 - 60分钟采集血液,测定血浆NT-proBNP浓度。采用Wilcoxon符号秩检验比较血浆NT-proBNP的个体内变化。

结果

10只犬中,7只在进行心包穿刺术前血浆NT-proBNP浓度处于参考区间内,10只犬中有6只在进行心包穿刺术后处于参考区间内。心包穿刺术后,NT-proBNP中位数浓度(733 pmol/L,范围250 - 3297)与术前测定值(643 pmol/L,范围250 - 3210,P = 0.004)相比有统计学显著升高。90%的犬在心包穿刺术后NT-proBNP浓度升高。

结论

血浆NT-proBNP的900 pmol/L上限参考值对犬心包积液和心包填塞的诊断不敏感。心包穿刺术后血浆NT-proBNP浓度通常会升高,可能与心室充盈和牵张改善有关。

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