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血浆心房利钠肽浓度在患有和未患心肌病的猫中的诊断准确性。

Diagnostic accuracy of plasma atrial natriuretic peptide concentrations in cats with and without cardiomyopathies.

作者信息

Heishima Y, Hori Y, Nakamura K, Yamashita Y, Isayama N, Kanno N, Katagi M, Onodera H, Yamano S, Aramaki Y

机构信息

School of Veterinary Medicine, Rakuno Gakuen University, 582 Midoricho, Bunkyodai, Ebetsu, Hokkaido 069-8501, Japan; Heisei Animal Hospital, 2-1-1 Futago-cho, Kasugai, Aichi 486-0955, Japan.

School of Veterinary Medicine, Rakuno Gakuen University, 582 Midoricho, Bunkyodai, Ebetsu, Hokkaido 069-8501, Japan.

出版信息

J Vet Cardiol. 2018 Aug;20(4):234-243. doi: 10.1016/j.jvc.2018.04.008. Epub 2018 May 25.

Abstract

OBJECTIVES

Plasma atrial natriuretic peptide (ANP) levels have been reported to be elevated in cats with cardiomyopathy. We investigated the diagnostic accuracy of plasma ANP concentration as an indicator of the severity of cardiomyopathies.

ANIMALS

This study included 78 control cats and 83 cats with various types of cardiomyopathy.

METHODS

This was a prospective multicentre study. Control cats were determined to have a normal heart, and diseased cats were diagnosed by echocardiography. Diseased cats were divided into asymptomatic cats without left atrial dilation (LAD), asymptomatic cats with LAD, and cats with heart failure. Plasma C-terminal ANP concentrations were measured using chemiluminescence.

RESULTS

The median plasma ANP concentration in controls was 43.3 (interquartile range, 33.0-56.3) pg/mL. Plasma ANP values were significantly higher in the cardiomyopathic cats with LAD and heart failure, but the values in cats without LAD were comparable to those in control cats. To distinguish cats with cardiomyopathy from controls, a plasma ANP concentration >77.5 pg/mL afforded sensitivity of 66.3% and specificity of 84.6%. Use of plasma ANP concentration >110.9 pg/mL to identify cats with LAD had a sensitivity of 73.6% and specificity of 93.5%. The areas under the receiver-operating characteristic curve were 0.80 and 0.86.

CONCLUSIONS

Plasma ANP concentrations were higher in cats with more advanced cardiomyopathy. Although assaying the ANP concentration alone may not help to diagnose cardiac disease, measuring provides additional information that is useful for assessing the severity of cardiomyopathies.

摘要

目的

据报道,患有心肌病的猫血浆心房利钠肽(ANP)水平会升高。我们研究了血浆ANP浓度作为心肌病严重程度指标的诊断准确性。

动物

本研究纳入了78只对照猫和83只患有各种类型心肌病的猫。

方法

这是一项前瞻性多中心研究。对照猫被确定心脏正常,患病猫通过超声心动图进行诊断。患病猫分为无左心房扩张(LAD)的无症状猫、有LAD的无症状猫和心力衰竭猫。使用化学发光法测量血浆C端ANP浓度。

结果

对照组血浆ANP浓度中位数为43.3(四分位间距,33.0 - 56.3)pg/mL。有LAD和心力衰竭的心肌病猫血浆ANP值显著更高,但无LAD的猫的值与对照猫相当。为了区分患有心肌病的猫和对照猫,血浆ANP浓度>77.5 pg/mL时,敏感性为66.3%,特异性为84.6%。使用血浆ANP浓度>110.9 pg/mL来识别有LAD的猫,敏感性为73.6%,特异性为93.5%。受试者操作特征曲线下面积分别为0.80和0.86。

结论

心肌病更严重的猫血浆ANP浓度更高。虽然单独检测ANP浓度可能无助于诊断心脏病,但测量可提供有助于评估心肌病严重程度的额外信息。

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