Klüser Lena, Maier Elizabeth T, Wess Gerhard
Clinic of Small Animal Medicine, LMU University, Munich, Germany.
J Vet Intern Med. 2019 Jan;33(1):54-63. doi: 10.1111/jvim.15384. Epub 2018 Dec 11.
Echocardiography and 24-hour ECG are the gold standard tests to diagnose dilated cardiomyopathy (DCM) in Doberman Pinschers (DP), but myocardial damage might be detected earlier using a high-sensitivity cardiac troponin I (hs-cTnI) assay.
To evaluate and compare an hs-cTnI assay (Advia Centaur TnI-Ultra assay) with a conventional cTnI assay in DP with different stages of DCM and in healthy DP.
Three hundred forty-five examinations from 162 DP with and 179 DP without DCM.
Prospective longitudinal study. Dogs were allocated into 6 groups based on echocardiographic and 24-hour ECG criteria: (1) healthy group (179 dogs), (2) last-normal group (29 dogs), which included dogs that were considered to be healthy at the time of their examination but were assigned to the last-normal group retrospectively when DCM was diagnosed at their next examination within 1.5 years, (3) only arrhythmias (45 dogs, 119 examinations), (4) only echocardiographic changes (24 dogs, 61 examinations), (5) echocardiographic changes with ventricular premature complexes (41 dogs, 100 examinations), and (6) decompensated (23 dogs, 36 examinations). Hs-cTnI and conventional cTnI concentration measurements were performed and compared.
A cutoff value of hs-cTnI concentration >0.113 ng/mL had a sensitivity of 81.2% and a specificity of 73.2% to identify the presence of DCM. The conventional cTnI assay showed a similar test performance, but the hs-cTnI assay identified more dogs (21/29 dogs, 72%) in the last-normal group compared to the conventional cTnI test (18/29 dogs, 62%).
The hs-cTnI is an additional test with good potential to identify early DCM.
超声心动图和24小时心电图是诊断杜宾犬扩张型心肌病(DCM)的金标准检查,但使用高敏心肌肌钙蛋白I(hs-cTnI)检测可能更早发现心肌损伤。
在不同阶段的DCM杜宾犬和健康杜宾犬中评估和比较hs-cTnI检测(Advia Centaur TnI-Ultra检测)与传统cTnI检测。
对162只患有DCM的杜宾犬和179只未患DCM的杜宾犬进行了345次检查。
前瞻性纵向研究。根据超声心动图和24小时心电图标准将犬分为6组:(1)健康组(179只犬),(2)末次正常组(29只犬),包括检查时被认为健康但在1.5年内下次检查诊断为DCM时被追溯分配到末次正常组的犬,(3)仅心律失常组(45只犬,119次检查),(4)仅超声心动图改变组(24只犬,61次检查),(5)伴有室性早搏的超声心动图改变组(41只犬,100次检查),以及(6)失代偿组(23只犬,36次检查)。进行hs-cTnI和传统cTnI浓度测量并比较。
hs-cTnI浓度>0.113 ng/mL的临界值识别DCM存在的敏感性为81.2%,特异性为73.2%。传统cTnI检测表现出相似的检测性能,但与传统cTnI检测(18/29只犬,62%)相比,hs-cTnI检测在末次正常组中识别出更多犬(21/29只犬,72%)。
hs-cTnI是一项有潜力识别早期DCM的附加检测。