Langford Vets, University of Bristol, Bristol, UK.
CVS Ltd, Norfolk, UK.
J Vet Intern Med. 2021 Sep;35(5):2094-2101. doi: 10.1111/jvim.16234. Epub 2021 Aug 10.
Infective endocarditis (IE) in dogs is associated with severe disease and a high case fatality rate but often presents with nonspecific clinical signs.
HYPOTHESIS/OBJECTIVES: Serum concentration of cardiac troponin-I (cTnI) is elevated in dogs with IE and can differentiate dogs with IE from dogs with other diseases with similar clinical features. Concentration of serum cTnI is negatively correlated with survival time in dogs with IE.
Seventy-two client-owned dogs; 29 with IE, 27 with stage-B myxomatous mitral valve disease (MMVD), and 16 with immune-mediated disease (IMD).
Retrospective clinical cohort study. Concentration of serum cTnI was measured in all dogs at time of diagnosis. Clinical findings and echocardiographic interpretation were also recorded. Statistical analyses included Kruskal-Wallis test, pairwise Mann-Whitney U tests, receiver operator characteristic, and Cox proportional hazards.
Serum concentration of cTnI was significantly higher in the IE group (0.69 ng/mL [0.03-80.8]) than in the MMVD (0.05 ng/mL [0.02-0.11], P < .001) and IMD groups (0.05 ng/mL [0.03-0.57], P < .001). Increased cTnI was a moderately accurate predictor of IE (area under the curve 0.857 (95% confidence interval [CI] 0.745-0.968, P < .001). A cTnI cutoff of 0.625 ng/mL had 100% specificity (95% CI 90%-100%) and 52% sensitivity (95% CI 33%-70%) in this study sample. There was no association between cTnI concentration and survival time in dogs with IE (hazard ratio 1.013, 95% CI 0.993-1.034, P = .2).
Cardiac troponin-I concentrations are higher in dogs with IE compared to dogs with preclinical MMVD or IMD. In dogs with a compatible clinical presentation, serum cTnI concentrations >0.625 ng/mL are supportive of IE.
犬传染性心内膜炎（IE）常导致严重疾病和高病死率，但临床症状常无特异性。
假设/目的：患 IE 的犬血清中心肌肌钙蛋白 I（cTnI）浓度升高，可将 IE 与具有相似临床特征的其他疾病的犬区分开来。IE 犬的 cTnI 浓度与存活时间呈负相关。
72 只患宠犬；29 只为 IE 犬，27 只为 B 期黏液瘤性二尖瓣疾病（MMVD）犬，16 只为免疫介导性疾病（IMD）犬。
回顾性临床队列研究。所有犬在确诊时均检测血清 cTnI 浓度。还记录了临床发现和超声心动图解读。统计分析包括 Kruskal-Wallis 检验、两两 Mann-Whitney U 检验、受试者工作特征曲线和 Cox 比例风险模型。
IE 组犬血清 cTnI 浓度显著高于 MMVD 组（0.05ng/mL[0.02-0.11]，P<.001）和 IMD 组（0.05ng/mL[0.03-0.57]，P<.001）。cTnI 升高是 IE 的中度准确预测指标（曲线下面积 0.857[95%置信区间（CI）0.745-0.968]，P<.001）。本研究样本中，cTnI 截断值为 0.625ng/mL 时，特异性为 100%（95%CI 90%-100%），敏感性为 52%（95%CI 33%-70%）。IE 犬的 cTnI 浓度与存活时间之间无相关性（危险比 1.013，95%CI 0.993-1.034，P=0.2）。
与处于临床前 MMVD 或 IMD 的犬相比，IE 犬的 cTnI 浓度更高。在具有匹配临床表现的犬中，cTnI 浓度>0.625ng/mL 支持 IE。
