J Am Vet Med Assoc. 2022 Jul 27;260(13):1626-1630. doi: 10.2460/javma.22.06.0257.
Occult feline hypertrophic cardiomyopathy (HCM) can result in unexpected sudden death or congestive heart failure (CHF) following routine interventions such as anesthesia, fluid administration, or, potentially, administration of corticosteroids. Consequently, clinicians would like to be able to screen at-risk cats to detect occult HCM and either avoid the risky intervention or attempt to reduce the risk of death or CHF. Currently, the feline N-terminal-proBrain natriuretic peptide test is the only potential screening test for detecting occult HCM. However, some cardiologists have pointed out the poor sensitivity of the test precludes its use as a screening test. This interpretation appears somewhat flawed. Using the current rapid test will allow clinicians to correctly identify half of the cats with moderate-to-severe occult HCM. A small number of cats without HCM will also test positive, necessitating an ultimately needless echocardiographic evaluation to demonstrate their disease-free status. However, the low prevalence of HCM in the general cat population and the apparently much lower rate of adverse events than would be predicted brings into question whether clinicians should bother screening. Therefore, until a more sensitive and accurate screening test becomes available, clinicians will have to decide for themselves whether identifying half of the at-risk cats of sudden death and CHF with this test is better than identifying none of them.
隐匿性猫肥厚型心肌病（HCM）可导致猫在接受常规干预（如麻醉、输液或潜在地使用皮质类固醇）后发生意外猝死或充血性心力衰竭（CHF）。因此，临床医生希望能够对高危猫进行筛查，以发现隐匿性 HCM，并避免危险的干预措施，或试图降低死亡或 CHF 的风险。目前，猫氨基末端脑利钠肽前体检测是唯一可用于检测隐匿性 HCM 的潜在筛查试验。然而，一些心脏病专家指出，该试验的敏感性较差，无法将其用作筛查试验。这种解释似乎有些缺陷。使用当前的快速检测方法，临床医生可以正确识别出一半患有中度至重度隐匿性 HCM 的猫。一小部分没有 HCM 的猫也会检测呈阳性，这需要最终进行不必要的超声心动图评估，以证明其无病状态。然而，肥厚型心肌病在普通猫群中的低流行率，以及明显低于预期的不良事件发生率，使得人们质疑临床医生是否应该进行筛查。因此，在更敏感和准确的筛查试验问世之前，临床医生将不得不自行决定，用这种检测方法识别出一半有猝死和 CHF 风险的猫是否比不识别出任何猫更好。
