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NT-proBNP、ANP 和 cTnI 水平诊断黏液样二尖瓣病变犬的准确性如何?

How accurate are NT-proBNP, ANP, and cTnI levels in diagnosing dogs with myxomatous mitral valve disease?

机构信息

Prasu Arthorn Veterinary Teaching Hospital, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand.

Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand.

出版信息

Open Vet J. 2024 Jun;14(6):1426-1441. doi: 10.5455/OVJ.2024.v14.i6.10. Epub 2024 Jun 30.

Abstract

BACKGROUND

Myxomatous mitral valve disease (MMVD) is prevalent in dogs. Specialized diagnostics (radiography and echocardiography) may be unavailable in some veterinary settings. Cardiac biomarkers offer potential alternatives.

AIM

This study evaluated the diagnostic value of -terminal fragments of pro-brain natriuretic peptides (NT-proBNPs), atrial natriuretic peptides (ANPs), and cardiac troponin I (cTnI) levels in dogs with MMVD.

METHODS

69 dogs with MMVD (asymptomatic and symptomatic) and 19 healthy controls were assessed. Biomarker levels were measured using commercial kit rapid tests.

RESULTS

Our results showed that the median NT-proBNP level in the symptomatic group was higher than those in the asymptomatic ( < 0.001) and control ( < 0.001) groups. Moreover, the median NT-proBNP level in the asymptomatic group was higher than that in the control group ( < 0.001). The cTnI level in the control group was lower than those in the asymptomatic ( = 0.039) and symptomatic ( = 0.001) groups. No statistically significant difference in the cTnI level was noted between the asymptomatic and symptomatic groups. The best cutoff value of the NT-proBNP level to differentiate the normal controls from dogs with MMVD with or without congestive heart failure was > 505.65 pmol/l [sensitivity, 76.8%; specificity, 89.5%; and area under the curve (AUC), 0.862]. The suggested cutoff value of the NT-proBNP level to differentiate symptomatic MMVD from asymptomatic MMVD was >787.65 pmol/l (sensitivity, 78.38%; specificity, 72.55%; and AUC, 0.792).

CONCLUSION

NT-proBNP and cTnI may serve as point-of-care tests for dyspneic dogs, aiding MMVD assessment where specialized diagnostics are limited.

摘要

背景

黏液样心肌二尖瓣病(MMVD)在犬中较为常见。在某些兽医环境中,可能无法进行专门的诊断(影像学和超声心动图)。心脏生物标志物提供了潜在的替代方法。

目的

本研究评估了终末端脑利钠肽前体(NT-proBNP)、心钠肽(ANP)和心肌肌钙蛋白 I(cTnI)在 MMVD 犬中的诊断价值。

方法

评估了 69 只 MMVD(无症状和有症状)犬和 19 只健康对照犬。使用商业试剂盒快速检测法测量生物标志物水平。

结果

我们的结果表明,有症状组的中位 NT-proBNP 水平高于无症状组(<0.001)和对照组(<0.001)。此外,无症状组的中位 NT-proBNP 水平高于对照组(<0.001)。对照组的 cTnI 水平低于无症状组(=0.039)和有症状组(=0.001)。无症状组和有症状组之间的 cTnI 水平无统计学差异。将 NT-proBNP 水平的最佳截断值>505.65 pmol/L 用于区分正常对照犬和有或无充血性心力衰竭的 MMVD 犬时,其敏感性为 76.8%,特异性为 89.5%,曲线下面积(AUC)为 0.862。将 NT-proBNP 水平的建议截断值>787.65 pmol/L 用于区分有症状 MMVD 和无症状 MMVD 时,其敏感性为 78.38%,特异性为 72.55%,AUC 为 0.792。

结论

NT-proBNP 和 cTnI 可作为呼吸困难犬的即时检测试验,有助于在专门诊断受限的情况下评估 MMVD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71db/11268905/47aa071e44b9/OpenVetJ-14-1426-g001.jpg

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