Costa-Rodríguez Noelia, Vera-Rodríguez Daniel Julio, Falcón-Cordón Soraya, Morales Beatriz Regina, Montoya-Alonso José Alberto, Morchón Rodrigo, Carretón Elena
Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas De Gran Canaria, Las Palmas, Spain.
Zoonotic Diseases and One Health Group, Laboratory of Parasitology, Faculty of Pharmacy, University of Salamanca, Salamanca, Spain.
Parasit Vectors. 2025 Jul 31;18(1):313. doi: 10.1186/s13071-025-06945-2.
Pulmonary hypertension (PH) is a frequent complication in dogs with heartworm disease caused by Dirofilaria immitis. Although echocardiography remains the main diagnostic tool, its operator- and preload-dependence may limit accuracy. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a cardiac biomarker that increases in response to ventricular wall stress and may be useful for monitoring right-sided heart disease. This study aimed to evaluate NT-proBNP concentrations in dogs with precapillary PH due to heartworm disease during adulticide treatment.
In total, 90 dogs diagnosed with heartworm disease were prospectively enrolled and classified according to the presence of PH based on echocardiographic criteria. NT-proBNP concentrations were measured on days 0, 30, 60, and 90 of adulticide treatment. Additional data collected included the presence/absence of microfilariae, clinical signs, parasite burden, and renal values. Dogs received adulticidal therapy following current international guidelines. Statistical analyses assessed correlations between NT-proBNP levels, epidemiological, clinical and echocardiographic classification, and treatment progression.
Dogs with PH had significantly higher NT-proBNP concentrations at baseline compared with those without PH (2038 ± 1671 versus 583 ± 185 pmol/L, P < 0.001). NT-proBNP levels were also positively correlated with parasite burden (r = 0.530, P < 0.05), presence of clinical signs (r = 0.456, P < 0.05), and age (r = 0.29, P < 0.05). During treatment, a progressive decrease in NT-proBNP concentrations was observed in dogs with PH, while levels remained stable in dogs without PH. Receiver operating characteristic (ROC) analysis identified a cut-off of 1524.8 pmol/L for detecting moderate-to-severe PH (sensitivity: 99%, specificity: 87%).
NT-proBNP is a valuable noninvasive biomarker for detecting and monitoring PH in dogs with heartworm disease. Its concentrations seem to reflect parasite burden, clinical status, and echocardiographic severity, and decline progressively with adulticide therapy. Integration of NT-proBNP into diagnostic and therapeutic protocols may enhance management of heartworm-infected dogs with suspected PH.
肺动脉高压（PH）是由犬恶丝虫引起的心丝虫病犬常见的并发症。尽管超声心动图仍是主要的诊断工具，但其对操作者的依赖性和前负荷依赖性可能会限制准确性。N端前脑钠肽（NT-proBNP）是一种心脏生物标志物，可因心室壁压力升高而升高，可能有助于监测右心疾病。本研究旨在评估在进行杀成虫治疗期间，因心丝虫病导致毛细血管前性PH的犬的NT-proBNP浓度。
总共前瞻性纳入90只诊断为心丝虫病的犬，并根据超声心动图标准，依据是否存在PH进行分类。在杀成虫治疗的第0、30、60和90天测量NT-proBNP浓度。收集的其他数据包括是否存在微丝蚴、临床症状、寄生虫负荷和肾脏指标。犬按照当前国际指南接受杀成虫治疗。统计分析评估NT-proBNP水平、流行病学、临床和超声心动图分类以及治疗进展之间的相关性。
与无PH的犬相比，有PH的犬在基线时NT-proBNP浓度显著更高（2038±1671对583±185 pmol/L，P<0.001）。NT-proBNP水平还与寄生虫负荷（r=0.530，P<0.05）、临床症状的存在（r=0.456，P<0.05）和年龄（r=0.29，P<0.05）呈正相关。在治疗期间，观察到有PH的犬NT-proBNP浓度逐渐降低，而无PH的犬水平保持稳定。受试者工作特征（ROC）分析确定检测中度至重度PH的临界值为1524.8 pmol/L（敏感性：99%，特异性：87%）。
NT-proBNP是检测和监测心丝虫病犬PH的一种有价值的非侵入性生物标志物。其浓度似乎反映了寄生虫负荷、临床状态和超声心动图严重程度，并随着杀成虫治疗而逐渐下降。将NT-proBNP纳入诊断和治疗方案可能会加强对疑似PH的心丝虫感染犬的管理。
