Singletary GE, Morris NA, Lynne O'Sullivan M, Gordon SG, Oyama MA. Prospective evaluation of NT-proBNP assay to detect occult dilated cardiomyopathy and predict survival in Doberman Pinschers.
J Vet Intern Med 2012;
26:1330-6. [PMID:
22998090 DOI:
10.1111/j.1939-1676.2012.1000.x]
[Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/16/2012] [Accepted: 08/14/2012] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND
Occult (asymptomatic) dilated cardiomyopathy (ODCM) is highly prevalent in Doberman Pinschers.
HYPOTHESIS/OBJECTIVES
Assess ability of NT-proBNP assay to detect ODCM and predict death.
ANIMALS
155 asymptomatic Dobermans presenting for ODCM screening.
METHODS
Echocardiography, 24-hour Holter, and NT-proBNP assay were performed prospectively. Diagnosis was based on increased left ventricular end-systolic dimension, >50 ventricular premature complexes (VPCs), or both on Holter. Utility was evaluated using receiver-operating characteristic curves. Effect of age, weight, sex, disease status, VPCs, and NT-proBNP on survival was analyzed using Kaplan-Meier and Cox-proportional hazard analysis.
RESULTS
Seventy-three (47.1%) Dobermans were diagnosed with ODCM, including 31, 17, and 25 that met Holter, echocardiographic, or both criteria, respectively. Sensitivity of NT-proBNP > 457 pmol/L to detect these groups was 45.2, 76.5, and 96.0%, respectively. Combination of NT-proBNP and Holter to detect ODCM yielded sensitivity of 94.5%, specificity of 87.8%, and accuracy of 91.0%. Follow-up data were available for 78 Dobermans. The median survival time of Dobermans with > 50 VPCs (469 days), NT-proBNP > 900 pmol/L (284 days), or ODCM (474 days) was significantly (P < .0001) shorter than those with < 50 VPCs (1743 days), NT-proBNP < 900 pmol/L (1743 days), or without disease (1743 days). NT-proBNP concentration and disease status were independently predictive of all-cause mortality.
CONCLUSIONS AND CLINICAL IMPORTANCE
The combination of NT-proBNP assay and Holter detected ODCM with high accuracy. NT-proBNP and disease status were independently associated with survival. NT-proBNP assay identified Dobermans with high probability of increased LVIDs consistent with ODCM, and can facilitate pursuit of confirmatory diagnostic testing, such as echocardiography, in suspected Dobermans.
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