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Stern JA, Rivas VN, Kaplan JL, Ueda Y, Oldach MS, Ontiveros ES, Kooiker KB, van Dijk SJ, Harris SP. Hypertrophic cardiomyopathy in purpose-bred cats with the A31P mutation in cardiac myosin binding protein-C. Sci Rep 2023; 13:10319. [PMID: 37365215 PMCID: PMC10293195 DOI: 10.1038/s41598-023-36932-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
We sought to establish a large animal model of inherited hypertrophic cardiomyopathy (HCM) with sufficient disease severity and early penetrance for identification of novel therapeutic strategies. HCM is the most common inherited cardiac disorder affecting 1 in 250-500 people, yet few therapies for its treatment or prevention are available. A research colony of purpose-bred cats carrying the A31P mutation in MYBPC3 was founded using sperm from a single heterozygous male cat. Cardiac function in four generations was assessed by periodic echocardiography and measurement of blood biomarkers. Results showed that HCM penetrance was age-dependent, and that penetrance occurred earlier and was more severe in successive generations, especially in homozygotes. Homozygosity was also associated with progression from preclinical to clinical disease. A31P homozygous cats represent a heritable model of HCM with early disease penetrance and a severe phenotype necessary for interventional studies aimed at altering disease progression. The occurrence of a more severe phenotype in later generations of cats, and the occasional occurrence of HCM in wildtype cats suggests the presence of at least one gene modifier or a second causal variant in this research colony that exacerbates the HCM phenotype when inherited in combination with the A31P mutation.
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Affiliation(s)
- Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1038 William Moore Dr, Raleigh, NC, 27606, USA
| | - Victor N Rivas
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1038 William Moore Dr, Raleigh, NC, 27606, USA
| | - Joanna L Kaplan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Yu Ueda
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1038 William Moore Dr, Raleigh, NC, 27606, USA
| | - Maureen S Oldach
- VCA Sacramento Veterinary Referral Center, 9801 Old Winery Place, Sacramento, CA, 95827, USA
| | - Eric S Ontiveros
- Rady Children's Institute for Genomic Medicine, 7910 Frost Street, San Diego, CA, 92123, USA
| | - Kristina B Kooiker
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, 98109, USA
| | - Sabine J van Dijk
- Department of Neurobiology, Physiology, and Behavior, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - Samantha P Harris
- Department of Neurobiology, Physiology, and Behavior, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA.
- Department of Physiology, College of Medicine-Tucson, University of Arizona, 313 Medical Research Building, 1656 E Mabel St., Tucson, AZ, 85724, USA.
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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Updates on Laboratory Evaluation of Feline Cardiac Diseases. Vet Sci 2021; 8:vetsci8030041. [PMID: 33802401 PMCID: PMC8000286 DOI: 10.3390/vetsci8030041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Laboratory tests can be altered in cardiovascular diseases and the investigation of specific tests or biomarkers may provide additional information about myocardial damage. Traditional laboratory tests, such as cell blood count, serum biochemistry, and coagulation, can be useful in investigating patients, but are not specific. However, markers like Troponin and Natriuretic Peptides may possibly furnish further data on myocardium damage and can be used in both studying and monitoring cats with cardiac disease. Moreover, the evaluation of the thyroid profile is very important as hyperthyroid cats concomitant cardiovascular diseases are very common and they can also be a direct consequence of endocrinopathy. The purpose of this manuscript is to provide the widest possible overview of what is present in the literature about the feline clinical pathology of heart diseases through a rational division of the main alterations of traditional tests and biomarkers.
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van Hoek I, Hodgkiss-Geere H, Bode EF, Hamilton-Elliott J, Mõtsküla P, Palermo V, Pereira YM, Culshaw GJ, Ivanova A, Dukes-McEwan J. Associations among echocardiography, cardiac biomarkers, insulin metabolism, morphology, and inflammation in cats with asymptomatic hypertrophic cardiomyopathy. J Vet Intern Med 2020; 34:591-599. [PMID: 32045061 PMCID: PMC7096615 DOI: 10.1111/jvim.15730] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/31/2020] [Indexed: 12/27/2022] Open
Abstract
Background Insulin, insulin‐like growth factor‐1 (IGF‐1), and inflammation possibly are involved in cats with asymptomatic hypertrophic cardiomyopathy (aHCM). Objectives To evaluate echocardiography, morphology, cardiac and inflammatory markers, insulin and IGF‐1 in cats with aHCM. Animals Fifty‐one client‐owned cats with aHCM. Methods Observational descriptive study. Variables (body weight [BW], body condition score [BCS], echocardiography, and serum concentrations of N‐terminal pro‐B‐type natriuretic peptide [NT‐proBNP], ultra‐sensitive troponin‐I [c‐TnI], serum amyloid A [SAA], insulin, glucose and IGF‐1) were evaluated for significant increases above echocardiography cutoff values and laboratory reference ranges, associations and effect of left atrial (LA) remodeling and generalized hypertrophy. Results Cats with aHCM had BCS ≥6/9 (P = .01) and insulin (P < .001), NT‐proBNP (P = .001) and cTn‐I (P < .001) above laboratory reference ranges. Associations were present between NT‐proBNP and maximum end‐diastolic interventricular septum thickness (IVSd; ρ = .32; P = .05), maximum end‐diastolic left ventricular free wall thickness;(ρ = .41; P = .01), LA/Aorta (ρ = .52; P = .001) and LA diameter (LA‐max; ρ = .32; P = .05); c‐TnI and LA/Aorta (ρ = .49; P = .003) and LA‐max (ρ = .28; P = .05); and SAA and number of IVSd regions ≥6 mm thickness (ρ = .28; P = .05). Body weight and BCS were associated with IGF‐1 (r = 0.44; P = .001), and insulin (ρ = .33; P = .02), glucose (ρ = .29; P = .04) and IGF‐1 (ρ = .32; P = .02), respectively. Concentrations of NT‐proBNP (P = .02) and c‐TnI (P = .01), and SAA (P = .02), were higher in cats with LA remodeling, and generalized hypertrophy, respectively. Conclusions and clinical importance Results suggest potential implications of insulin, IGF‐1, and inflammation in cats with aHCM, but it remains to be confirmed whether these findings represent a physiological process or a part of the pathogenesis and development of disease.
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Affiliation(s)
| | - Hannah Hodgkiss-Geere
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
| | - Elizabeth F Bode
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
| | - Julie Hamilton-Elliott
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
| | - Paul Mõtsküla
- The Cardiology Clinic, Anderson Moores Veterinary Specialists, Hampshire, UK
| | - Valentina Palermo
- The Cardiology Clinic, Anderson Moores Veterinary Specialists, Hampshire, UK
| | - Yolanda M Pereira
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Geoff J Culshaw
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Anna Ivanova
- Center for statistics, University of Hasselt, Hasselt, Belgium
| | - Jo Dukes-McEwan
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Leahurst, University of Liverpool, Neston, UK
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de Lima GV, Ferreira FDS. N-terminal-pro brain natriuretic peptides in dogs and cats: A technical and clinical review. Vet World 2017; 10:1072-1082. [PMID: 29062197 PMCID: PMC5639106 DOI: 10.14202/vetworld.2017.1072-1082] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/18/2017] [Indexed: 01/16/2023] Open
Abstract
Biomarkers are quantitative indicators of biological processes performed by an organ or system. In recent years, natriuretic peptides (NPs) have emerged as important tools in the diagnosis and therapeutic monitoring of heart diseases. Research has shown that serum and plasma levels of N-terminal pro brain NP (NT-proBNP) in dogs and cats are the only biomarkers that afford to diagnose and monitor congestive processes and, indirectly, the myocardial function of small animals. The present review discusses the peer-reviewed specialized literature about NT-proBNP and presents and compares the potential clinical applications of this NP in veterinary medicine of small animals, considering diagnosis, follow-up, and prognosis of myocardial or systemic diseases. The relevance of NT-proBNP is associated with sample stability, easy determination in laboratory, sensitivity, accuracy, and the possibility to analyze myocardial function. These advantages are specially important when NT-proBNP is compared with other cardiac biomarkers, mostly those that indicate the integrity of the myocardial cell. Fast NT-proBNP assays are marketed today and may be used in association with complementary tests. Together, these methods are an important source of information in differential diagnosis of heart and lung diseases as well in the early diagnosis of cardiopathy in dogs and cats, proving valuable tools in treatment and prognosis.
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Harris AN, Beatty SS, Estrada AH, Winter B, Bohannon M, Sosa I, Hanscom J, Mainville CA, Gallagher AE. Investigation of an N-Terminal Prohormone of Brain Natriuretic Peptide Point-of-Care ELISA in Clinically Normal Cats and Cats With Cardiac Disease. J Vet Intern Med 2017; 31:994-999. [PMID: 28617995 PMCID: PMC5508306 DOI: 10.1111/jvim.14776] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/02/2017] [Accepted: 05/06/2017] [Indexed: 12/14/2022] Open
Abstract
Background N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP) concentrations may be increased in cats with various cardiac disorders. The point‐of‐care (POC) ELISA assay uses the same biologic reagents as the quantitative NT‐proBNP ELISA. Previous studies have evaluated the sensitivity and specificity of the POC ELISA in cats with cardiac disease. Objectives To prospectively evaluate the diagnostic utility of the POC ELISA in a select population of cats. Animals Thirty‐eight client‐owned cats presented to the University of Florida Cardiology Service for cardiac evaluation. Fifteen apparently healthy cats recruited as part of another study. Methods Physical examination and echocardiography were performed in all cats. The POC ELISA was assessed visually as either positive or negative by a reader blinded to the echocardiographic findings, and results were analyzed relative to quantitative assay results. Results Twenty‐six cats were diagnosed with underlying cardiac disease, and 27 cats were considered free of cardiac disease. Cats with cardiac disease included: 21 with hypertrophic cardiomyopathy, 2 with unclassified cardiomyopathy, 2 with restrictive cardiomyopathy, and 1 with 3rd degree atrioventricular (AV) block. The POC ELISA differentiated cats with cardiac disease with a sensitivity of 65.4% and specificity of 100%. Conclusions and Clinical Importance The POC NT‐proBNP ELISA performed moderately well in a selected population of cats. A negative test result cannot exclude the presence of underlying cardiac disease, and a positive test result indicates that cardiac disease likely is present, but further diagnostic investigation would be indicated for a definitive diagnosis.
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Affiliation(s)
- A N Harris
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - S S Beatty
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - A H Estrada
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - B Winter
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - M Bohannon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - I Sosa
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - J Hanscom
- IDEXX Laboratories, Inc, Westbrook, ME
| | | | - A E Gallagher
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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Smith KF, Quinn RL, Rahilly LJ. Biomarkers for differentiation of causes of respiratory distress in dogs and cats: Part 1 - Cardiac diseases and pulmonary hypertension. J Vet Emerg Crit Care (San Antonio) 2015; 25:311-29. [DOI: 10.1111/vec.12318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 03/22/2015] [Indexed: 12/18/2022]
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Oyama MA, Boswood A, Connolly DJ, Ettinger SJ, Fox PR, Gordon SG, Rush JE, Sisson DD, Stepien RL, Wess G, Zannad F. Clinical usefulness of an assay for measurement of circulating N-terminal pro-B-type natriuretic peptide concentration in dogs and cats with heart disease. J Am Vet Med Assoc 2014; 243:71-82. [PMID: 23786193 DOI: 10.2460/javma.243.1.71] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mark A Oyama
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Sangster JK, Panciera DL, Abbott JA, Zimmerman KC, Lantis AC. Cardiac biomarkers in hyperthyroid cats. J Vet Intern Med 2013; 28:465-72. [PMID: 24350989 PMCID: PMC4857992 DOI: 10.1111/jvim.12259] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/21/2013] [Accepted: 10/24/2013] [Indexed: 11/30/2022] Open
Abstract
Background Hyperthyroidism has substantial effects on the circulatory system. The cardiac biomarkers NT‐proBNP and troponin I (cTNI) have proven useful in identifying cats with myocardial disease but have not been extensively investigated in hyperthyroidism. Hypothesis Plasma NT‐proBNP and cTNI concentrations are higher in cats with primary myocardial disease than in cats with hyperthyroidism and higher in cats with hyperthyroidism than in healthy control cats. Animals Twenty‐three hyperthyroid cats, 17 cats with subclinical hypertrophic cardiomyopathy (HCM), and 19 euthyroid, normotensive healthy cats ≥8 years of age. Fourteen of the hyperthyroid cats were re‐evaluated 3 months after administration of radioiodine (131I). Methods Complete history, physical examination, complete blood count, serum biochemistries, urinalysis, blood pressure measurement, serum T4 concentration, plasma concentrations of NT‐proBNP and cTNI, and echocardiogram were obtained prospectively from each cat. Results Hyperthyroid cats and cats with HCM had plasma NT‐proBNP and cTNI concentrations that were significantly higher than those of healthy cats, but there was no significant difference between hyperthyroid cats and cats with HCM with respect to the concentration of either biomarker. In hyperthyroid cats that were re‐evaluated 3 months after 131I treatment, plasma NT‐proBNP and cTNI concentrations as well as ventricular wall thickness had decreased significantly. Conclusions and Clinical Importance Although there may be a role for NT‐proBNP in monitoring the cardiac response to treatment of hyperthyroidism, neither NT‐proBNP nor cTNI distinguish hypertrophy associated with hyperthyroidism from primary HCM. Therefore, the thyroid status of older cats should be ascertained before interpreting NT‐proBNP and cTNI concentrations.
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Affiliation(s)
- J K Sangster
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA
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Hassdenteufel E, Henrich E, Hildebrandt N, Stosic A, Schneider M. Assessment of circulating N-terminal pro B-type natriuretic peptide concentration to differentiate between cardiac from noncardiac causes of pleural effusion in cats. J Vet Emerg Crit Care (San Antonio) 2013; 23:416-22. [PMID: 23859335 DOI: 10.1111/vec.12074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 06/02/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the diagnostic ability of blood N-terminal pro B-type natriuretic peptide (NT-proBNP) measurement to differentiate between congestive heart failure (CHF) and noncardiogenic causes for moderate to severe pleural effusion in cats. DESIGN Prospective observational study. SETTING University teaching hospital. ANIMALS Twenty-one cats with moderate to severe pleural effusion. INTERVENTIONS Venous blood sampling for NT-proBNP measurement. MEASUREMENT AND RESULTS According to the results of echocardiographic examination, cats were classified in a group with CHF (n = 11) or noncongestive heart failure (N-CHF, n = 10). NT-proBNP was measured via a feline-specific test in EDTA plasma with protease inhibitor. NT-proBNP was significantly (P < 0.0001) higher in the CHF group ( median 982 pmol/L, 355-1,286 pmol/L) than in the N-CHF group (median 69 pmol/L, 26 - 160 pmol/L) and discriminated exactly (area under the curve = 1.0, 95% confidence interval 1.0-1.0) between both groups. Optimum cut-off value considering all samples was 258 pmol/L. CONCLUSION In this small population of cats with pleural effusion, NT-proBNP was able to differentiate between cats with cardiogenic and noncardiogenic causes of effusion. With the currently recommended method of measurement (ie, EDTA plasma with protease inhibitor), a cut-off value of 258 pmol/L discriminates effectively between cats with and without CHF.
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Affiliation(s)
- Esther Hassdenteufel
- Department of Clinical Studies, Small Animal Clinic, University of Giessen, 35392, Giessen, Germany.
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Johns SM, Nelson OL, Gay JM. Left atrial function in cats with left-sided cardiac disease and pleural effusion or pulmonary edema. J Vet Intern Med 2012; 26:1134-9. [PMID: 22805204 DOI: 10.1111/j.1939-1676.2012.00967.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 04/13/2012] [Accepted: 05/25/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Congestive heart failure (CHF) in cats with left-sided heart disease is sometimes manifest as pleural effusion, in other cases as pulmonary edema. HYPOTHESIS Those cats with pleural effusion have more severe left atrial (LA) dysfunction than cats with pulmonary edema. ANIMALS 30 healthy cats, 22 cats with pleural effusion, and 12 cats with pulmonary edema. All cats were client owned. METHODS Retrospective study. Measurements of LA size and function were made using commercial software on archived echocardiograms. Cases were identified through searches of medical records and of archived echocardiograms for cats with these conditions. RESULTS There was no difference (P = .3) in LA size between cats with pleural effusion and cats with pulmonary edema. Cats with pleural effusion had poorer (P = .04) LA active emptying and increased (P = .006) right ventricular (RV) diameter when compared with cats with pulmonary edema and healthy cats. Cats that exhibited LA active emptying of <7.9%, total emptying of <13.6% (diameter) or <19.4% (area), or RV diameter of >3.6 mm were significantly (P < .001) more likely to manifest pleural effusion. CONCLUSIONS AND CLINICAL IMPORTANCE Poorer LA function and increased RV dimensions are associated with pleural effusion in cats with left-sided heart disease.
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Affiliation(s)
- S M Johns
- Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, WA 99164, USA.
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Jung S, Kittleson M. The Effect of Atenolol on NT-proBNP and Troponin in Asymptomatic Cats with Severe Left Ventricular Hypertrophy because of Hypertrophic Cardiomyopathy: A Pilot Study. J Vet Intern Med 2011; 25:1044-9. [DOI: 10.1111/j.1939-1676.2011.0754.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Wess G, Daisenberger P, Mahling M, Hirschberger J, Hartmann K. Utility of measuring plasma N-terminal pro-brain natriuretic peptide in detecting hypertrophic cardiomyopathy and differentiating grades of severity in cats. Vet Clin Pathol 2011; 40:237-44. [PMID: 21434959 DOI: 10.1111/j.1939-165x.2011.00305.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cats with hypertrophic cardiomyopathy (HCM) often have no clinical signs or subtle signs. Measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) has been demonstrated in people to be highly specific for heart disease and also correlates with severity of HCM. NT-proBNP may also be valuable in detecting and grading HCM in cats, but results to date have been equivocal. OBJECTIVES The aims of this study were to evaluate NT-proBNP as a screening test for diagnosis of HCM in cats and determine an appropriate cut-off value and to determine if NT-proBNP concentrations correlated with severity of HCM in cats. METHODS Plasma NT-proBNP concentrations were measured in 201 cats using an ELISA designed for use in cats. Cats were classified using echocardiography as clinically healthy controls (n=99) or cats with equivocal (n=9), mild (n=15), moderate (n=17), or severe (n=61) HCM. RESULTS NT-proBNP concentrations (median; 25th-75th interquartile percentiles) in mildly (216.1; 87.6-392.5 pmol/L), moderately (282.7; 131.9-466.6 pmol/L), and severely (839.5; 655.3-1046.4 pmol/L) affected cats were significantly higher than those in healthy controls (18.9; 3.4-62.4 pmol/L). Concentrations in severely affected cats were significantly higher than in cats from other HCM groups. There was no significant difference between mild and moderate HCM. Cut-off values >49 pmol/L had a sensitivity of 97.8% and specificity of 66.7%; >100 pmol/L had a sensitivity of 92.4% and specificity of 93.9%; and >150 pmol/L had a sensitivity of 88% and a specificity of 100%. CONCLUSIONS NT-proBNP with a cut-off value of >100 pmol/L was useful in detecting even mild HCM. Cats with increased NT-proBNP concentrations should be examined by echocardiography.
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Affiliation(s)
- Gerhard Wess
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany.
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