title: Distinguishing cardiac and noncardiac dyspnea in 48 dogs using plasma atrial natriuretic factor, B-type natriuretic factor, endothelin, and cardiac troponin-I.
abstract: BACKGROUND
  It is challenging to differentiate congestive heart failure (CHF) from noncardiac cause of dyspnea.
  
  
  OBJECTIVE
  Circulating concentrations of atrial natriuretic peptide (NT-proANP), B-type natriuretic peptide (BNP), endothelin-I (ET-1), and cardiac troponin-I (cTnI) can be used to help distinguish between cardiac and noncardiac causes of dyspnea in dogs.
  
  
  METHODS
  Forty-eight client-owned dogs admitted to a veterinary teaching hospital for respiratory distress.
  
  
  METHODS
  Blood samples from patients were prospectively obtained. The etiology of dyspnea was determined by using physical examination, thoracic radiographs, and echocardiography.
  
  
  RESULTS
  CHF was diagnosed in 22 dogs, and dyspnea of noncardiac origin (noHD group) was diagnosed in 26 dogs. Analyses revealed significant difference between groups for NT-proANP (geometric mean, 95% confidence [CI]; no HD: 0.26 nmol/mL, 95% CI 0.17-1.09; CHF: 1.38 nmol/mL, 95% CI 1.09-1.74 nmol/mL; P < .0001), BNP (noHD: 12.18 pg/mL, 95% CI 10.91-16.17 pg/mL; CHF: 34.97 pg/mL, 95% CI 23.51-52.02 pg/mL; P < .0001), and ET-1 (noHD: 0.32 fmol/mL, 95% CI 0.23-0.46 fmol/mL; CHF: 1.26 fmol/mL, 95% CI 0.83-1.91 fmol/mL; P < .0001). Plasma cTnI concentrations were not significantly different between groups (noHD: 0.29 ng/mL, 95% CI 0.12-0.72 ng/mL; CHF: 0.42 ng/mL, 95% CI 0.18-0.97, P = .53). Receiver operating curves indicated areas under the curve for NT-proANP, BNP, and ET-1 of 0.946, 0.886, and 0.849, respectively.
  
  
  CONCLUSIONS
  Plasma NT-proANP, BNP, and ET-1, but not cTnI, appear useful for distinguishing between dogs with cardiac and noncardiac causes of dyspnea, with plasma NT-proANP having the highest sensitivity (95.5%) and specificity (84.6%).
authors.affiliation: Veterinary Specialists Incorporated-Animal Heart Centers, 91 NE 6th Street, Homestead, FL 33030, USA. prosekr@mail.vetmed.ufl.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Prosek
authors.forename: D David
authors.initials: DD
authors.lastname: Sisson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oyama
authors.forename: Philip F
authors.initials: PF
authors.lastname: Solter
mesh_terms: D000818:Animals; D009320:Atrial Natriuretic Factor / Q000097:blood*; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000097:blood / Q000175:diagnosis*; D004285:Dogs; D004417:Dyspnea / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D016232:Endothelins / Q000097:blood*; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000097:blood*
chemical_list: D016232:Endothelins; D019210:Troponin I; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor