title: Assessment of the diagnostic accuracy of circulating natriuretic peptide concentrations to distinguish between cats with cardiac and non-cardiac causes of respiratory distress.
abstract: OBJECTIVE
  To determine if serum natriuretic peptide (NP) concentrations could distinguish cardiac from non-cardiac causes of respiratory distress (RD) in cats.
  
  
  METHODS
  Seventy-four cats from 1 university hospital were used.
  
  
  METHODS
  Serum NP concentrations were measured in 41 cats with non-cardiac respiratory distress (RD-NC) and compared to 33 cats with RD due to congestive heart failure (RD+CHF) using sandwich enzyme immunoassays (ELISA).
  
  
  RESULTS
  RD-NC cats had lower (P=0.0001) median NT-proANP and NT-proBNP concentrations (614 and 45 fmol/mL, respectively) than RD+CHF cats (1690 and 523 fmol/mL, respectively). The area under the curve was 0.88 and 0.96 for the receiver operating curve analysis of the diagnostic accuracy of NT-proANP and NT-proBNP concentrations to discriminate RD+CHF from RD-NC cats (P=0.036). An optimum cut-off concentration of 986 fmol/mL for NT-proANP and 220 fmol/mL for NT-proBNP accurately discriminated RD-NC from RC+CHF cats with a sensitivity of 93.8% and 93.9% and a specificity of 80.3% and 87.8%, respectively.
  
  
  CONCLUSIONS
  Serum NP concentrations were different in RD+CHF cats compared to RD-NC cats. Evaluation of circulating NP concentrations may be helpful in the initial approach to cats presenting with respiratory distress, particularly if advances in ELISA technology result in a rapid cage-side test.
authors.affiliation: Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7TA, UK. dconnolly@rvc.ac.uk
authors.forename: David J
authors.initials: DJ
authors.lastname: Connolly
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Soares Magalhaes
authors.forename: Virginia Luis
authors.initials: VL
authors.lastname: Fuentes
authors.forename: Adrian
authors.initials: A
authors.lastname: Boswood
authors.forename: Georgina
authors.initials: G
authors.lastname: Cole
authors.forename: Alisdair
authors.initials: A
authors.lastname: Boag
authors.forename: Harriet M
authors.initials: HM
authors.lastname: Syme
mesh_terms: D000818:Animals; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002371:Cat Diseases / Q000097:blood* / Q000175:diagnosis; D002415:Cats; D016001:Confidence Intervals; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay / Q000662:veterinary; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D012372:ROC Curve; D012120:Respiration Disorders / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor