title: Multicenter evaluation of plasma N-terminal probrain natriuretic peptide (NT-pro BNP) as a biochemical screening test for asymptomatic (occult) cardiomyopathy in cats.
abstract: BACKGROUND
  B-type natriuretic peptide concentrations reliably distinguish between cardiac and respiratory causes of dyspnea, but its utility to detect asymptomatic cats with occult cardiomyopathy (OCM) is unresolved.
  
  
  OBJECTIVE
  Determine whether plasma N terminal probrain natriuretic peptide (NT-proBNP) concentration can discriminate asymptomatic cats with OCM from normal cats, and whether NT-proBNP concentration correlates with clinical, biochemical, and echocardiographic parameters.
  
  
  METHODS
  One hundred and fourteen normal, healthy cats; 113 OCM cats.
  
  
  METHODS
  Prospective, multicenter, case-controlled study. NT-proBNP was prospectively measured and cardiac status was determined from history, physical examination, and M-mode/2D/Doppler echocardiography. Optimal cut-off values were derived using receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  NT-proBNP was higher (median, interquartile range [25th and 75th percentiles]) in (1) OCM (186 pmol/L; 79, 478 pmol/L) versus normal (24 pmol/L; 24, 32 pmol/L) (P < .001); and (2) hypertrophic obstructive cardiomyopathy (396 pmol/L; 205, 685 pmol/L) versus hypertrophic cardiomyopathy (112 pmol/L; 48, 318 pmol/L) (P < .001). In OCM, NT-proBNP correlated (1) positively with LVPWd (ρ = 0.23; P = .01), LA/Ao ratio (ρ = 0.31; P < .001), LVs (ρ = 0.33; P < .001), and troponin-I (ρ = 0.64; P < .001), and (2) negatively with %FS (ρ = -0.27; P = .004). Area under ROC curve was 0.92; >46 pmol/L cut-off distinguished normal from OCM (91.2% specificity, 85.8% sensitivity); >99 pmol/L cut-off was 100% specific, 70.8% sensitive.
  
  
  CONCLUSIONS
  Plasma NT-proBNP concentration reliably discriminated normal from OCM cats, and was associated with several echocardiographic markers of disease severity. Further studies are needed to assess test performance in unselected, general feline populations, and evaluate relationships between NT-proBNP concentrations and disease progression.
authors: Animal Medical Center, New York, NY, USA. philip.fox@amcny.org
authors: P R
authors: PR
authors: Fox
authors: J E
authors: JE
authors: Rush
authors: C A
authors: CA
authors: Reynolds
authors: T C
authors: TC
authors: Defrancesco
authors: B W
authors: BW
authors: Keene
authors: C E
authors: CE
authors: Atkins
authors: S G
authors: SG
authors: Gordon
authors: K E
authors: KE
authors: Schober
authors: J D
authors: JD
authors: Bonagura
authors: R L
authors: RL
authors: Stepien
authors: H B
authors: HB
authors: Kellihan
authors: K A
authors: KA
authors: Macdonald
authors: L B
authors: LB
authors: Lehmkuhl
authors: T P
authors: TP
authors: Nguyenba
authors: N
authors: N
authors: Sydney Moise
authors: B K
authors: BK
authors: Lefbom
authors: D F
authors: DF
authors: Hogan
authors: M A
authors: MA
authors: Oyama
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D016022:Case-Control Studies; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis*; D002415:Cats; D005260:Female; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain