title: Prospective evaluation of NT-proBNP assay to detect occult dilated cardiomyopathy and predict survival in Doberman Pinschers.
abstract: BACKGROUND
  Occult (asymptomatic) dilated cardiomyopathy (ODCM) is highly prevalent in Doberman Pinschers.
  
  
  OBJECTIVE
  Assess ability of NT-proBNP assay to detect ODCM and predict death.
  
  
  METHODS
  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
  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.
authors.affiliation: Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: G E
authors.initials: GE
authors.lastname: Singletary
authors.forename: N A
authors.initials: NA
authors.lastname: Morris
authors.forename: M
authors.initials: M
authors.lastname: Lynne O'Sullivan
authors.forename: S G
authors.initials: SG
authors.lastname: Gordon
authors.forename: M A
authors.initials: MA
authors.lastname: Oyama
mesh_terms: D000818:Animals; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000662:veterinary*; D004283:Dog Diseases / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D004285:Dogs; D005260:Female; D053208:Kaplan-Meier Estimate; D008136:Longevity; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain