title: Multi-centered investigation of a point-of-care NT-proBNP ELISA assay to detect moderate to severe occult (pre-clinical) feline heart disease in cats referred for cardiac evaluation.
abstract: OBJECTIVE
  To prospectively evaluate the diagnostic accuracy of a point-of-care (POC) N-terminal pro-B-type natriuretic peptide (NT-proBNP) ELISA to assess the likelihood of moderate to severe occult heart disease (OcHD) in a clinical population of cats suspected to have heart disease.
  
  
  METHODS
  One hundred and forty-six asymptomatic client-owned cats with a heart murmur, gallop rhythm, arrhythmia, or cardiomegaly.
  
  
  METHODS
  Physical examination, blood pressure measurement and echocardiography were performed prospectively. Point-of-care ELISA was visually assessed as either positive or negative by a reader blinded to the echocardiographic results.
  
  
  RESULTS
  Forty-three healthy cats, 50 mild OcHD, 31 moderate OcHD, 6 severe OcHD, and 16 cats equivocal for OcHD were examined. Cats with OcHD included 65 with hypertrophic cardiomyopathy, 6 with restrictive or unclassified cardiomyopathy, 1 with arrhythmogenic right ventricular cardiomyopathy, and 15 with non-cardiomyopathic forms of heart disease. Point-of-care ELISA differentiated cats with moderate or severe OcHD with sensitivity/specificity of 83.8%/82.6% and overall accuracy of 82.9%. Positive POC ELISA increased likelihood of moderate or severe OcHD by a factor of 4.8 vs. those that tested negative. Point-of-care ELISA differentiated cats with moderate or severe cardiomyopathic OcHD with sensitivity/specificity of 88.6%/81.3% and overall accuracy of 83.2%.
  
  
  CONCLUSIONS
  In a select sample of cats referred for cardiac evaluation, positive POC NT-proBNP ELISA increases likelihood of moderate to severe OcHD while negative POC NT-proBNP ELISA result excludes moderate to severe OcHD.
authors.affiliation: Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia, PA 19104, USA.
authors.forename: Maggie C
authors.initials: MC
authors.lastname: Machen
authors.affiliation: Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St, Philadelphia, PA 19104, USA. Electronic address: maoyama@vet.upenn.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oyama
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
authors.forename: Sonya G
authors.initials: SG
authors.lastname: Gordon
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, MA 01536, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Rush
authors.affiliation: Michigan Veterinary Specialists, 29080 Inkster Rd, Southfield, MI 48034, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Achen
authors.affiliation: Department of Medical Sciences, University of Wisconsin, 2015 Linden Dr, Madison, WI 53706, USA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Stepien
authors.affiliation: The Animal Medical Center, 510 East 62nd St, New York, NY 10065, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Fox
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Saunders
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Rd, North Grafton, MA 01536, USA.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Cunningham
authors.affiliation: The Animal Medical Center, 510 East 62nd St, New York, NY 10065, USA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Lee
authors.affiliation: Department of Medical Sciences, University of Wisconsin, 2015 Linden Dr, Madison, WI 53706, USA.
authors.forename: Heidi B
authors.initials: HB
authors.lastname: Kellihan
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis*; D002415:Cats; D004797:Enzyme-Linked Immunosorbent Assay / Q000662:veterinary*; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: BNP; Blood tests; Cardiomyopathy; Natriuretic peptides