title: Serum cardiac troponin I in canine syncope and seizures.
abstract: OBJECTIVE
  To determine if serum cardiac troponin I (cTnI) concentration distinguishes between cardiogenic syncope and collapsing dogs presenting with either generalized epileptic seizures (both with and without cardiac disease) or vasovagal syncope.
  
  
  METHODS
  Seventy-nine prospectively recruited dogs, grouped according to aetiology of collapse: generalized epileptic seizures (group E), cardiogenic syncope (group C), dogs with both epileptic seizures and cardiac disease (group B), vasovagal syncope (group V) or unclassified (group U).
  
  
  METHODS
  Most patients had ECG (n = 78), echocardiography (n = 78) and BP measurement (n = 74) performed. Dogs with a history of intoxications, trauma, evidence of metabolic disorders or renal insufficiency (based on serum creatinine concentrations >150 μmol/L and urine specific gravity <1.030) were excluded. Serum cTnI concentrations were measured and compared between groups using non-parametric statistical methods. Multivariable regression analysis investigated factors associated with cTnI. Receiver operator characteristic curve analysis examined whether cTnI could identify cardiogenic syncope.
  
  
  RESULTS
  Median cTnI concentrations were higher in group C than E (cTnI: 0.165 [0.02-27.41] vs. 0.03 [0.01-1.92] ng/mL; p<0.05). Regression analysis found that serum cTnI concentrations decreased with increasing time from collapse (p=0.015) and increased with increasing creatinine concentration (p=0.028). Serum cTnI diagnosed cardiogenic syncope with a sensitivity of 75% and specificity of 80%.
  
  
  CONCLUSIONS
  Serum cTnI concentrations were significantly different between groups C and E. However, due to the overlap in cTnI concentrations between groups cTnI, measurement in an individual is not optimally discriminatory to differentiate cardiogenic syncope from collapse with generalized epileptic seizures (both with and without cardiac disease) or vasovagal syncope.
authors.affiliation: Northwest Surgeons, Delamere House, Ashville Point, Sutton Weaver, Runcorn WA7 3FW, UK; Units E & F, Telford Court, Chestergates Road, Chester CH1 6LT, UK. Electronic address: emily@cheshirecardiology.com.
authors.forename: E
authors.initials: E
authors.lastname: Dutton
authors.affiliation: University of Liverpool, School of Veterinary Science, Leahurst, Chester High Road, Neston CH64 7TE, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dukes-McEwan
authors.affiliation: PJC Clinical Epidemiology, 68 Marshlands Road, Little Neston, Neston, Cheshire CH64 0SW, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Cripps
mesh_terms: D000818:Animals; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000097:blood*; D004285:Dogs; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D008297:Male; D011446:Prospective Studies; D012640:Seizures / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000662:veterinary*; D013575:Syncope / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I
keywords: Arrhythmias; Cardiac disease; Collapse; Epilepsy