Assessment of the diagnostic accuracy of circulating natriuretic peptide concentrations to distinguish between cats with cardiac and non-cardiac causes of respiratory distress

J Vet Cardiol. 2009 May:11 Suppl 1:S41-50. doi: 10.1016/j.jvc.2009.03.001. Epub 2009 Apr 25.

Abstract

Objectives: To determine if serum natriuretic peptide (NP) concentrations could distinguish cardiac from non-cardiac causes of respiratory distress (RD) in cats.

Animals: 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.

MeSH terms

  • Animals
  • Atrial Natriuretic Factor / blood*
  • Biomarkers / blood
  • Case-Control Studies
  • Cat Diseases / blood*
  • Cat Diseases / diagnosis
  • Cats
  • Confidence Intervals
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay / veterinary
  • Female
  • Heart Failure / blood
  • Heart Failure / diagnosis
  • Heart Failure / veterinary*
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood
  • Protein Precursors / blood
  • ROC Curve
  • Respiration Disorders / blood
  • Respiration Disorders / diagnosis
  • Respiration Disorders / veterinary*
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • N-terminal proatrial natriuretic peptide
  • Peptide Fragments
  • Protein Precursors
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor