Key result
Plasma NT-proBNP measurement with a cut-off >100 pmol/L accurately detected hypertrophic cardiomyopathy in cats, demonstrating 92.4% sensitivity and 93.9% specificity.
Why the study?
Does plasma NT-proBNP measurement accurately detect and grade the severity of hypertrophic cardiomyopathy in cats?
Observational (n=201)
Does plasma NT-proBNP measurement accurately detect and grade the severity of hypertrophic cardiomyopathy in cats?
Effect estimate: Sensitivity 92.4%, Specificity 93.9% (>100 pmol/L)
Plasma NT-proBNP measurement is a highly sensitive and specific screening test for detecting hypertrophic cardiomyopathy in cats, with levels correlating with disease severity.
Supports NT-proBNP screening for feline HCM; leaves open prospective validation before clinical adoption.
BACKGROUND: Cats with hypertrophic cardiomyopathy (HCM) often have no clinical signs or subtle signs. Measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) has been demonstrated in people to be highly specific for heart disease and also correlates with severity of HCM. NT-proBNP may also be valuable in detecting and grading HCM in cats, but results to date have been equivocal. OBJECTIVES: The aims of this study were to evaluate NT-proBNP as a screening test for diagnosis of HCM in cats and determine an appropriate cut-off value and to determine if NT-proBNP concentrations correlated with severity of HCM in cats. METHODS: Plasma NT-proBNP concentrations were measured in 201 cats using an ELISA designed for use in cats. Cats were classified using echocardiography as clinically healthy controls (n=99) or cats with equivocal (n=9), mild (n=15), moderate (n=17), or severe (n=61) HCM. RESULTS: NT-proBNP concentrations (median; 25th-75th interquartile percentiles) in mildly (216.1; 87.6-392.5 pmol/L), moderately (282.7; 131.9-466.6 pmol/L), and severely (839.5; 655.3-1046.4 pmol/L) affected cats were significantly higher than those in healthy controls (18.9; 3.4-62.4 pmol/L). Concentrations in severely affected cats were significantly higher than in cats from other HCM groups. There was no significant difference between mild and moderate HCM. Cut-off values >49 pmol/L had a sensitivity of 97.8% and specificity of 66.7%; >100 pmol/L had a sensitivity of 92.4% and specificity of 93.9%; and >150 pmol/L had a sensitivity of 88% and a specificity of 100%. CONCLUSIONS: NT-proBNP with a cut-off value of >100 pmol/L was useful in detecting even mild HCM. Cats with increased NT-proBNP concentrations should be examined by echocardiography.
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Wess et al. (2011) conducted an observational in Hypertrophic cardiomyopathy (n=201). Plasma NT-proBNP measurement vs. Echocardiography (healthy controls) was evaluated on Diagnosis of hypertrophic cardiomyopathy and correlation with severity (Sensitivity 92.4%, Specificity 93.9% (>100 pmol/L)). Plasma NT-proBNP measurement with a cut-off >100 pmol/L accurately detected hypertrophic cardiomyopathy in cats, demonstrating 92.4% sensitivity and 93.9% specificity.