【突破性檢測】狗狗呼吸困難與心臟病診斷新利器：NT-proBNP測試

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重點說明：研究顯示，NT-proBNP測試為獸醫臨床心臟病診斷提供重要參考，尤其在分辨呼吸困難狗狗的心臟與非心臟病因上具有顯著價值。這項測試能夠有效評估心臟負荷，幫助識別無症狀心雜音狗狗中的嚴重先天性心臟病。研究建議不同NT-proBNP濃度層級對應不同的心臟負荷程度，為獸醫提供了更精確的治療方針。

E Haßdenteufel 1, J-G Kresken, E Henrich, N Hildebrandt, C Schneider, A Stosic, M Schneider

Affiliations expand
PMID: 22688794

https://pubmed.ncbi.nlm.nih.gov/22688794/

Abstract

The cardiac biomarker NT-proBNP indicates cardiac load in terms of myocardial wall stress. The objective of the study was to compare the results of NT-proBNP measurements in healthy dogs and dogs with dyspnea as well as asymptomatic dogs with heart murmur with the literature.

Between April 2007 and December 2007 dogs with dyspnea of non-cardiac origin (n=11), dogs with dyspnea of cardiac origin (n=18) and asymptomatic dogs with heart murmur (n=22) were included. Twelve clinically healthy dogs served as a control group. All animals underwent cardiologic examination including echocardiography and measurement of serum NT-proBNP concentration. Serum was centrifuged and frozen within 30 minutes and was stored frozen until analysis was performed.

Median NT-proBNP concentration in healthy dogs was 240 pmol/l (range 131-546 pmol/l). Dogs with dyspnea and primary respiratory disease displayed a median NT-proBNP concentration of 876 pmol/l (range 97-2614 pmol/l). In patients with dyspnea of non-cardiac origin, there was a difference in the values of NT-proBNP of dogs with and without pulmonary hypertension diagnosed by echocardiography. Dogs with dyspnea of cardiac origin displayed a median NT-proBNP concentration of 2000 pmol/l (range 137-2614 pmol/l). Low normal NT-proBNP values were only found in patients with pericardial effusion. Median NT-proBNP concentration in asymptomatic dogs with heart murmur was 698.5 pmol/l (range 121-2614 pmol/l). Considerably increased values were particularly measured in asymptomatic patients with severe congenital heart disease.

NT-proBNP represents a useful additional diagnostic parameter in veterinary clinical cardiology to assess the severity of cardiac disease. Interpretation must take into consideration the clinical picture of the patient, as dogs with severe arrhythmias, sepsis and pulmonary thromboembolism may display high NT-proBNP levels without congestive heart failure. Our results indicate the following cut-off values: <500 pmol/l: no relevant cardiac load; 500-900 pmol/l: moderate cardiac load; >900 pmol/l: severe cardiac load.

摘要

心臟生物標誌物NT-proBNP指示了心肌壁壓力方面的心臟負荷。該研究的目標是比較健康犬隻和有呼吸困難犬隻以及無症狀心雜音犬隻的NT-proBNP測量結果與文獻中的結果。

於2007年4月至2007年12月間，納入了非心臟原因引起的呼吸困難犬隻（n=11），心臟原因引起的呼吸困難犬隻（n=18）和無症狀心雜音犬隻（n=22）。12隻臨床上健康的犬隻作為對照組。所有動物均接受了心臟學檢查，包括心臟超聲檢查和血清NT-proBNP濃度的測量。血清在30分鐘內被離心並凍結，直到分析前一直保存在冷凍狀態。

健康犬隻的NT-proBNP中位數濃度為240 pmol/l（範圍131-546 pmol/l）。主要呼吸系統疾病引起的呼吸困難犬隻的NT-proBNP中位數濃度為876 pmol/l（範圍97-2614 pmol/l）。在非心臟原因引起的呼吸困難患者中，通過心臟超聲檢查診斷出有無肺高壓的犬隻，其NT-proBNP值存在差異。心臟原因引起的呼吸困難犬隻的NT-proBNP中位數濃度為2000 pmol/l（範圍137-2614 pmol/l）。只有在心包積液患者中發現了低正常的NT-proBNP值。無症狀心雜音犬隻的NT-proBNP中位數濃度為698.5 pmol/l（範圍121-2614 pmol/l）。特別是在有嚴重先天性心臟病的無症狀患者中測量到了明顯增高的值。

NT-proBNP是獸醫臨床心臟學中評估心臟病嚴重程度的有用附加診斷參數。解釋必須考慮到患者的臨床圖像，因為有嚴重心律失常、敗血症和肺栓塞的犬隻可能會在沒有充血性心力衰竭的情況下顯示出高NT-proBNP水平。我們的結果指示了以下分界值：<500 pmol/l：無相關心臟負荷；500-900 pmol/l：中度心臟負荷；>900 pmol/l：嚴重心臟負荷。