Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

Evaluation of Plasma NT-proBNP Concentration in Dogs with Chronic Mitral Valve Insufficiency

개의 만성 이첨판 폐쇄부전증 환자군에서 혈장 NT-proBNP 농도 평가연구

  • Lee, Seunggon (Cardiology Services, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, North Carolina State University) ;
  • Hyun, Changbaig (Section of Small Animal Internal Medicine, School of Veterinary Medicine and Institute of Veterinary Medicine, Kangwon National University)
  • 이승곤 (미국 노스캐롤라이나 대학교, 수의과대학) ;
  • 현창백 (강원대학교 수의학과 소동물 내과교실)
  • Accepted : 2013.06.10
  • Published : 2013.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study aimed to evaluate the plasma concentration of NT-proBNP in dogs with different stages of heart failure by chronic mitral valve insufficiency (CMVI). Fifty small-breed dogs with CMVI and 7 healthy control dogs without cardiac disease and critical systemic diseases were included in the study population. As a preliminary study, we compared the plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the echocardiographic parameters between dogs of the International Small Animal Cardiac Health Council (ISACHC) classes. Then, we evaluated the associations between NT-proBNP and echocardiographic parameters. Plasma NT-proBNP levels showed a significant difference among the ISACHC groups. In the comparison between echocardiographic parameters and NT-proBNP, NT-proBNP were found to be associated with left atrium/aorta (LA/AO), early diastolic transmitral flow (E) velocity, late diastolic transmitral flow (A) velocity, end diastolic volume index (EDVI). Our study found plasma NT-proBNP might be useful to predict the disease progression in dogs with CMVI.

본 연구는 개의 이첨판 폐쇄부전증(CMVI) 환자군에서 혈장 NT-proBNP농도를 평가한 연구이다. 본 연구를 위해 CMVI에 이환된 50마리와 건강한 대조군 7마리를 대상으로 일반적인 심초음파 검사와 혈중NT-proBNP농도를 측정하였다. 심부전의 심하기에 따라 분류된 환자군에서 측정된 NT-proBNP농도와 심초음파 인덱스의 상호관련성을 평가하였다. 혈중 NT-proBNP 농도는 심부전의 심하기에 따라 상승하였다. 또한 심초음파 인덱스중 left atrium/aorta (LA/AO), early diastolic transmitral flow (E) velocity, late diastolic transmitral flow (A) velocity, end diastolic volume index (EDVI) 등과 밀접한 관련성이 관찰되었다. 본 연구는 이첨판 폐쇄부전증 환자의 예후를 평가하는데 중요할 것으로 보인다.

Keywords

References

  1. Appleton CP and Hatle LK. The natural history of left ventricular filling abnormalities: assessment by two dimensional and Doppler echocardiography. Echocardiography 1992; 9: 437-445. https://doi.org/10.1111/j.1540-8175.1992.tb00486.x
  2. Atkins C, Bonagura J, Ettinger S. Guidelines for the diagnosis and treatment of canine chronic valvular heart disease. J Vet Intern Med 2009; 23: 1142-1150. https://doi.org/10.1111/j.1939-1676.2009.0392.x
  3. Barbosa MM, Nunes Mdo C, Castro LR, Nominato LF, Alencar MC, and Ribeiro AL. Correlation between NT-pro BNP levels and early mitral annulus velocity (E') in patients with non-STsegment elevation acute coronary syndrome. Echocardiography 2008; 25: 353-359. https://doi.org/10.1111/j.1540-8175.2007.00618.x
  4. Behnes M, Lang S, Breithardt OA. Association of NT-pro- BNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema. J Heart Valve Dis 2008; 17: 557-565.
  5. Berni A, Cappelli F, Bitossi L. Non-invasive tissue Doppler imaging pulmonary capillary wedge pressure measurement improves NT-proBNP prognostic value in heart failure. Acta Cardiol 2009; 64: 213-218. https://doi.org/10.2143/AC.64.2.2036140
  6. Bonagura JD and Schober KE. Can ventricular function be assessed by echocardiography in chronic canine mitral valve disease? J Small Anim Pract 2009; 50 Suppl 1: 12-24. https://doi.org/10.1111/j.1748-5827.2009.00803.x
  7. Borgarelli M and Haggstrom J. Canine degenerative myxomatous mitral valve disease: natural history, clinical presentation and therapy. Vet Clin North Am Small Anim Pract 2010; 40: 651-663. https://doi.org/10.1016/j.cvsm.2010.03.008
  8. Borgarelli M, Savarino P, Crosara S. Survival characteristics and prognostic variables of dogs with mitral regurgitation attributable to myxomatous valve disease. J Vet Intern Med 2008; 22: 120-128. https://doi.org/10.1111/j.1939-1676.2007.0008.x
  9. Boswood A, Dukes-McEwan J, Loureiro J. The diagnostic accuracy of different natriuretic peptides in the investigation of canine cardiac disease. J Small Anim Pract 2008; 49: 26-32.
  10. Bruch C, Stypmann J, Gradaus R, Breithardt G, and Wichter T. Usefulness of tissue Doppler imaging for estimation of filling pressures in patients with primary or secondary pure mitral regurgitation. Am J Cardiol 2004; 93: 324-328. https://doi.org/10.1016/j.amjcard.2003.10.012
  11. Chetboul V. Advanced techniques in echocardiography in small animals. Vet Clin North Am Small Anim Pract 2010; 40: 529-543. https://doi.org/10.1016/j.cvsm.2010.03.007
  12. Chetboul V, Serres F, Tissier R. Association of plasma Nterminal pro-B-type natriuretic peptide concentration with mitral regurgitation severity and outcome in dogs with asymptomatic degenerative mitral valve disease. J Vet Intern Med 2009; 23: 984-994. https://doi.org/10.1111/j.1939-1676.2009.0347.x
  13. Chetboul V and Tissier R. Echocardiographic assessment of canine degenerative mitral valve disease. J Vet Cardiol 2012; 14: 127-148. https://doi.org/10.1016/j.jvc.2011.11.005
  14. Chowdhury P, Choudhary R, and Maisel A. The appropriate use of biomarkers in heart failure. Med Clin North Am 2012; 96: 901-913. https://doi.org/10.1016/j.mcna.2012.07.002
  15. Cote E. Echocardiography: common pitfalls and practical solutions. Clin Tech Small Anim Pract 2005; 20: 156-163. https://doi.org/10.1053/j.ctsap.2005.05.003
  16. Diwan A, McCulloch M, Lawrie GM, Reardon MJ, and Nagueh SF. Doppler estimation of left ventricular filling pressures in patients with mitral valve disease. Circulation 2005; 111: 3281-3289. https://doi.org/10.1161/CIRCULATIONAHA.104.508812
  17. Dokainish H, Zoghbi WA, Lakkis NM, et al. Optimal noninvasive assessment of left ventricular filling pressures: a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters. Circulation 2004; 109: 2432-2439. https://doi.org/10.1161/01.CIR.0000127882.58426.7A
  18. Fox PR, Oyama MA, Reynolds C. Utility of plasma Nterminal pro-brain natriuretic peptide (NT-proBNP) to distinguish between congestive heart failure and non-cardiac causes of acute dyspnea in cats. J Vet Cardiol 2009; 11 Suppl 1: S51-61. https://doi.org/10.1016/j.jvc.2008.12.001
  19. Fox PR, Rush JE, Reynolds CA. Multicenter evaluation of plasma N-terminal probrain natriuretic peptide (NT-pro BNP) as a biochemical screening test for asymptomatic (occult) cardiomyopathy in cats. J Vet Intern Med 2011; 25: 1010-1016. https://doi.org/10.1111/j.1939-1676.2011.00776.x
  20. Fox PR and Sisson D. Textbook of canine and feline cardiology. 2 ed. Philadelphia: WB Saunders, 1999.
  21. Frederiksen CA, Juhl-Olsen P, Jakobsen CJ, and Sloth E. Echocardiographic evaluation of systolic and diastolic function: a preoperative study of correlation with serum NTproBNP. J Cardiothorac Vasc Anesth 2012; 26: 197-203. https://doi.org/10.1053/j.jvca.2011.07.022
  22. Freed LA, Levy D, Levine RA. Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med 1999; 341: 1-7. https://doi.org/10.1056/NEJM199907013410101
  23. Gaasch WH, Levine HJ, Quinones MA, and Alexander JK. Left ventricular compliance: mechanisms and clinical implications. Am J Cardiol 1976; 38: 645-653. https://doi.org/10.1016/S0002-9149(76)80015-X
  24. Grewal J, McKelvie R, Lonn E. BNP and NT-proBNP predict echocardiographic severity of diastolic dysfunction. Eur J Heart Fail 2008; 10: 252-259. https://doi.org/10.1016/j.ejheart.2008.01.017
  25. Hall C. Essential biochemistry and physiology of (NT-pro) BNP. Eur J Heart Fail 2004; 6: 257-260. https://doi.org/10.1016/j.ejheart.2003.12.015
  26. Kim HN and Januzzi JL, Jr. Natriuretic peptide testing in heart failure. Circulation 2011; 123: 2015-2019. https://doi.org/10.1161/CIRCULATIONAHA.110.979500
  27. Knebel F, Eddicks S, Schimke I. Myocardial tissue Doppler echocardiography and N-terminal B-type natriuretic peptide (NT-proBNP) in diastolic and systolic heart failure. Cardiovasc Ultrasound 2008; 6: 45. https://doi.org/10.1186/1476-7120-6-45
  28. Mak GS, DeMaria A, Clopton P, and Maisel AS. Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function: comparison with tissue Doppler imaging recordings. Am Heart J 2004; 148: 895-902. https://doi.org/10.1016/j.ahj.2004.02.016
  29. Mercier E, Mathieu M, Sandersen CF, Delvaux FH, Clercx CM, and Entee KM. Evaluation of the influence of age on pulmonary arterial pressure by use of right ventricular catheterization, pulsed-wave Doppler echocardiography, and pulsed-wave tissue Doppler imaging in healthy Beagles. Am J Vet Res 2010; 71: 891-897. https://doi.org/10.2460/ajvr.71.8.891
  30. Nagueh SF, Sun H, Kopelen HA, Middleton KJ, and Khoury DS. Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler. J Am Coll Cardiol 2001; 37: 278-285. https://doi.org/10.1016/S0735-1097(00)01056-1
  31. Nishimura RA and Tajik AJ. Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone. J Am Coll Cardiol 1997; 30: 8-18. https://doi.org/10.1016/S0735-1097(97)00144-7
  32. Oh JK, Appleton CP, Hatle LK, Nishimura RA, Seward JB, and Tajik AJ. The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography. Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 1997; 10: 246-270. https://doi.org/10.1016/S0894-7317(97)70062-2
  33. Ommen SR, Nishimura RA, Appleton CP. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study. Circulation 2000; 102: 1788-1794. https://doi.org/10.1161/01.CIR.102.15.1788
  34. Oyama MA, Fox PR, Rush JE, Rozanski EA, and Lesser M. Clinical utility of serum N-terminal pro-B-type natriuretic peptide concentration for identifying cardiac disease in dogs and assessing disease severity. J Am Vet Med Assoc 2008; 232: 1496-1503. https://doi.org/10.2460/javma.232.10.1496
  35. Oyama MA and Singletary GE. The use of NT-proBNP assay in the management of canine patients with heart disease. Vet Clin North Am Small Anim Pract 2010; 40: 545-558. https://doi.org/10.1016/j.cvsm.2010.03.004
  36. Oyama MA, Sisson DD, Bulmer BJ, and Constable PD. Echocardiographic estimation of mean left atrial pressure in a canine model of acute mitral valve insufficiency. J Vet Intern Med 2004; 18: 667-672. https://doi.org/10.1111/j.1939-1676.2004.tb02604.x
  37. Paulus WJ, Tschope C, Sanderson JE. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007; 28: 2539-2550. https://doi.org/10.1093/eurheartj/ehm037
  38. Schober KE, Bonagura JD, Scansen BA, Stern JA, and Ponzio NM. Estimation of left ventricular filling pressure by use of Doppler echocardiography in healthy anesthetized dogs subjected to acute volume loading. Am J Vet Res 2008; 69: 1034-1049. https://doi.org/10.2460/ajvr.69.8.1034
  39. Schober KE, Hart TM, Stern JA. Effects of treatment on respiratory rate, serum natriuretic peptide concentration, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure secondary to degenerative mitral valve disease and dilated cardiomyopathy. J Am Vet Med Assoc 2011; 239: 468-479. https://doi.org/10.2460/javma.239.4.468
  40. Schober KE, Stern JA, DaCunha DN, Pedraza-Toscano AM, Shemanski D, and Hamlin RL. Estimation of left ventricular filling pressure by Doppler echocardiography in dogs with pacing-induced heart failure. J Vet Intern Med 2008; 22: 578-585. https://doi.org/10.1111/j.1939-1676.2008.0099.x
  41. Serres F, Pouchelon JL, Poujol L. Plasma N-terminal pro-Btype natriuretic peptide concentration helps to predict survival in dogs with symptomatic degenerative mitral valve disease regardless of and in combination with the initial clinical status at admission. J Vet Cardiol 2009; 11: 103-121. https://doi.org/10.1016/j.jvc.2009.07.001
  42. Singletary GE, Rush JE, Fox PR, Stepien RL, and Oyama MA. Effect of NT-pro-BNP assay on accuracy and confidence of general practitioners in diagnosing heart failure or respiratory disease in cats with respiratory signs. J Vet Intern Med 2012; 26: 542-546. https://doi.org/10.1111/j.1939-1676.2012.00916.x
  43. Stefanadis C, Dernellis J, and Toutouzas P. A clinical appraisal of left atrial function. Eur Heart J 2001; 22: 22-36. https://doi.org/10.1053/euhj.1999.2581
  44. Tarnow I, Olsen LH, Kvart C. Predictive value of natriuretic peptides in dogs with mitral valve disease. Vet J 2009; 180: 195-201. https://doi.org/10.1016/j.tvjl.2007.12.026
  45. Teshima K, Asano K, Sasaki Y. Assessment of left ventricular function using pulsed tissue Doppler imaging in healthy dogs and dogs with spontaneous mitral regurgitation. J Vet Med Sci 2005; 67: 1207-1215. https://doi.org/10.1292/jvms.67.1207
  46. Tidholm A, Ljungvall I, Hoglund K, Westling AB, and Haggstrom J. Tissue Doppler and strain imaging in dogs with myxomatous mitral valve disease in different stages of congestive heart failure. J Vet Intern Med 2009;23: 1197-1207. https://doi.org/10.1111/j.1939-1676.2009.0403.x
  47. Tretjak M, Verovnik F, Benko D, and Kozelj M. Tissue Doppler velocities of mitral annulus and NT-proBNP in patients with heart failure. Eur J Heart Fail 2005; 7: 520-524. https://doi.org/10.1016/j.ejheart.2004.07.011
  48. Tschope C, Kasner M, Westermann D, Gaub R, Poller WC, and Schultheiss HP. The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements. Eur Heart J 2005; 26: 2277-2284. https://doi.org/10.1093/eurheartj/ehi406
  49. Tsutsui H, Urabe Y, Mann DL. Effects of chronic mitral regurgitation on diastolic function in isolated cardiocytes. Circ Res 1993; 72: 1110-1123. https://doi.org/10.1161/01.RES.72.5.1110
  50. Uretsky S, Supariwala A, Nidadovolu P. Quantification of left ventricular remodeling in response to isolated aortic or mitral regurgitation. J Cardiovasc Magn Reson 2010; 12: 32. https://doi.org/10.1186/1532-429X-12-32
  51. Wolf J, Gerlach N, Weber K, Klima A, and Wess G. Lowered N-terminal pro-B-type natriuretic peptide levels in response to treatment predict survival in dogs with symptomatic mitral valve disease. J Vet Cardiol 2012; 14: 399-408. https://doi.org/10.1016/j.jvc.2012.05.005
  52. Yu CM, Sanderson JE, Marwick TH, and Oh JK. Tissue Doppler imaging a new prognosticator for cardiovascular diseases. J Am Coll Cardiol 2007; 49: 1903-1914. https://doi.org/10.1016/j.jacc.2007.01.078
  53. Zacharopoulou I, Mornos C, Manolis AJ. The relationship between the time interval difference of isovolumic relaxation (T[IVRT-IVRTa]) and serum levels of N-terminal pro-brain natriuretic peptide in patients with intermediate E/Ea ratio. Hellenic J Cardiol 2011; 52: 23-29.
  54. Zile MR, Tomita M, Nakano K. Effects of left ventricular volume overload produced by mitral regurgitation on diastolic function. Am J Physiol 1991; 261: H1471-1480.