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Research article - Peer-reviewed, 2022

Prospective evaluation of the combined value of physical examination and biomarker variables in screening for preclinical dilated cardiomyopathy in Doberman Pinschers

Gordon, S. G.; Wesselowski, S.; Estrada, A. H.; Braz-Ruivo, L.; Morris, N.; Haggstrom, J.; O'Grady, M. R.; Malcolm, E.

Abstract

Introduction: Screening to assess likelihood of preclinical dilated cardi-omyopathy (PC-DCM) prior to advanced diagnostic tests in Doberman Pinschers (DP) is desirable. Objective: To investigate the combined value of physical examination (PE), N -term-inal pro B-type natriuretic peptide (NTproBNP) and cardiac troponin I (cTnI) for identifying PC-DCM in DP. Animals, materials and methods: All dogs underwent: PE, echocardiogram, 3-min ECG and cardiac biomarker measurement. Asymptomatic DP specialIntscript were classified based on 3-min ECG and echocardiogram as: No-DCM/MMVD or myxomatous mitral valve disease (MMVD), PC-DCM based on echocardiogram (PC-DCM-Echo), PC-DCM based on arrhythmias with a normal echocardiogram (PC-DCM-ECG), equivocal DCM (EQ-DCM), and MMVD. Receiver operator characteristic curves and prediction models were derived. Results: Heart murmurs and arrhythmias were rare and gallop sounds were absent in No-DCM/MMVD DP. Dogs > four years old and males had higher probabilities of PC-DCM-Echo. Prediction models incorporating PE variables with NTproBNP had an area under the curve (AUC) of 0.940 for distinguishing between PC-DCM-Echo and all other groups, which was similar to the AUC for NTproBNP (0.939) or cTnI (0.932) alone. Discrimination between No-DCM/MMVD and all other groups was simi-lar for NTproBNP (0.781) and cTnI (0.742) as individual tests, however, models com-bining PE variables and NTproBNP increased the AUC to 0.812. An NTproBNP cut-off of >548 pmol/L, was 100% sensitive and 77.3% specific for detecting PC-DCM-Echo. Conclusions: Both NTproBNP and cTnI had good utility as sole tests to discriminate PC-DCM-Echo DP from all others. Models differentiating No-DCM/MMVD DP from all other DP were improved by using PE and NTproBNP together. 2022 Elsevier B.V. All rights reserved.

Keywords

NTproBNP; Occult; Asymptomatic; PDK4; Troponin

Published in

Journal of Veterinary Cardiology
2022, Volume: 40, pages: 69-83
Publisher: ELSEVIER

    UKÄ Subject classification

    Clinical Science

    Publication identifier

    DOI: https://doi.org/10.1016/j.jvc.2022.01.004

    Permanent link to this page (URI)

    https://res.slu.se/id/publ/117357