The work was carried out at the Royal Veterinary College, the Beaumont Animals’ Hospital, Camden, and the Blue Cross Animal Hospital, Victoria.
The Combined Prognostic Potential of Serum High-Sensitivity Cardiac Troponin I and N-Terminal pro-B-Type Natriuretic Peptide Concentrations in Dogs with Degenerative Mitral Valve Disease
Article first published online: 28 FEB 2012
Copyright © 2012 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 26, Issue 2, pages 302–311, March-April 2012
How to Cite
Hezzell, M.J., Boswood, A., Chang, Y.-M., Moonarmart, W., Souttar, K. and Elliott, J. (2012), The Combined Prognostic Potential of Serum High-Sensitivity Cardiac Troponin I and N-Terminal pro-B-Type Natriuretic Peptide Concentrations in Dogs with Degenerative Mitral Valve Disease. Journal of Veterinary Internal Medicine, 26: 302–311. doi: 10.1111/j.1939-1676.2012.00894.x
- Issue published online: 20 MAR 2012
- Article first published online: 28 FEB 2012
- Manuscript Accepted: 12 JAN 2012
- Manuscript Revised: 13 DEC 2011
- Manuscript Received: 18 JUL 2011
- Petplan Charitable Trust
- IDEXX Ltd
- Risk stratification;
- Valvular disease
Identification of factors associated with decreased survival in dogs with degenerative mitral valve disease (DMVD) will allow more accurate prognosis. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is negatively associated with survival in dogs with DMVD. In human patients, multimarker strategies provide superior risk stratification compared with single markers.
High-sensitivity cardiac troponin I (hscTnI) and other clinical variables will be associated with survival time in dogs with DMVD. Measuring hscTnI and NT-proBNP in combination will be prognostically superior to measurement of either marker alone. The rate of change of these markers will vary according to cause of death.
Client-owned dogs (n = 202) with DMVD of varying severity and age-matched healthy control dogs (n = 30) recruited from first opinion private practice.
Prospective cohort study relating clinical variables at enrollment in dogs with DMVD to survival time (all-cause, cardiac, and noncardiac mortality). Multivariable Cox regression analysis was used to identify factors associated with survival. Measurements were obtained approximately every 6 months. Repeated measures models were constructed to assess changes over time.
hscTnI, LVEDDN, heart rate, and age were independently associated with decreased survival time (all-cause mortality). Survival times were shortest in dogs in which both serum hscTnI and NT-proBNP were increased. hscTnI and NT-proBNP increased more rapidly in dogs that died of cardiac disease.
Conclusions and Clinical Importance
Serum hscTnI has prognostic value in dogs with DMVD. Measurement of NT-proBNP and hscTnI is prognostically superior to measuring either alone. Serial measurement strategies provide additional prognostic information.