Investigation of an N-Terminal Prohormone of Brain Natriuretic Peptide Point-of-Care ELISA in Clinically Normal Cats and Cats With Cardiac Disease

J Vet Intern Med. 2017 Jul;31(4):994-999. doi: 10.1111/jvim.14776. Epub 2017 Jun 15.

Abstract

Background: N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations may be increased in cats with various cardiac disorders. The point-of-care (POC) ELISA assay uses the same biologic reagents as the quantitative NT-proBNP ELISA. Previous studies have evaluated the sensitivity and specificity of the POC ELISA in cats with cardiac disease.

Objectives: To prospectively evaluate the diagnostic utility of the POC ELISA in a select population of cats.

Animals: Thirty-eight client-owned cats presented to the University of Florida Cardiology Service for cardiac evaluation. Fifteen apparently healthy cats recruited as part of another study.

Methods: Physical examination and echocardiography were performed in all cats. The POC ELISA was assessed visually as either positive or negative by a reader blinded to the echocardiographic findings, and results were analyzed relative to quantitative assay results.

Results: Twenty-six cats were diagnosed with underlying cardiac disease, and 27 cats were considered free of cardiac disease. Cats with cardiac disease included: 21 with hypertrophic cardiomyopathy, 2 with unclassified cardiomyopathy, 2 with restrictive cardiomyopathy, and 1 with 3rd degree atrioventricular (AV) block. The POC ELISA differentiated cats with cardiac disease with a sensitivity of 65.4% and specificity of 100%.

Conclusions and clinical importance: The POC NT-proBNP ELISA performed moderately well in a selected population of cats. A negative test result cannot exclude the presence of underlying cardiac disease, and a positive test result indicates that cardiac disease likely is present, but further diagnostic investigation would be indicated for a definitive diagnosis.

Keywords: Cardiac disease; Biomarker; Feline; NT-proBNP.

MeSH terms

  • Animals
  • Atrioventricular Block / blood
  • Atrioventricular Block / diagnosis
  • Atrioventricular Block / veterinary
  • Cardiomyopathies / blood
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / veterinary
  • Cardiomyopathy, Hypertrophic / blood
  • Cardiomyopathy, Hypertrophic / diagnosis
  • Cardiomyopathy, Hypertrophic / veterinary
  • Case-Control Studies
  • Cat Diseases / blood
  • Cat Diseases / diagnosis*
  • Cats
  • Enzyme-Linked Immunosorbent Assay / methods
  • Enzyme-Linked Immunosorbent Assay / veterinary*
  • Female
  • Heart Diseases / blood
  • Heart Diseases / diagnosis
  • Heart Diseases / veterinary*
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Point-of-Care Systems
  • Sensitivity and Specificity

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain