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Comparative Study
. 2019 Jan;33(1):54-63.
doi: 10.1111/jvim.15384. Epub 2018 Dec 11.

Evaluation of a high-sensitivity cardiac troponin I assay compared to a first-generation cardiac troponin I assay in Doberman Pinschers with and without dilated cardiomyopathy

Lena Klüser  1 , Elizabeth T Maier  1 , Gerhard Wess  1
Affiliations
Comparative Study

Evaluation of a high-sensitivity cardiac troponin I assay compared to a first-generation cardiac troponin I assay in Doberman Pinschers with and without dilated cardiomyopathy

Lena Klüser et al. J Vet Intern Med. 2019 Jan.

Abstract

Background: Echocardiography and 24-hour ECG are the gold standard tests to diagnose dilated cardiomyopathy (DCM) in Doberman Pinschers (DP), but myocardial damage might be detected earlier using a high-sensitivity cardiac troponin I (hs-cTnI) assay.

Objective: To evaluate and compare an hs-cTnI assay (Advia Centaur TnI-Ultra assay) with a conventional cTnI assay in DP with different stages of DCM and in healthy DP.

Animals: Three hundred forty-five examinations from 162 DP with and 179 DP without DCM.

Methods: Prospective longitudinal study. Dogs were allocated into 6 groups based on echocardiographic and 24-hour ECG criteria: (1) healthy group (179 dogs), (2) last-normal group (29 dogs), which included dogs that were considered to be healthy at the time of their examination but were assigned to the last-normal group retrospectively when DCM was diagnosed at their next examination within 1.5 years, (3) only arrhythmias (45 dogs, 119 examinations), (4) only echocardiographic changes (24 dogs, 61 examinations), (5) echocardiographic changes with ventricular premature complexes (41 dogs, 100 examinations), and (6) decompensated (23 dogs, 36 examinations). Hs-cTnI and conventional cTnI concentration measurements were performed and compared.

Results: A cutoff value of hs-cTnI concentration >0.113 ng/mL had a sensitivity of 81.2% and a specificity of 73.2% to identify the presence of DCM. The conventional cTnI assay showed a similar test performance, but the hs-cTnI assay identified more dogs (21/29 dogs, 72%) in the last-normal group compared to the conventional cTnI test (18/29 dogs, 62%).

Conclusions and clinical importance: The hs-cTnI is an additional test with good potential to identify early DCM.

Keywords: Advia Centaur TnI-Ultra assay; DCM; Doberman cardiomyopathy; biomarker; cTnI; high-sensitivity cTnI assay.

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Figures

Figure 1
Figure 1
This Bland‐Altman plot displays the agreement between cTnI concentrations obtained from serum and EDTA‐plasma using an hs‐cTnI assay (Advia Centaur TnI‐Ultra assay; Siemens Healthcare Diagnostics). CTnI, cardiac troponin I; EDTA, ethylendiaminetetraacetic acid; hs‐cTnI, high‐sensitivity cTnI
Figure 2
Figure 2
Bland‐Altman plot for displaying the agreement between cTnI concentrations obtained from the hs‐cTnI assay (Advia Centaur TnI‐Ultra assay; Siemens Healthcare Diagnostics) (using EDTA‐plasma) and a conventional cTnI assay (Immulite 2000 troponin I test; Siemens Healthcare Diagnostics) (using serum). CTnI, cardiac troponin I; EDTA, ethylendiaminetetraacetic acid; hs‐cTnI, high‐sensitivity cTnI
Figure 3
Figure 3
Relationship between age and EDTA‐plasma cTnI concentration (ng/mL) in healthy Doberman Pinschers using an hs‐cTnI assay (Advia Centaur TnI‐Ultra assay; Siemens Healthcare Diagnostics) (P < .001). CTnI, cardiac troponin I; EDTA, ethylendiaminetetraacetic acid; hs‐cTnI, high‐sensitivity cTnI
Figure 4
Figure 4
Box plots for graphically depicting the distribution of 524 EDTA‐plasma hs‐cTnI concentrations of 179 healthy Doberman Pinschers and 162 Doberman Pinschers with DCM in different disease groups. Each plot displays the interquartile range (IQR) and the band inside the box is the median. The whiskers are 1.5 times the IQR. Circles and asterisks represent outlier concentrations 1.5‐3 times and >3 times the IQR, respectively. The horizontal line displays the cutoff value of hs‐cTnI concentration >0.113 ng/mL. CHF, congestive heart failure; CTnI, cardiac troponin I; DCM, dilated cardiomyopathy; EDTA, ethylendiaminetetraacetic acid; hs‐CTnI, high‐sensitivity cTnI; VPC, ventricular premature complexes
Figure 5
Figure 5
Comparison of ROC curves obtained from an hs‐cTnI assay (Advia Centaur TnI‐Ultra assay; Siemens Healthcare Diagnostics) (using EDTA‐plasma) and a conventional cTnI assay (Immulite 2000 troponin I test; Siemens Healthcare Diagnostics) (using serum) to detect occult DCM in Doberman Pinschers. CTnI, cardiac troponin I; EDTA, ethylendiaminetetraacetic acid; hs‐cTnI, high‐sensitivity cTnI; ROC, receiver operator curves
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References

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