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. 2023 May-Jun;37(3):900-909.
doi: 10.1111/jvim.16702. Epub 2023 Apr 15.

N-terminal brain natriuretic peptide, cardiac troponin-I, and point-of-care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites

Alice G N Morey  1 , Kenneth E Lamb  2 , James J Karnia  1 , Kelly E Wiggen  1 , Bridget M Lyons  1 , Laura A Nafe  1 , Stacey B Leach  1
Affiliations

N-terminal brain natriuretic peptide, cardiac troponin-I, and point-of-care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites

Alice G N Morey et al. J Vet Intern Med. 2023 May-Jun.

Abstract

Background: Nonhemorrhagic ascites (NHA) can be caused by cardiac diseases (cNHA) and noncardiac diseases (ncNHA). N-terminal brain natriuretic peptide (NT-proBNP), cardiac troponin-I (cTnI), and point-of-care ultrasound (POCUS) may differentiate between cNHA and ncNHA.

Hypothesis/objectives: We compared NT-proBNP and cTnI concentrations as well as POCUS findings in dogs presented with cNHA and ncNHA.

Animals: Dogs (n = 60) were enrolled based on identification of NHA with an effusion packed cell volume < 10%.

Methods: Blood samples were collected and POCUS was performed on all dogs. Dogs were diagnosed with cNHA (n = 28) or ncNHA (n = 32) based on echocardiography. The cNHA group was subdivided into cardiac non-pericardial disease (n = 17) and pericardial disease (n = 11).

Results: The NT-proBNP concentration (median; range pmol/L) was significantly higher in the cNHA group (4510; 250-10 000) compared to the ncNHA group (739.5; 250-10 000; P = .01), with a sensitivity of 53.8% and specificity of 85.7% using a cut-off of 4092 pmol/L. The NT-proBNP concentrations were significantly higher in the cardiac non-pericardial disease group (8339; 282-10 000) compared with the pericardial disease group (692.5; 250-4928; P = .002). A significant difference in cTnI concentration (median; range ng/L) between the cNHA group (300; 23-112 612) and ncNHA group (181; 17-37 549) was not detected (P = .41). A significantly higher number of dogs had hepatic venous and caudal vena cava distension in the cNHA group compared to the ncNHA group, respectively (18/28 vs 3/29, P < .0001 and 13/27 vs 2/29, P < .001). Gall bladder wall edema was not significantly different between groups (4/28 vs 3/29, P = .74).

Conclusions and clinical importance: NT-proBNP concentration and POCUS help distinguish between cNHA and ncNHA.

Keywords: BNP; canine; congestive heart failure; echocardiography.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart showing the number of dogs enrolled into each group after identification of nonhemorrhagic ascites (PCV < 10%).
FIGURE 2
FIGURE 2
Flow chart showing the number of dogs that had physical examination, point‐of‐care ultrasound (POCUS), and cardiac biomarker results analyzed throughout the study.
FIGURE 3
FIGURE 3
Box and whisker plot showing the plasma concentration of NT‐proBNP in dogs with cardiac (n = 26) and noncardiac causes (n = 28) of nonhemorrhagic ascites (P = .01). Center line shows the median value; box limits indicate the 25th and 75th percentiles, and the whiskers extend 1.5 times the interquartile range. Outliers are represented as dots and + sign represents the mean.
FIGURE 4
FIGURE 4
Box and whisker plot showing the plasma concentration of NT‐proBNP in dogs with cardiac non‐pericardial disease (n = 16) and noncardiac causes (n = 28) of nonhemorrhagic ascites (P < .001). Center line shows the median value; box limits indicate the 25th and 75th percentiles, and the whiskers extend 1.5 times the interquartile range. Outliers are represented as dots and + sign represents the mean.
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