N-Terminal Pro-B-Type Natriuretic Peptide and Phonocardiography in Differentiating Innocent Cardiac Murmurs from Congenital Cardiac Anomalies in Asymptomatic Puppies.
J Vet Intern Med
; 31(3): 661-667, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28316101
ABSTRACT
BACKGROUND:
Differentiating innocent cardiac murmurs from murmurs caused by congenital cardiac anomalies can be challenging with auscultation alone in asymptomatic puppies.HYPOTHESIS:
Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations and phonocardiograms recorded by an electronic stethoscope can differentiate innocent from pathologic cardiac murmurs. ANIMALS A total of 186 client-owned asymptomatic dogs 135 Cairn Terriers (age 45-124 days), 20 adult Cairn Terriers (age 7.5 months to 13.5 years), and 31 puppies of various breeds (age 29-396 days).METHODS:
Study design is a cross-sectional survey. Each dog was auscultated, and when a cardiac murmur was heard, a phonocardiogram was recorded and an echocardiogram was performed. Plasma NT-proBNP concentrations were measured by a single laboratory by an ELISA.RESULTS:
No significant (P = .41) difference in plasma NT-proBNP levels was found between puppies without a murmur and puppies with an innocent murmur (median 300 versus 326 pmol/L), and between clinically healthy adult Cairn Terriers and Cairn Terrier puppies. Plasma NT-proBNP levels in puppies with a congenital heart disease were significantly (P < .001) higher than those in puppies with innocent murmurs (median 1,102 versus 326 pmol/L). However, some puppies with severe pulmonic stenosis did not have increased plasma NT-proBNP levels. On phonocardiograms, innocent murmurs had a significantly (P < .001) shorter "murmur-to-systole duration ratio" than the abnormal ones (median 66 versus 100%). The "murmur-to-S1 (first cardiac sound) amplitude ratio" was significantly (P < .001) lower of the innocent murmurs compared with that of the abnormal ones (median 16 versus 58 %). CONCLUSIONS AND CLINICAL IMPORTANCE Plasma NT-proBNP concentrations within the reference range do not rule out a congenital cardiac anomaly. Murmurs longer than 80% of the systole are most likely abnormal, whereas murmurs shorter than that could be either innocent or pathologic.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fragmentos de Peptídeos
/
Biomarcadores
/
Sopros Cardíacos
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Peptídeo Natriurético Encefálico
/
Doenças do Cão
/
Cardiopatias Congênitas
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Animals
Idioma:
En
Revista:
J Vet Intern Med
Assunto da revista:
MEDICINA INTERNA
/
MEDICINA VETERINARIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Holanda