Evaluation of point-of-care thoracic ultrasound and NT-proBNP for the diagnosis of congestive heart failure in cats with respiratory distress

Autor: Jessica L. Ward, Yamir Reina-Doreste, Gregory R. Lisciandro, Teresa C. DeFrancesco, Kari Kurtz, Wendy A. Ware, Austin K. Viall, Brent Aona
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
cardiac
040301 veterinary sciences
Pleural effusion
Point-of-Care Systems
point‐of‐care
Cardiology
Standard Article
Cat Diseases
Pericardial effusion
lung
0403 veterinary science
03 medical and health sciences
0302 clinical medicine
Internal medicine
Natriuretic Peptide
Brain
medicine
Animals
False Positive Reactions
cardiovascular diseases
feline
Respiratory system
False Negative Reactions
Retrospective Studies
Heart Failure
CATS
Lung
General Veterinary
Respiratory distress
business.industry
Area under the curve
030208 emergency & critical care medicine
04 agricultural and veterinary sciences
respiratory
medicine.disease
Standard Articles
Peptide Fragments
medicine.anatomical_structure
Echocardiography
Heart failure
Cats
biomarker
Female
SMALL ANIMAL
B‐lines
business
Biomarkers
Zdroj: Journal of Veterinary Internal Medicine
ISSN: 0891-6640
DOI: 10.1111/jvim.15246
Popis: Background The diagnosis of congestive heart failure (CHF) in cats is challenging. Point-of-care (POC) thoracic ultrasound and NT-proBNP testing are emerging tools that may aid in diagnosis. Hypothesis/objectives To assess the diagnostic accuracy of POC lung ultrasound (LUS), focused cardiac ultrasound (FCU), and NT-proBNP in predicting a final diagnosis of CHF. Animals Fifty-one cats in respiratory distress. Methods Blood NT-proBNP, LUS, and FCU evaluating left atrial (LA) size and presence of pericardial effusion (PCEFF) were performed in all cats. Lung ultrasound findings including pleural effusion (PLEFF), number of B-lines, and sub-pleural abnormalities were noted. Medical records were evaluated for final diagnosis. Results Thirty-three of 51 (65%) cats were diagnosed with CHF. Lung ultrasound and blood NT-proBNP were significant predictors of CHF in a multivariate model. The LUS criterion that maximized accuracy for CHF diagnosis was presence of >1 site strongly positive for B-lines (>3 B-lines per site), resulting in sensitivity of 78.8%, specificity of 83.3%, and area under the curve (AUC) of 0.833. Subjective LA enlargement was 97.0% sensitive and 100% specific for CHF (AUC 0.985). Presence of PCEFF also was 100% specific, but only 60.6% sensitive, for CHF (AUC 0.803). A positive blood NT-proBNP test was 93.9% sensitive and 72.2% specific for the diagnosis of CHF (AUC 0.831). Conclusions and clinical importance Point-of-care diagnostic techniques of LUS, FCU, and NT-proBNP are useful to diagnose CHF in cats with respiratory distress.
Databáze: OpenAIRE
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