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J Vet Intern Med. 2016 Mar-Apr;30(2):536-42. doi: 10.1111/jvim.13831. Epub 2016 Jan 27.

Differentiation of Cardiac from Noncardiac Pleural Effusions in Cats using Second-Generation Quantitative and Point-of-Care NT-proBNP Measurements.

Author information

1
Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
2
Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA.
3
Department of Clinical Sciences and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.

Abstract

BACKGROUND:

Pleural effusion is a common cause of dyspnea in cats. N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement, using a first-generation quantitative ELISA, in plasma and pleural fluid differentiates cardiac from noncardiac causes of pleural effusion.

HYPOTHESIS/OBJECTIVES:

To determine whether NT-proBNP measurements using second-generation quantitative ELISA and point-of-care (POC) tests in plasma and pleural fluid distinguish cardiac from noncardiac pleural effusions and how results compare to the first-generation ELISA.

ANIMALS:

Thirty-eight cats (US cohort) and 40 cats (UK cohort) presenting with cardiogenic or noncardiogenic pleural effusion.

METHODS:

Prospective cohort study. Twenty-one and 17 cats in the US cohort, and 22 and 18 cats in the UK cohort were classified as having cardiac or noncardiac pleural effusion, respectively. NT-proBNP concentrations in paired plasma and pleural fluid samples were measured using second-generation ELISA and POC assays.

RESULTS:

The second-generation ELISA differentiated cardiac from noncardiac pleural effusion with good diagnostic accuracy (plasma: sensitivity, 95.2%, specificity, 82.4%; pleural fluid: sensitivity, 100%, specificity, 76.5%). NT-proBNP concentrations were greater in pleural fluid (719 pmol/L (134-1500)) than plasma (678 pmol/L (61-1500), P = 0.003), resulting in different cut-off values depending on the sample type. The POC test had good sensitivity (95.2%) and specificity (87.5%) when using plasma samples. In pleural fluid samples, the POC test had good sensitivity (100%) but low specificity (64.7%). Diagnostic accuracy was similar between first- and second-generation ELISA assays.

CONCLUSIONS AND CLINICAL IMPORTANCE:

Measurement of NT-proBNP using a quantitative ELISA in plasma and pleural fluid or POC test in plasma, but not pleural fluid, distinguishes cardiac from noncardiac causes of pleural effusion in cats.

KEYWORDS:

Biomarker; Blood testing; Cardiomyopathy; Dyspnea; Natriuretic peptide

PMID:
26813037
PMCID:
PMC4913612
DOI:
10.1111/jvim.13831
[Indexed for MEDLINE]
Free PMC Article

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