Cardiac biomarkers (NT-proBNP and cardiac troponin-I) and point-of-care ultrasound in dogs with cardiac and non-cardiac causes of non-hemorrhagic ascites
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Background: Non-hemorrhagic ascites (NHA) can be caused by cardiac diseases (cNHA) and non-cardiac 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: This study compared NT-proBNP and cTnI concentrations, as well as POCUS findings in dogs presenting with cNHA and ncNHA. Animals: Dogs (n=60) were enrolled based on identification of NHA with an effusion PCV < 10 percent. Methods: Blood samples were collected, and POCUS 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 (mean[plus or minus]SD pmol/L) was significantly higher in the cNHA group (4869[plus or minus]4078) compared with the ncNHA group (1882[plus or minus]2627) (p=0.022), with a sensitivity of 53.8 percent and specificity of 85.7 percent using a cut-off of 4092 pmol/L. The NT-proBNP concentrations were significantly higher in the cardiac non-pericardial disease group (7177[plus or minus]3435) compared with the pericardial disease group (1179[plus or minus]1398) (p < 0.0001). A significant difference in cTnI concentration (mean[plus or minus]SD ng/L) between the cNHA group (6522[plus or minus]23186) and ncNHA group (1701[plus or minus]7040) was not detected (p=0.3). A significantly higher number of dogs had hepatic venous and CaVC distension in the cNHA group compared with the ncNHA group respectively (18/28 vs 3/29, p < 0.0001 and 13/27 vs 2/29, p < 0.001). Gall bladder wall edema was not significantly different between groups (4/28 vs 3/29, p=0.74). Conclusions and clinical importance: NT-proBNP and POCUS help distinguish between cNHA and ncNHA.
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M.S.