Differentiating between feline pleural effusions of cardiac and non‐cardiac origin using pleural fluid NT‐proBNP concentrations. (7th November 2013)

• Record Type: Journal Article
• Authors: Humm, K.; Hezzell, M.; Sargent, J.; Connolly, D. J.; Boswood, A.
• Is Part Of: Journal of small animal practice. Volume 54:Number 12(2013:Dec.)
• Page Start: 656
• Page End: 661
• Publication Date: 2013-11-07
• Subjects: Veterinary medicine -- Periodicals; Veterinary Medicine -- Periodicals; 636.089
• DOI: 10.1111/jsap.12152
• Languages: English
• ISSNs: 0022-4510

Abstract

<abstract abstract-type="main" id="jsap12152-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jsap12152-sec-0001" sec-type="section"> <title>Objective</title> <p id="jsap12152-para-0001"> <bold>To assess whether pleural fluid and urine amino terminal proB‐type natriuretic peptide (NT‐proBNP) can distinguish cardiac from non‐cardiac causes of pleural effusion.</bold> </p> </sec> <sec id="jsap12152-sec-0002" sec-type="section"> <title>Methods</title> <p id="jsap12152-para-0002"> <bold>Blood, urine and pleural fluid were prospectively collected from cats presenting with pleural effusion categorised as cardiac or non‐cardiac in origin. NT‐ProBNP concentrations were measured using a feline‐specific enzyme‐linked immunosorbent assay. Groups were statistically compared and receiver operating characteristic curves constructed to determine cut‐offs to distinguish cardiac from non‐cardiac pleural effusion in plasma, pleural fluid and urine.</bold> </p> </sec> <sec id="jsap12152-sec-0003" sec-type="section"> <title>Results</title> <p id="jsap12152-para-0003"> <bold>Forty cats with pleural effusion (22 cardiac and 18 non‐cardiac) were studied. NT‐proBNP concentrations in plasma and pleural fluid were strongly correlated. Plasma (P<0·001) and pleural fluid (P<0·001) NT‐proBNP concentrations and urinary NT‐proBNT/creatinine ratios (P=0·035) were significantly higher in the cardiac group. After receiver operating characteristic curve analysis a plasma NT‐proBNP cut‐off of 214·3 pmol/mL was suggested [sensitivity=86·4% (95% CI: 66·7 to 95·3%), specificity=88·9% (95% CI: 67·2 to 96·9%)] and a pleural fluid NT‐proBNP cut‐off of 322·3 pmol/mL was suggested [sensitivity=100% (95% CI: 85·1 to 100%), specificity=94·4% (95% CI: 74·2 to 99·0%)]. No cut‐off with adequate sensitivity and specificity for urinary NT‐proBNP/creatinine ratios was suggested.</bold> </p> </sec> <sec id="jsap12152-sec-0004" sec-type="section"> <title>Clinical Significance</title> <p id="jsap12152-para-0004"> <bold>Measurement of NT‐proBNP in pleural fluid distinguishes cardiac from non‐cardiac causes of pleural effusion in cats.</bold> </p> </sec> </abstract>