NT-pro BNP in Dogs with Atrial Fibrillation
ACVIM 2008
E.A. Shipley;A.B. Saunders; S.G. Gordon; R.M. Roland; L.T. Drourr; S.E. Achen; M.W. Miller
Department of Small Animal Clinical Sciences and Michael E. DeBakey Institute, Texas A&M University
College Station, TX, USA

Atrial fibrillation (AF) complicates heart failure secondary to acquired heart disease in dogs. NT-proBNP release occurs in response to increased filling pressures and wall stress. Humans with AF have higher NT-proBNP concentrations, even when clinically stable, compared to those in sinus rhythm (SR). We hypothesized dogs with AF would have elevated NT-proBNP compared to dogs in SR. If NT-proBNP concentrations are higher in AF, then this may affect cutoff values or case management. The purpose of this study was to compare NT-proBNP in dogs with AF secondary to severe chronic degenerative valve disease (CVD) and dilated cardiomyopathy (DCM) to a similar group of dogs in SR. NT-proBNP was measured using a commercial laboratory (Veterinary Diagnostics Institute, Irvine, CA). Thoracic radiographs and echocardiography confirmed severe CVD and DCM. 12 dogs with AF (7 CVD, 5 DCM) were evaluated 17 times; 10 dogs in SR (7 CVD, 3 DCM) were evaluated 15 times. There was no significant difference in age, ISACHC score or furosemide dose between CVD AF and SR groups or DCM AF and SR groups. Heart rate had no affect on NT-proBNP. When all NT-proBNP values were analyzed; AF was 2405.94 ± 737.82 (mean ± SD) compared to SR (1900.40 ± 880.83; P = 0.08). Dogs were classified as stable or unstable based on presence or absence of clinical signs, blood work and thoracic radiograph analysis, and medication adjustments; there were too few numbers to determine clinical significance. Dogs with multiple samples only had their first evaluation included in further analysis.

 

N

Age (yrs)
mean ± SD

Sex

ISACHC
(II, IIIA, IIIB)

Furosemide
(mg/kg/day)
mean ± SD

NT-proBNP
(pmol/L) mean ± SD

NT-proBNP
(pmol/L)
range

CVD AF

7

12.1 ± 1.21

4M3F

5, 1, 1

3.71 ± 2.67

2102.00 ± 934.86

429-3000

CVD SR

7

10.2 ± 1.60

3M4F

4, 2, 1

3.84 ± 1.63

2067.85 ± 932.27

181-3000

DCM AF

5

5.4 ± 3.51

4M1F

1, 4, 0

4.28 ± 3.81

2816.80 ± 409.65

2084-3000

DCM SR

3

6.7 ± 3.06

3M

0, 2, 1

6.48 ± 2.30

2462.67 ± 930.69

1388-3000

Median NT-proBNP concentration in dogs with AF was comparable to dogs in SR. Although not statistically significant, there was a trend towards higher NT-proBNP concentrations in dogs with AF versus SR and with DCM when compared to CVD. Further studies are warranted to evaluate NT-proBNP concentrations in dogs with AF. Findings may facilitate therapeutic decision making.

Speaker Information
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Eryn Shipley


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