N-terminal brain natriuretic peptide, cardiac troponin-I, and point-of-care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites.

Abstract

BACKGROUND: Nonhemorrhagic ascites (NHA) can be caused by cardiac diseases (cNHA) and noncardiac 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: We compared NT-proBNP and cTnI concentrations as well as POCUS findings in dogs presented with cNHA and ncNHA. ANIMALS: Dogs (n&#x2009;=&#x2009;60) were enrolled based on identification of NHA with an effusion packed cell volume&#x2009;<&#x2009;10%. METHODS: Blood samples were collected and POCUS was performed on all dogs. Dogs were diagnosed with cNHA (n&#x2009;=&#x2009;28) or ncNHA (n&#x2009;=&#x2009;32) based on echocardiography. The cNHA group was subdivided into cardiac non-pericardial disease (n&#x2009;=&#x2009;17) and pericardial disease (n&#x2009;=&#x2009;11). RESULTS: The NT-proBNP concentration (median; range pmol/L) was significantly higher in the cNHA group (4510; 250-10&#x2009;000) compared to the ncNHA group (739.5; 250-10&#x2009;000; P&#x2009;=&#x2009;.01), with a sensitivity of 53.8% and specificity of 85.7% using a cut-off of 4092&#x2009;pmol/L. The NT-proBNP concentrations were significantly higher in the cardiac non-pericardial disease group (8339; 282-10&#x2009;000) compared with the pericardial disease group (692.5; 250-4928; P&#x2009;=&#x2009;.002). A significant difference in cTnI concentration (median; range ng/L) between the cNHA group (300; 23-112&#x2009;612) and ncNHA group (181; 17-37&#x2009;549) was not detected (P&#x2009;=&#x2009;.41). A significantly higher number of dogs had hepatic venous and caudal vena cava distension in the cNHA group compared to the ncNHA group, respectively (18/28 vs 3/29, P&#x2009;<&#x2009;.0001 and 13/27 vs 2/29, P&#x2009;<&#x2009;.001). Gall bladder wall edema was not significantly different between groups (4/28 vs 3/29, P&#x2009;=&#x2009;.74). CONCLUSIONS AND CLINICAL IMPORTANCE: NT-proBNP concentration and POCUS help distinguish between cNHA and ncNHA.