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Serial N-terminal pro-B-type Natriuretic Peptide and Myocardial Strain Imaging in Preclinical Dilated Cardiomyopathy in the Doberman Pinscher

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Title: Serial N-terminal pro-B-type Natriuretic Peptide and Myocardial Strain Imaging in Preclinical Dilated Cardiomyopathy in the Doberman Pinscher
Author: Raheb, Shari
Department: Department of Clinical Studies
Program: Clinical Studies
Advisor: O'Sullivan, LynneFonfara, Sonja
Abstract: Dilated cardiomyopathy (DCM) is a common cardiac disease in the Doberman pinscher, and consists of a preclinical period (occult DCM; ODCM) that is variable in duration between patients. Routine assessment generally consists of yearly echocardiographic and Holter monitoring, however investigations into how these tools or others may identify risk of heart failure or cardiac death are scarce. In human cardiology, the biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) and myocardial strain imaging have been used as prognostic tools, with serial measurements considered to be superior in regards to risk assessment, yet canine investigations in this field are limited. In the present study, serial NT-proBNP and echocardiographic measurements, including myocardial strain by speckle tracking echocardiography, were performed in 20 Doberman pinschers diagnosed with ODCM based on echocardiography and Holter assessment. The patients were evaluated every 3 to 4 months between January 2015 and September 2018 until cardiac outcome, defined as first onset of congestive heart failure or sudden death, or end of the study. The biomarker NT-proBNP increased over the study period, and its increase over the final two visits was a relevant predictor of cardiac outcome. Dogs that went on to experience congestive heart failure or sudden death had significantly higher NT-proBNP values over all time points than dogs that did not experience a cardiac outcome. Myocardial strain parameters did not show predictable patterns over time, and largely were not useful in risk assessment. Left atrial size, left ventricular systolic dimension normalized to body weight, and fractional shortening at the final visit were significantly associated with cardiac outcome, as was an increase in left ventricular systolic volume between the final two visits. Identifying prognostic indicators for dogs with ODCM could have important implications for monitoring and therapeutic recommendations. The information gained from the present study may be used for subsequent larger investigations into NT-proBNP and conventional echocardiographic parameters for monitoring and evaluation of prognosis in Doberman pinschers with ODCM, whereas myocardial strain parameters might be of limited use for monitoring and assessing prognosis in ODCM in this species.
URI: https://hdl.handle.net/10214/23690
Date: 2020-12
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
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Attribution-NonCommercial-NoDerivatives 4.0 International Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International