Herndon WE, Rishniw M, Schrope D, Sammarco CD, Boddy KN, Sleeper MM. Assessment of plasma cardiac troponin I concentration as a means to differentiate cardiac and noncardiac causes of dyspnea in cats.
J Am Vet Med Assoc 2009;
233:1261-4. [PMID:
18922052 DOI:
10.2460/javma.233.8.1261]
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Abstract
OBJECTIVE
To determine whether plasma cardiac troponin I (cTnI) concentrations can be used to discriminate cardiac from noncardiac causes of dyspnea in cats.
DESIGN
Prospective, multicenter study.
ANIMALS
Client-owned cats with dyspnea attributable to congestive heart failure (D-CHF; n=31) or to noncardiac causes (D-NCC; n=12).
PROCEDURES
For each cat, plasma cTnI concentration was analyzed by use of a solid-phase radial partition immunoassay; values in cats with D-CHF and D-NCC were compared. A receiver operating characteristic curve was analyzed to determine the accuracy of plasma cTnI concentration for diagnosis of D-CHF.
RESULTS
Median plasma concentration of cTnI in cats with D-CHF (1.59 ng/mL; range, 0.20 to 30.24 ng/mL) was significantly higher than in cats with D-NCC (0.165 ng/mL; range, 0.01 to 1.42 ng/mL). With regard to the accuracy of plasma cTnI concentration for diagnosis of D-CHF, the area under the receiver operating characteristic curve was 0.84. At plasma concentrations > or = 0.2 ng/mL, cTnI had 100% sensitivity but only 58% specificity for identification of CHF as the cause of dyspnea. At plasma concentrations > or = 1.43 ng/mL, cTnI had 100% specificity and 58% sensitivity for identification of CHF as the cause of dyspnea.
CONCLUSIONS AND CLINICAL RELEVANCE
On the basis of the derived diagnostic limits, CHF as the cause of dyspnea could be ruled in or ruled out without additional diagnostic testing in > 50% of the study cats. Measurement of plasma cTnI concentration may be clinically useful for differentiation of cardiac from noncardiac causes of dyspnea in cats. (J Am Vet
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