Differentiating between feline pleural effusions of cardiac and non-cardiac origin using pleural fluid NT-proBNP concentrations

作者：Humm K^*; Hezzell M; Sargent J; Connolly D J; Boswood A

来源：Journal of Small Animal Practice, 2013, 54(12): 656-661.

DOI：10.1111/jsap.12152

Objective: 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.
Methods: 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.
Results: 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.
Clinical Significance: Measurement of NT-proBNP in pleural fluid distinguishes cardiac from non-cardiac causes of pleural effusion in cats.

• 出版日期2013-12