Biomarker changes with systolic anterior motion of the mitral valve in cats with hypertrophic cardiomyopathy.

Abstract

BackgroundN‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and cardiac troponin‐I (cTnI) are biomarkers commonly evaluated in cats with suspected heart disease. Many cats with hypertrophic cardiomyopathy (HCM) have systolic anterior motion of the mitral valve (SAM), but its influence on circulating NT‐proBNP or cTnI concentrations is currently unknown.Hypothesis/ObjectivesCats with HCM and SAM (HCMSAM+) have higher NT‐proBNP and cTnI concentrations than do cats with HCM but without SAM (HCMSAM−).AnimalsOne hundred forty cats with HCM: 70 with SAM and 70 without SAM.MethodsRetrospective case‐to‐case study. Cats were recruited if diagnosed with HCM by echocardiography and results were available for NT‐proBNP or cTnI concentrations or both. Cats with SAM were matched to those without SAM for clinical presentation, left atrial (LA) size and left ventricular (LV) fractional shortening.ResultsA total of 119 NT‐proBNP and 123 cTnI results were available. The HCMSAM+ cats had higher median concentrations than did HCMSAM− cats for NT‐proBNP (729 pmoL/L; interquartile range [IQR], 275‐1467 versus 65 pmoL/L; IQR, 25‐271; P < .001) and cTnI (0.27 ng/mL; IQR, 0.10‐0.81 versus 0.07 ng/mL; IQR, 0.01‐0.43; P = .002). In general linear models for both NT‐proBNP and cTnI, the independent explanatory variables were SAM, congestive heart failure, maximal LV wall thickness, and LA size.Conclusions and Clinical ImportanceFor cats with HCM and equivalent LA size and LV systolic function, those with SAM had higher NT‐proBNP and cTnI concentrations than did those without SAM. Presence of SAM should be considered when interpreting biomarker concentrations in cats with HCM.