Abstract
BackgroundCurrently, the pathogenesis of congestive heart failure (CHF) in cats is not fully understood.ObjectiveTo identify novel biomarkers for CHF in cats caused by primary cardiomyopathy, particularly related to cardiovascular‐renal axis disorder and systemic inflammatory response.AnimalsTwenty‐five cats in CHF caused by primary cardiomyopathy, 12 cats with preclinical cardiomyopathy, and 20 healthy controls.MethodsCase control and observational case series. The following serum biomarkers were compared among the 3 cat groups: a cardiorenal profile that included N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), symmetric dimethylarginine (SDMA), and creatinine and an inflammatory profile that included 7 acute‐phase proteins (APPs). Survival analyses and longitudinal studies were performed in CHF cats.ResultsAll cardiorenal biomarkers were positively correlated and higher in CHF cats, and high NT‐proBNP and SDMA were associated with poor clinical outcome. Cats with CHF had significantly higher leucine‐rich alpha‐2‐glycoprotein 1, serum amyloid A, and ceruloplasmin, and these APPs were positively correlated with NT‐proBNP and left atrial size. In a multivariable survival analysis, alpha‐1‐acid glycoprotein concentration (P = .01), body weight (P = .02) and left atrial‐to‐aortic root ratio (P = .01) were independent prognostic factors for CHF in these cats.Conclusions and Clinical ImportanceIn cats, CHF is an inflammatory disorder and outcome in CHF may be determined by the extent of inflammation and possibly the amount of residual renal function. These novel biomarkers have potential use for the clinical management, prognosis, and future research into CHF and cardiomyopathy in cats.
Highlights
Biomarkers have drawn considerable attention in cardiovascular medicine in both the human medical and in veterinary fields
Serum creatinine concentration is used for monitoring renal function in patients with cardiac disease as a marker of glomerular filtration rate (GFR), but its sensitivity and specificity are inferior to the newer marker of GFR, symmetric dimethylarginine (SDMA).[13-16]
The results of our study indicate that both cardiovascular-renal axis disorder (CvRD) and an inflammatory response occurred in cats with congestive heart failure (CHF) caused by primary cardiomyopathy
Summary
Biomarkers have drawn considerable attention in cardiovascular medicine in both the human medical and in veterinary fields. Cats with CHF had significantly higher leucine-rich alpha-2-glycoprotein 1, serum amyloid A, and Abbreviations: AGP, alpha-1-acid glycoprotein; ANOVA, analysis of variance; APP, acute-phase protein; ATE, arterial thromboembolism; AV, atrioventricular; BP, blood pressure; CHF, congestive heart failure; CI, confidence interval; CKD, chronic kidney disease; CRP, C-reactive protein; cTnI, cardiac troponin I; CvRD, cardiovascular-renal axis disorder; DCM, dilated cardiomyopathy; DSH, domestic short hair; GFR, glomerular filtration rate; HCM, hypertrophic cardiomyopathy; Hp, haptoglobin; HR, hazard ratio; ICU, intensive care unit; IQR, interquartile range; ISACHC, International Small Animal Cardiac Health Council; IVSd, interventricular septum thickness at end diastole; LA, left atrial; LA/Ao, left atrial-to-aortic root ratio; LRG1, leucine-rich alpha2-glycoprotein 1; LV FS, left ventricular fractional shortening; LVFWd, left ventricular free wall thickness at end diastole; NT-proBNP, N-terminal pro-brain natriuretic peptide; PCT, procalcitonin; PE, point estimate; RCM, restrictive cardiomyopathy; ROC, receiver operating characteristic; SAA, serum amyloid A; SDMA, symmetric dimethylarginine; SEC, spontaneous echocardiographic contrast; SPARCL, spatial proximity analyte reagent capture luminescence; UCM, unclassified cardiomyopathy
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