Abstract
Biomarkers are quantitative indicators of biological processes performed by an organ or system. In recent years, natriuretic peptides (NPs) have emerged as important tools in the diagnosis and therapeutic monitoring of heart diseases. Research has shown that serum and plasma levels of N-terminal pro brain NP (NT-proBNP) in dogs and cats are the only biomarkers that afford to diagnose and monitor congestive processes and, indirectly, the myocardial function of small animals. The present review discusses the peer-reviewed specialized literature about NT-proBNP and presents and compares the potential clinical applications of this NP in veterinary medicine of small animals, considering diagnosis, follow-up, and prognosis of myocardial or systemic diseases. The relevance of NT-proBNP is associated with sample stability, easy determination in laboratory, sensitivity, accuracy, and the possibility to analyze myocardial function. These advantages are specially important when NT-proBNP is compared with other cardiac biomarkers, mostly those that indicate the integrity of the myocardial cell. Fast NT-proBNP assays are marketed today and may be used in association with complementary tests. Together, these methods are an important source of information in differential diagnosis of heart and lung diseases as well in the early diagnosis of cardiopathy in dogs and cats, proving valuable tools in treatment and prognosis.
Highlights
Biomarkers are quantitative indicators of biological processes performed by an organ or system
The relevance of NT-proBNP is associated with sample stability, easy determination in laboratory, sensitivity, accuracy, and the possibility to analyze myocardial function
These advantages are specially important when NT-proBNP is compared with other cardiac biomarkers, mostly those that indicate the integrity of the myocardial cell
Summary
Biomarkers are quantitative indicators of biological processes performed by an organ or system. Obstacles to the clinical use of NPs include physiological and pathological factors associated with cardiac function, which may directly affect NP concentrations and not indicate clearly the occurrence of a pathological process For this reason, various authors have looked into ways to adjust individual reference and cutoff values concerning misdiagnosis of processes in diseases [13,41,42]. In the effort to differentiate respiratory from cardiac and non-cardiac signs, guidelines have been published concerning the use of NT-proBNP assays in dogs and cats These guidelines include: (i) Normal or reduced levels of NT-proBNP are more common in non-cardiac conditions, while high levels are typical of cardiopathies, (ii) in animals with asymptomatic heart disease, high NT-proBNP levels may be misdiagnosed as having non-cardiac causes, such as a respiratory condition, and (iii) NT-proBNP levels have to be analyzed in the context of clinical record, physical examination, and conventional diagnosis methods like imaging [6,44].
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