C09 - Evaluation of Cardiac Biomarkers and Point-of-care Ultrasound in Dogs with Non-hemorrhagic Ascites

Abstract:
Background:
Non-hemorrhagic ascites (NHA) can be caused by cardiac and non-cardiac disease. N-terminal brain natriuretic peptide (NT-proBNP), cardiac troponin-I (cTnI) and point-of-care ultrasound (POCUS) may aid in differentiating between cardiac and non-cardiac causes of NHA.

Hypothesis/Objectives:
This study compared NT-proBNP and cTnI concentrations in dogs presenting for cardiac and non-cardiac causes of NHA. This study also compared POCUS findings, specifically hepatic venous and caudal vena cava (CaVC) distension, and gall bladder wall edema.

Animals:
Client-owned dogs (n=60) were enrolled based on identification of NHA with an effusion packed cell volume < 10%.

Methods:
Blood samples and POCUS were collected from dogs. Dogs were diagnosed with cardiac (n=28) or non-cardiac (n=32) NHA based on echocardiography. The cardiac group was subdivided into pericardial disease (n=11) and non-pericardial cardiac disease (n=17).

Results:
A significant difference in NT-proBNP concentration (mean±SD pmol/L) was noted between cardiac (4869±4078) and non-cardiac (1882±2627) groups (p=0.022), with a sensitivity of 53.8% and specificity of 85.7% at a cut-off of 4092 pmol/L. The NT-proBNP concentrations were also significantly different between pericardial (1179±1398) and non-pericardial cardiac (7177±3435) groups (p < 0.0001). There were no significant differences in cTnI concentrations between groups. Significant differences in POCUS findings between the cardiac and non-cardiac groups included hepatic venous distension (18/28 vs 3/29, p < 0.0001) and CaVC distension (13/27 vs 2/29, p < 0.001), but not gall bladder wall edema (4/28 vs 3/29, p=0.7373).

Conclusions and clinical importance:
NT-proBNP and POCUS help distinguish between cardiac and non-cardiac causes of NHA.