[논문]개의 만성 이첨판 폐쇄부전증 환자군에서 혈장 NT-proBNP 농도 평가연구

이승곤; 현창백

개의 만성 이첨판 폐쇄부전증 환자군에서 혈장 NT-proBNP 농도 평가연구
Evaluation of Plasma NT-proBNP Concentration in Dogs with Chronic Mitral Valve Insufficiency 원문보기

Journal of veterinary clinics = 한국임상수의학회지, v.30 no.3, 2013년, pp.151 - 158

이승곤 (미국 노스캐롤라이나 대학교, 수의과대학) , 현창백 (강원대학교 수의학과 소동물 내과교실)

초록
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본 연구는 개의 이첨판 폐쇄부전증(CMVI) 환자군에서 혈장 NT-proBNP농도를 평가한 연구이다. 본 연구를 위해 CMVI에 이환된 50마리와 건강한 대조군 7마리를 대상으로 일반적인 심초음파 검사와 혈중NT-proBNP농도를 측정하였다. 심부전의 심하기에 따라 분류된 환자군에서 측정된 NT-proBNP농도와 심초음파 인덱스의 상호관련성을 평가하였다. 혈중 NT-proBNP 농도는 심부전의 심하기에 따라 상승하였다. 또한 심초음파 인덱스중 left atrium/aorta (LA/AO), early diastolic transmitral flow (E) velocity, late diastolic transmitral flow (A) velocity, end diastolic volume index (EDVI) 등과 밀접한 관련성이 관찰되었다. 본 연구는 이첨판 폐쇄부전증 환자의 예후를 평가하는데 중요할 것으로 보인다.

Abstract ▼ AI-Helper

This study aimed to evaluate the plasma concentration of NT-proBNP in dogs with different stages of heart failure by chronic mitral valve insufficiency (CMVI). Fifty small-breed dogs with CMVI and 7 healthy control dogs without cardiac disease and critical systemic diseases were included in the study population. As a preliminary study, we compared the plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the echocardiographic parameters between dogs of the International Small Animal Cardiac Health Council (ISACHC) classes. Then, we evaluated the associations between NT-proBNP and echocardiographic parameters. Plasma NT-proBNP levels showed a significant difference among the ISACHC groups. In the comparison between echocardiographic parameters and NT-proBNP, NT-proBNP were found to be associated with left atrium/aorta (LA/AO), early diastolic transmitral flow (E) velocity, late diastolic transmitral flow (A) velocity, end diastolic volume index (EDVI). Our study found plasma NT-proBNP might be useful to predict the disease progression in dogs with CMVI.

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문제 정의

The aim of this study was to identify the relationship between NT-proBNP and conventional echocardiographic indices in dogs with different stages of heart failure by chronic mitral valve insufficiency (CMVI). We hypothesized that dogs with the plasma levels of NT-proBNP in dogs with CMVI would have statistically significant relation with one of transmitral flow indices or TDI indices.
This study was designed to evaluate the relationship between NT-proBNP and echocardiographic parameters in dogs with CMVI. First of all, we compared the echocardiographic parameters and plasma concentrations of NT-proBNP with the International Small Animal cardiac Health Council (ISACHC) classes in this study population, thereby making it possible to determine whether the data distributions in this study are consistent with those of previous studies.

가설 설정

The aim of this study was to identify the relationship between NT-proBNP and conventional echocardiographic indices in dogs with different stages of heart failure by chronic mitral valve insufficiency (CMVI). We hypothesized that dogs with the plasma levels of NT-proBNP in dogs with CMVI would have statistically significant relation with one of transmitral flow indices or TDI indices.

제안 방법

This study was designed to evaluate the relationship between NT-proBNP and echocardiographic parameters in dogs with CMVI. First of all, we compared the echocardiographic parameters and plasma concentrations of NT-proBNP with the International Small Animal cardiac Health Council (ISACHC) classes in this study population, thereby making it possible to determine whether the data distributions in this study are consistent with those of previous studies. Second, we statistically analyzed the relationship between NT-proBNP and echocardiographic parameters.
First of all, we compared the echocardiographic parameters and plasma concentrations of NT-proBNP with the International Small Animal cardiac Health Council (ISACHC) classes in this study population, thereby making it possible to determine whether the data distributions in this study are consistent with those of previous studies. Second, we statistically analyzed the relationship between NT-proBNP and echocardiographic parameters.
Seven dogs served as healthy controls, judged as normal on the basis of blood biochemistry, echocardiography, blood pressure, and electrocardiography. The diagnosis of CMVI was made on the basis of clinical signs, X-ray data, and echocardiographic findings, according to guidelines (2) for the diagnosis of CMVI in dogs. The dogs with CMVI were then divided into 3 groups [ISACHC class I (class Ia and class Ib): asymptomatic; ISACHC class II: symptomatic; ISACHC class III (class IIIa and class IIIb), advanced to refractory], according to the criteria proposed by the ISACHC for the functional classification of heart failure (20).
For these reason, in terms of comparing NT-proBNP with the echocardiographic parameters in patients with primary mitral regurgitation, there are very few human studies eligible to be compared with this present study. Thus, the interpretation of this study result shall focus on associations between hemodynamics of CMVI and plasma NT-proBNP, rather than comparing it with previous studies.

대상 데이터

The study population composed 57 client-owned dogs (mean age: 10.4 ± 2.93 years; range: 4-15 years) with or without CMVI.

데이터처리

If statistical significance was obtained between groups, multiple comparisons (Scheffe post hoc test) were used to detect significant differences. Differences among the ISACHC groups in NT-proBNP, conventional echocardiographic variables were evaluated by 1-way ANOVA. Pearson’s coefficient of correlation was used to evaluate the strength of the association between NT-proBNP and echocardiographic imagingderived variables such as conventional echocardiographic variables and TDI-derived variables, which were visualized using a scatter plot and linear regression line.
Pearson’s coefficient of correlation was used to evaluate the strength of the association between NT-proBNP and echocardiographic imagingderived variables such as conventional echocardiographic variables and TDI-derived variables, which were visualized using a scatter plot and linear regression line.
The statistical methods used were one-way analysis of variance (ANOVA), and Pearson’s coefficient of correlation.

성능/효과

Among the parameters, LA/AO- ratio, E and A, free wall E/E’, and EDVI were significantly associated with the plasma NT-proBNP levels.
In conclusion, we found that plasma NT-proBNP levels were significantly correlated with LA/AO, A and E, E/E’-ratio and EDVI.
In this study, we found that LA, LA/AO, EF, FS, E and A, EDV and EDVI increased as the ISACHC class increased. These findings are compatible with those of previous studies in dogs with CMVI (6,13,45,46).

후속연구

This makes it difficult to determine whether patients with various degrees of CMVI have systolic or diastolic heart failure on the basis of echocardiographic parameters alone (6,13). Therefore, further studies are needed with regard to the diagnosis of diastolic dysfunction in dogs with CMVI. On the basis of the preliminary study involving echocardiographic parameters, we confirmed that the hemodynamic characteristics of this study population corroborate the results of previous studies in dogs with CMVI (6,13,45,46).

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개의 만성 이첨판 폐쇄부전증 환자군에서 혈장 NT-proBNP 농도 평가연구
Evaluation of Plasma NT-proBNP Concentration in Dogs with Chronic Mitral Valve Insufficiency 원문보기

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개의 만성 이첨판 폐쇄부전증 환자군에서 혈장 NT-proBNP 농도 평가연구 Evaluation of Plasma NT-proBNP Concentration in Dogs with Chronic Mitral Valve Insufficiency 원문보기

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개의 만성 이첨판 폐쇄부전증 환자군에서 혈장 NT-proBNP 농도 평가연구
Evaluation of Plasma NT-proBNP Concentration in Dogs with Chronic Mitral Valve Insufficiency 원문보기

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