Evaluation of point-of-care thoracic ultrasound and NT-proBNP for the diagnosis of congestive heart failure in cats with respiratory distress

Journal of Veterinary Internal Medicine
Jessica L WardTeresa C DeFrancesco

Abstract

The diagnosis of congestive heart failure (CHF) in cats is challenging. Point-of-care (POC) thoracic ultrasound and NT-proBNP testing are emerging tools that may aid in diagnosis. To assess the diagnostic accuracy of POC lung ultrasound (LUS), focused cardiac ultrasound (FCU), and NT-proBNP in predicting a final diagnosis of CHF. Fifty-one cats in respiratory distress. Blood NT-proBNP, LUS, and FCU evaluating left atrial (LA) size and presence of pericardial effusion (PCEFF) were performed in all cats. Lung ultrasound findings including pleural effusion (PLEFF), number of B-lines, and sub-pleural abnormalities were noted. Medical records were evaluated for final diagnosis. Thirty-three of 51 (65%) cats were diagnosed with CHF. Lung ultrasound and blood NT-proBNP were significant predictors of CHF in a multivariate model. The LUS criterion that maximized accuracy for CHF diagnosis was presence of >1 site strongly positive for B-lines (>3 B-lines per site), resulting in sensitivity of 78.8%, specificity of 83.3%, and area under the curve (AUC) of 0.833. Subjective LA enlargement was 97.0% sensitive and 100% specific for CHF (AUC 0.985). Presence of PCEFF also was 100% specific, but only 60.6% sensitive, for CHF (AUC 0.803). A pos...Continue Reading

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Citations

Jul 19, 2019·Journal of Veterinary Internal Medicine·Kerry A LoughranMarc S Kraus
Apr 4, 2020·Journal of Veterinary Internal Medicine·Virginia Luis FuentesJoshua A Stern
Dec 4, 2020·Journal of Veterinary Internal Medicine·Shane D MurphyTeresa C DeFrancesco
Jul 24, 2021·American Journal of Veterinary Research·Jessica L WardTeresa C DeFrancesco
Jul 24, 2021·Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology·M B T BachJ Koch
Aug 30, 2021·The Veterinary Clinics of North America. Small Animal Practice·Kerry Loughran
Oct 26, 2021·Journal of Feline Medicine and Surgery·Mark D Kittleson, Etienne Côté
Oct 26, 2021·Journal of Feline Medicine and Surgery·Mark D Kittleson, Etienne Côté

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Methods Mentioned

BETA
sedation
bronchoalveolar lavage
ELISA

Software Mentioned

NCSS
VetBLUE
SonoSite
MedCalc

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