Feline Arteriyel Tromboembolizm Tanısı ve Prognozunda Kardiyak Biyobelirteçlerin Rolü ve Önemi

Feline arteriyel tromboembolizm (FATE), miyokardiyal hastalıkların en sık görülen ve genellikle kötü bir prognoza sahip olan bir komplikasyonudur. Bu çalışmanın amacı, FATE gelişmiş kedilerde, N-terminal prohormon beyin natriüretik peptid (NT-proBNP), kreatinin kinaz (CK_MB) ve cTnI, cTnT serum seviyelerinin diyagnostik ve prognostik önemini belirlemektir. Çalışma için iki grup (I ve II) oluşturuldu. HCM teşhisi almış kediler grup I’e (n=10) dahil edildi. Akut FATE gelişimi olan HCM’li kediler ise grup II’e (n=10) dahil edildi. cTnI, cTnT, NT-proBNP, CK-MB seviyeleri tüm grupta analiz edildi ve kardiyak belirteçlerin sonuçları ile sol ventrikül ölçümleri gruplar arasında Mann-Whitney U non-parametrik test ile karşılaştırıldı. Kardiyak belirteçlerin seviyesi, ekokardiyografik ölçümler ve yaşam süreleri Pearson korrelasyon testi ile karşılştırıldı. Gruplar arasında sol atriyum çapı (P

Role and Importance of Cardiac Biomarkers in Diagnosis and Prognosis of Feline Arterial Thromboembolism

Feline arterial thromboembolism (FATE) is a common complication of myocardial disease, often having poor prognosis. The purposeof this study is to evaluate the diagnostic and prognostic value of serum levels of cardiac biomarkers (N-terminal prohormone of brainnatriuretic peptide [NT- proBNP], creatine kinase isoenzyme-MB [CK-MB], and cardiac troponins [cTnI and cTnT] in cats with hypertrophiccardiomyopathy (HCM) that was complicated by FATE. Two groups were constituted in the study. Cats with a diagnosis of HCM were includedin group I (n=10) and cats with HCM having acute episodes of FATE were included in group II (n=10). Results of cardiac biomarkers andechocardiographic measurements of left ventricle related parameters were compared between groups. The ratio of left atrium to aorta(P

PDF

___

1. Haggstrom J: Hypertrophic cardiomyopathy in cats-it used to be so simple! J Feline Med Surg, 5 (2): 139-141, 2003. DOI: 10.1016/S1098- 612X(02)00128-6
2. Hemdon WE, Kittleson MD, Sanderson K, Drobatz KJ, Clifford CA, Gelzer A, Summerfield NJ, Linde A, Sleeper MM: Cardiac troponin I in feline hypertrophic cardiomyopathy. J Vet Intern Med, 16 (5): 558-564, 2002. DOI: 10.1111/j.1939-1676.2002.tb02387.x
3. Maron BJ, Fox PR: Hypertrophic cardiomyopathy in man and cats. J Vet Cardiol, 17 (Suppl. 1): S6-S9, 2015. DOI: 10.1016/j.jvc.2015.03.007
4. Langhorn R, Willesen JL: Cardiac troponins in dogs and cats. J Vet Intern Med, 30 (1): 36-50, 2016. DOI: 10.1111/jvim.13801
5. Langhorn R, Tarnow I, Willesen JL, Kjelgaard-Hansen M, Skovgaard IM, Koch J: Cardiac troponin I and T as prognostic markers in cats with hypertrophic cardiomyopathy. J Vet Intern Med, 28, 1485-1491, 2014. DOI: 10.1111/jvim.12407
6. Borgeat K, Connolly DJ, Luis Fuentes V: Cardiac biomarkers in cats. J Vet Cardiol, 17 (Suppl. 1): S74-S86, 2015. DOI: 10.1016/j.jvc.2015.08.001
7. Langhorn R, Willesen JL, Tarnow I, Kjelgaard-Hansen M, Koch J: Cardiac troponin I in three cat breeds with hypertrophic cardiomyopathy. Vet Rec, 178 (21): 532, 2016. DOI: 10.1136/vr.103549
8. Fuentes VL, Wilkie LJ: Asymptomatic hypertrophic cardiomyopathy: Diagnosis and therapy. Vet Clin North Am Small Anim Pract, 47 (5): 1041- 1054, 2017. DOI: 10.1016/j.cvsm.2017.05.002
9. Hori Y, Iguchi M, Heishima Y, Yamashita Y, Nakamura K, Hirakawa A, Kitade A, Ibaragi T, Katagi M, Sawada T, Yuki M, Kanno N, Inaba H, Isayama N, Onodera H, Iwasa N, Kino M, Narukawa M, Uchida S: Diagnostic utility of cardiac troponin I in cats with hypertrophic cardiomyopathy. J Vet Intern Med, 32, 922-929, 2018. DOI: 10.1111/jvim.15131
10. Fuentes VL, Abbott J, Chetboul V, Côté E, Fox PR, Häggström J, Kittleson MD, Schober K, Stern JA: ACVIM consensus statement guidelines for the classification,diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med, 34, 1062-1077, 2020. DOI: 10.1111/ jvim.15745
11. Buchanan JW, Bücheler J: Vertebral scale system to measure canine heart size in radiographs. J Am Vet Med Assoc, 206 (2):194-199, 1995.
12. Boon JA: Veterinary Echocardiography. Second ed., 41-111, Wiley- Blackwell, West Sussex, 2011.
13. Rishniw M, Barr SC, Simpson KW, Winand NJ, Wootton JA: Cloning and sequencing of the canine and feline cardiac troponin I genes. Am J Vet Res, 65 (1): 53-58, 2004. DOI: 10.2460/ajvr.2004.65.53
14. Biondo AW, Liu ZL, Wiedmeyer CE, de Morais HS, Sisson DD, Solter PE:Genomic sequence and cardiac expression of atrial natriuretic peptide in cats. Am J Vet Res, 63 (2): 236-240, 2002. DOI: 10.2460/ajvr.2002.63.236.
15. Seilhamer JJ, Arfsten A, Miller JA, Lundquist P, Scarborough RM, Lewicki JA, Porter JG: Human and canine gene homologs of porcine brain natriuretic peptide. Biochem Biophys Res Commun, 165, 650-658, 1989. DOI: 10.1016/s0006-291x(89)80015-4
16. Luis Fuentes V: Arterial thromboembolism: Risks, realities and a rational first-line approach. J Feline Med Surg, 14 (7): 459-470, 2012. DOI: 10.1177/1098612X12451547
17. Moore KE, Morris N, Dhupa N, Murtaugh RJ, Rush JE: Retrospective study of streptokinase administration in 46 cats with arterial thromboembolism. J Vet Emerg Crit Care, 10 (4): 245-257, 2000. DOI: 10.1111/ j.1476-4431.2000.tb00010.x
18. Smith SA, Tobias AH: Feline arterial thromboembolism: An update. Vet Clin North Am Small Anim Pract, 34 (5): 1245-1271, 2004. DOI: 10.1016/j. cvsm.2004.05.006
19. Welch KM, Rozanski EA, Freeman LM, Rush JE: Prospective evaluation of tissue plasminogen activator in 11 cats with arterial thromboembolism. J Feline Med Surg, 12 (2): 122-128, 2010. DOI: 10.1016/j. jfms.2009.08.001
20. Payne JR, Brodbelt DC, Luis Fuentes V: Cardiomyopathy prevalence in 780 apparently healthy cats in rehoming centres (the CatScan study). J Vet Cardiol,17 (Suppl. 1): S244-S257, 2015. DOI: 10.1016/j.jvc.2015.03.008
21. Nokthong N, Pongsawat P, Leurdthainarong P, Sritrirasri S, Surachetpong SD: A study of factors associated with arterial thromboembolism in cats affected with hypertrophic cardiomyopathy in Thailand. Thai J Vet Med, 50 (2): 179-184, 2020.
22. Locquet L, Paepe D, Daminet S, Smets P: Feline arterial thromboembolism: Prognostic factors and treatment. Vlaams Diergeneeskd Tijdschr, 87 (3): 164-175, 2018. DOI: 10.21825/vdt.v87i3.16080
23. Harpster NK, Baty CJ: Warfarin therapy of the cat at risk of thromboembolism. In, Bonagura JD (Ed): Kirk’s Current Veterinary Therapy-XII, 12th ed., 868-873, WB Saunders, Philadelphia, 1995.
24. Hassan MH, Abu-Seida AM, Torad FA, Hassan EA: Feline aortic thromboembolism: Presentation, diagnosis, and treatment outcomes of 15 cats. Open Vet J, 10 (3): 340-346, 2020. DOI: 10.4314/ovj.v10i3.13
25. Hogan DF, Brainard BM: Cardiogenic embolism in the cat. J Vet Cardiol, 17 (Suppl 1): S202-S214, 2015. DOI: 10.1016/j.jvc.2015.10.006
26. Hogan DF: Feline cardiogenic arterial thromboembolism prevention and therapy. Vet Clin North Am Small Anim Pract, 47 (5): 1065-1082, 2017. DOI: 10.1016/j.cvsm.2017.05.001
27. Guillaumin J, Gibson RMB, Goy-Thollot I, Bonagura JD: Thrombolysis with tissue plasminogen activator (TPA) in feline acute aortic thromboembolism: a retrospective study of 16 cases. J Feline Med Surg, 21 (4): 340- 346, 2019. DOI: 10.1177/1098612X18778157
28. Atkins CE, Gallo AM, Kurzman ID, Cowen P: Risk factors, clinical signs and survival in cats with a clinical diagnosis of idiopathic hypertrophic cardiomyopathy: 74 cases (1985-1989). J Am Vet Med Assoc, 201 (4): 613- 618, 1992.
29. Borgeat K, Wright J, Garrod O, Payne JR, Fuentes VL: Arterial thromboembolism in 250 cats in general practice: 2004-2012. J Vet Intern Med, 28 (1): 102-108, 2014. DOI: 10.1111/jvim.12249
30. Hertzsch S, Roos A, Wess G: Evaluation of a sensitive cardiac troponin I assay as a screening test for the diagnosis of hypertrophic cardiomyopathy in cats. J Vet Intern Med, 33 (3): 1242-1250, 2019. DOI: 10.1111/jvim.15498
31. Ironside VA, Tricklebank PR, Boswood A: Risk indictors in cats with preclinical hypertrophic cardiomyopathy: a prospective cohort study. J Feline Med Surg, 23 (2): 149-159, 2021. DOI: 10.1177/1098612X20938651
32. Oyama MA: Using cardiac biomarkers in veterinary practice. Vet Clin North Am Small Anim Pract, 43 (6): 1261-1272, 2013. DOI: 10.1016/j. cvsm.2013.07.010
33. Coskun B, Kırkıl G, Muz MH, Yıldız M, Ozbay Y: Submasif pulmoner tromboemboli olgularında sağ ventrikül disfonksiyonunu saptamada beyin natriüretik peptid ve kardiyak troponin I’nın tanı değeri. Turk Toraks Derg, 13, 163-168, 2012. DOI: 10.5152/ttd.2012.34
34. Aksay E, Yanturali S, Kiyan S: Can elevated troponin I levels predict complicated clinical course and inhospital mortality in patients with acute pulmonary embolism. Am J Emerg Med, 25, 138-143, 2007. DOI: 10.1016/j.ajem.2006.06.005
35. Meyer T, Binder L, Hruska N, Luthe H, Buchwald AB: Cardiac troponin I elevation in acute pulmonary embolism is associated with right ventricular dysfunction. J Am Coll Cardiol, 36 (5): 1632-1636, 2000. DOI: 10.1016/s0735-1097(00)00905-0