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Uso do NT-ProBNP (Fração N-terminal do Peptídeo Natriurético tipo B) na Avaliação Diagnóstica e Prognóstica de Cães e Gatos com Insuficiência Cardíaca Congestiva
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Abstract(s)
O uso de biomarcadores na medicina veterinária está se tornando cada vez mais significativo e exige
pesquisas aprofundadas para melhorar a sensibilidade e a especificidade de alguns desses marcadores,
de modo a integrá-los como exames de rotina na prática veterinária geral. Esta revisão traz
informações relativas ao biomarcador cardíaco NT-proBNP (fração N-terminal do peptídeo natriurético
tipo B). O objetivo desta revisão é demonstrar, com base em diferentes estudos, de que forma esse
biomarcador pode auxiliar os veterinários na distinção entre uma causa cardíaca e uma causa
respiratória em cães e gatos apresentados em clínica por uma dificuldade respiratória, bem como em
casos de insuficiência cardíaca congestiva, a utilização na avaliação prognóstica. Em situações de
emergência, esse teste orienta de maneira eficaz o diagnóstico veterinário. Os últimos estudo
compilados nesta revisão permitiem definir limites rigorosos desse biomarcador no sangue,
possibilitando, assim, distinguir uma descompensação cardíaca de uma respiratória: em cães, um valor
superior a 900 pmol/L indica insuficiência cardíaca, enquanto em gatos, um valor superior a 270 pmol/L
é considerada uma indicação de insuficiência cardíaca.Embora o NT-proBNP se apresente como uma
ferramenta extremamente promissora, os estudos revelam que, no momento atual, ele não pode ser
utilizado isoladamente para estabelecer um diagnóstico definitivo e deve ser combinado a outros
exames como os de diagnóstico por imagem ,por exemplo. Nos próximos anos, pesquisas adicionais
sobre esse biomarcador, envolvendo um maior número de pacientes, serão necessárias para investigar
melhor o seu poder diagnóstico em situações de emergência e avaliação prognóstica e para
estabelecer valores de referência específicos para as diferentes patologias cardíacas, bem como uma
padronização desses valores de acordo com as raças dos animais, a fim de otimizar sua aplicabilidade
clínica.
The use of biomarkers in veterinary medicine is becoming increasingly significant and requires in-depth research to improve the sensitivity and specificity of some of these markers, so as to integrate them as routine tests in general veterinary practice. This review provides information regarding the cardiac biomarker NT-proBNP (N-terminal fragment of B-type natriuretic peptide). The aim of this review is to demonstrate, based on various studies, how this biomarker can assist veterinarians in distinguishing between a cardiac cause and a respiratory cause in dogs and cats presented at the clinic with respiratory distress, as well as its use in prognostic evaluation in cases of congestive heart failure. In emergency situations, this test effectively guides veterinary diagnosis. The latest studies compiled in this review have enabled the establishment of strict blood biomarker thresholds, thus allowing differentiation between cardiac and respiratory decompensation: in dogs, a value above 900 pmol/L indicates heart failure, while in cats, a value above 270 pmol/L is considered an indication of heart failure. Although NT-proBNP appears to be an extremely promising tool, studies reveal that, at present, it cannot be used in isolation to establish a definitive diagnosis and must be combined with other tests, such as diagnostic imaging, for example. In the coming years, additional research on this biomarker, involving a larger number of patients, will be necessary to better investigate its diagnostic power in emergency situations and prognostic evaluation and to establish specific reference values for the different cardiac pathologies, as well as a standardization of these values according to the animal breeds, in order to optimize their clinical applicability.
The use of biomarkers in veterinary medicine is becoming increasingly significant and requires in-depth research to improve the sensitivity and specificity of some of these markers, so as to integrate them as routine tests in general veterinary practice. This review provides information regarding the cardiac biomarker NT-proBNP (N-terminal fragment of B-type natriuretic peptide). The aim of this review is to demonstrate, based on various studies, how this biomarker can assist veterinarians in distinguishing between a cardiac cause and a respiratory cause in dogs and cats presented at the clinic with respiratory distress, as well as its use in prognostic evaluation in cases of congestive heart failure. In emergency situations, this test effectively guides veterinary diagnosis. The latest studies compiled in this review have enabled the establishment of strict blood biomarker thresholds, thus allowing differentiation between cardiac and respiratory decompensation: in dogs, a value above 900 pmol/L indicates heart failure, while in cats, a value above 270 pmol/L is considered an indication of heart failure. Although NT-proBNP appears to be an extremely promising tool, studies reveal that, at present, it cannot be used in isolation to establish a definitive diagnosis and must be combined with other tests, such as diagnostic imaging, for example. In the coming years, additional research on this biomarker, involving a larger number of patients, will be necessary to better investigate its diagnostic power in emergency situations and prognostic evaluation and to establish specific reference values for the different cardiac pathologies, as well as a standardization of these values according to the animal breeds, in order to optimize their clinical applicability.
Description
Keywords
Biomarcadores Diagnóstico Insuficiência cardíaca congestiva Prognóstico Doença respiratória Cães Gatos Biomarkers Diagnosis Congestive heart failure Prognosis Respiratory disease Dogs Cats