Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease
Abstract Background Treatment is indicated in dogs with preclinical degenerative mitral valve disease (DMVD) and cardiomegaly (stage B2). This is best diagnosed using echocardiography; however, relying upon this limits access to accurate diagnosis. Objectives To evaluate whether cardiac biomarker co...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-03-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16083 |
| _version_ | 1811182156412616704 |
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| author | Jenny Wilshaw Steven L. Rosenthal Gerhard Wess Dave Dickson Luca Bevilacqua Emily Dutton Michael Deinert Ricardo Abrantes Ingo Schneider Mark A. Oyama Sonya G. Gordon Jonathan Elliott Dong Xia Adrian Boswood |
| author_facet | Jenny Wilshaw Steven L. Rosenthal Gerhard Wess Dave Dickson Luca Bevilacqua Emily Dutton Michael Deinert Ricardo Abrantes Ingo Schneider Mark A. Oyama Sonya G. Gordon Jonathan Elliott Dong Xia Adrian Boswood |
| author_sort | Jenny Wilshaw |
| collection | DOAJ |
| description | Abstract Background Treatment is indicated in dogs with preclinical degenerative mitral valve disease (DMVD) and cardiomegaly (stage B2). This is best diagnosed using echocardiography; however, relying upon this limits access to accurate diagnosis. Objectives To evaluate whether cardiac biomarker concentrations can be used alongside other clinical data to identify stage B2 dogs. Animals Client‐owned dogs (n = 1887) with preclinical DMVD prospectively sampled in Germany, the United Kingdom, and the United States. Methods Dogs that met inclusion criteria and were not receiving pimobendan (n = 1245) were used for model development. Explanatory (multivariable logistic regression) and predictive models were developed using clinical observations, biochemistry, and cardiac biomarker concentrations, with echocardiographically confirmed stage B2 disease as the outcome. Receiver operating characteristic curves assessed the ability to identify stage B2 dogs. Results Age, appetite, serum alanine aminotransferase activity, body condition, serum creatinine concentration, murmur intensity, and plasma N‐terminal propeptide of B‐type natriuretic peptide (NT‐proBNP) concentration were independently associated with the likelihood of being stage B2. The discriminatory ability of this explanatory model (area under curve [AUC], 0.84; 95% confidence interval [CI], 0.82‐0.87) was superior to NT‐proBNP (AUC, 0.77; 95% CI, 0.74‐0.80) or the vertebral heart score alone (AUC, 0.76; 95% CI, 0.69‐0.83). A predictive logistic regression model could identify the probability of being stage B2 (AUC test set, 0.86; 95% CI, 0.81‐0.91). Conclusion and Clinical Importance Our findings indicate accessible measurements could be used to screen dogs with preclinical DMVD. Encouraging at‐risk dogs to seek further evaluation could result in a greater proportion of cases being appropriately managed. |
| first_indexed | 2024-04-11T09:28:28Z |
| format | Article |
| id | doaj.art-e800dba2bc934b3984fe987d7d25f209 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-04-11T09:28:28Z |
| publishDate | 2021-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-e800dba2bc934b3984fe987d7d25f2092022-12-22T04:31:59ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762021-03-0135275577010.1111/jvim.16083Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve diseaseJenny Wilshaw0Steven L. Rosenthal1Gerhard Wess2Dave Dickson3Luca Bevilacqua4Emily Dutton5Michael Deinert6Ricardo Abrantes7Ingo Schneider8Mark A. Oyama9Sonya G. Gordon10Jonathan Elliott11Dong Xia12Adrian Boswood13Department of Clinical Science and Services, Royal Veterinary College University of London London UKCVCA Cardiac Care for Pets Towson Maryland USAClinic of Small Animal Medicine Ludwig‐Maximilians‐University of Munich Munich GermanyHeartVets Porthcawl UKStamford Veterinary Centre Lincolnshire UKCheshire Cardiology Cheshire UKFachtierarztpraxis Am Sandpfad Wiesloch GermanyRA Kardiologie Muehlheim am Main GermanyTierarzt Ingo Schneider Nidderau GermanyDepartment of Veterinary Clinical Studies, School of Veterinary Medicine University of Pennsylvania Philadelphia Pennsylvania USACollege of Veterinary Medicine Texas A&M University College Station Texas USADepartment of Comparative Biomedical Science, Royal Veterinary College University of London London UKResearch Support Office, Royal Veterinary College University of London London UKDepartment of Clinical Science and Services, Royal Veterinary College University of London London UKAbstract Background Treatment is indicated in dogs with preclinical degenerative mitral valve disease (DMVD) and cardiomegaly (stage B2). This is best diagnosed using echocardiography; however, relying upon this limits access to accurate diagnosis. Objectives To evaluate whether cardiac biomarker concentrations can be used alongside other clinical data to identify stage B2 dogs. Animals Client‐owned dogs (n = 1887) with preclinical DMVD prospectively sampled in Germany, the United Kingdom, and the United States. Methods Dogs that met inclusion criteria and were not receiving pimobendan (n = 1245) were used for model development. Explanatory (multivariable logistic regression) and predictive models were developed using clinical observations, biochemistry, and cardiac biomarker concentrations, with echocardiographically confirmed stage B2 disease as the outcome. Receiver operating characteristic curves assessed the ability to identify stage B2 dogs. Results Age, appetite, serum alanine aminotransferase activity, body condition, serum creatinine concentration, murmur intensity, and plasma N‐terminal propeptide of B‐type natriuretic peptide (NT‐proBNP) concentration were independently associated with the likelihood of being stage B2. The discriminatory ability of this explanatory model (area under curve [AUC], 0.84; 95% confidence interval [CI], 0.82‐0.87) was superior to NT‐proBNP (AUC, 0.77; 95% CI, 0.74‐0.80) or the vertebral heart score alone (AUC, 0.76; 95% CI, 0.69‐0.83). A predictive logistic regression model could identify the probability of being stage B2 (AUC test set, 0.86; 95% CI, 0.81‐0.91). Conclusion and Clinical Importance Our findings indicate accessible measurements could be used to screen dogs with preclinical DMVD. Encouraging at‐risk dogs to seek further evaluation could result in a greater proportion of cases being appropriately managed.https://doi.org/10.1111/jvim.16083caninecardiac biomarkermachine learningNT‐proBNPprediction |
| spellingShingle | Jenny Wilshaw Steven L. Rosenthal Gerhard Wess Dave Dickson Luca Bevilacqua Emily Dutton Michael Deinert Ricardo Abrantes Ingo Schneider Mark A. Oyama Sonya G. Gordon Jonathan Elliott Dong Xia Adrian Boswood Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease Journal of Veterinary Internal Medicine canine cardiac biomarker machine learning NT‐proBNP prediction |
| title | Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease |
| title_full | Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease |
| title_fullStr | Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease |
| title_full_unstemmed | Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease |
| title_short | Accuracy of history, physical examination, cardiac biomarkers, and biochemical variables in identifying dogs with stage B2 degenerative mitral valve disease |
| title_sort | accuracy of history physical examination cardiac biomarkers and biochemical variables in identifying dogs with stage b2 degenerative mitral valve disease |
| topic | canine cardiac biomarker machine learning NT‐proBNP prediction |
| url | https://doi.org/10.1111/jvim.16083 |
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