Plasma N-Terminal Probrain Natriuretic Peptide, Vascular Endothelial Growth Factor, and Cardiac Troponin I as Novel Biomarkers of Hypertensive Disease and Target Organ Damage in Cats.
Plasma N-Terminal Probrain Natriuretic Peptide, Vascular Endothelial Growth Factor, and Cardiac Troponin I as Novel Biomarkers of Hypertensive Disease and Target Organ Damage in Cats.
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DOI：
10.1111/jvim.14655
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发表时间：
2017-05
影响因子：
2.6
通讯作者：
Elliott J
中科院分区：
文献类型：
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作者：
Bijsmans ES;Jepson RE;Wheeler C;Syme HM;Elliott J
在不存在眼靶器官损伤（眼-TOD）的情况下，猫的高血压诊断具有挑战性。生物标志物将为高血压的诊断提供额外的支持。血管内皮生长因子（VEGF）、N-末端前利钠肽（NT-proBNP）、心肌肌钙蛋白I（cTnI）和尿蛋白/肌酐比值（UPC）是全身性高血压的预测因子，在伴或不伴眼TOD的高血压猫中将升高，并在抗高血压治疗后降低。在健康老年猫、血压正常的慢性肾病（CKD）猫、有高血压性视网膜病变证据的高血压猫（HT-眼-TOD）和无高血压性眼-TOD的高血压猫（HT-noTOD）中测定了血浆VEGF、NT-proBNP和cTnI浓度和UPC。进行组间比较。建立多变量二元逻辑回归模型，以确定高血压和眼-TOD的独立生物标志物。绘制受试者工作特征（ROC）曲线以评估临床使用。HT‐ocular‐TOD猫的VEGF显著高于所有其他组（P < .05），NT‐proBNP显著高于健康猫（P < .001）。健康猫的cTnI显著低于所有其他组（P < .05）。各组UPC无差异（P = .08）。心肌肌钙蛋白I和VEGF是高血压的独立预测因子（P <0.05），但没有一种生物标志物是眼TOD的独立预测因子。随着降压治疗的进行，N末端普罗布兰利钠肽浓度下降（P < .001）。ROC曲线表明，没有一种生物标志物符合作为诊断高血压或相关眼-TOD的诊断试验的标准。尽管存在统计学显著性和眼部-TOD、抗高血压治疗或两者的变化，但VEGF、NT-proBNP和cTnI并不能作为高血压的有用诊断检测。持续升高的收缩压（SBP）测量结合眼底镜检查仍然是诊断猫高血压的首选方法。
In the absence of ocular target organ damage (ocular‐TOD), diagnosis of hypertension is challenging in cats. Biomarkers would provide additional support for the diagnosis of hypertension. Vascular endothelial growth factor (VEGF), N‐terminal probrain natriuretic peptide (NT‐proBNP), cardiac troponin I (cTnI), and urine protein‐to‐creatinine ratio (UPC) are predictors of systemic hypertension, will be increased in cats with hypertension with or without ocular‐TOD, and will decrease with antihypertensive treatment. Plasma VEGF, NT‐proBNP, and cTnI concentrations and UPC were determined in healthy geriatric cats, normotensive cats with chronic kidney disease (CKD), hypertensive cats with evidence of hypertensive retinopathy (HT‐ocular‐TOD), and hypertensive cats without hypertensive ocular‐TOD (HT‐noTOD). Comparisons among groups were performed. Multivariable binary logistic regression models were built to identify independent biomarkers of hypertension and ocular‐TOD. Receiver operator characteristic (ROC) curves were drawn to assess clinical use. Cats with HT‐ocular‐TOD had significantly higher VEGF than all other groups (P < .05) and significantly higher NT‐proBNP than healthy cats (P < .001). Healthy cats had significantly lower cTnI than all other groups (P < .05). No differences were found among groups for UPC (P = .08). Cardiac troponin I and VEGF were independent predictors of hypertension (P < .05), but none of the biomarkers were independent predictors of ocular‐TOD. N‐terminal probrain natriuretic peptide concentrations decreased with antihypertensive treatment (P < .001). The ROC curves indicated that none of the biomarkers met the criteria to function as diagnostic tests for the diagnosis of hypertension or associated ocular‐TOD. Despite statistical significance and changes with ocular‐TOD, antihypertensive treatment, or both, VEGF, NT‐proBNP, and cTnI did not function as useful diagnostic tests for hypertension. Persistently increased systolic blood pressure (SBP) measurements in combination with fundoscopy remains the preferred method for diagnosis of feline hypertension.