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Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus

Aona, Brent D., Rush, John E., Rozanski, Elizabeth A., Cunningham, Suzanne M., Sharp, Claire R., Freeman, Lisa M.
Journal of veterinary emergency and critical care 2017 v.27 no.6 pp. 631-637
biomarkers, digestive system diseases, dogs, echocardiography, lactic acid, natriuretic peptides, observational studies, tachycardia, troponin I
OBJECTIVE: To assess abnormalities in concentrations of cardiac troponin I (cTnI), lactate, and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV). DESIGN: Prospective observational study. SETTING: University hospital. ANIMALS: Twenty‐two dogs with naturally occurring GDV. SAMPLES: Concentrations of cTnI, plasma lactate, and NT‐proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Cardiac rhythms were categorized on a 0–4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R‐on‐T phenomenon or ventricular tachycardia). Echocardiography was performed 6–18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n = 9], Grade 4 [n = 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P = 0.002) or Grade 1 (P = 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r = −0.52, P = 0.01) and systole (r = −0.57, P = 0.006), left ventricular free wall in diastole (LWDd, r = 0.59, P = 0.004), and interventricular septal thickness in diastole (IVDs, r = 0.65, P = 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P = 0.04) and IVSd (P = 0.05), and received significantly less fluids in the first 24 (P = 0.02) and 48 hours (P = 0.03) of hospitalization. CONCLUSIONS: Concentrations of cTnI and NT‐proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted.