Those cardiac biomarker might be worth it....

Cardiac Biomarker Profiles in Dogs with Naturally Occurring Precapillary Pulmonary Hypertension

J. Lichtenberger, E. Côté, S.D. Forney, K.A. Barrett, S.J. Ettinger.

Background
Precapillary pulmonary hypertension (Pre-PH) in dogs is a condition characterized by increased pulmonary arterial pressure due to intrinsic vascular disease, lung disease, or thromboembolic events. Diagnosing Pre-PH can be challenging due to non-specific clinical signs and the limitations of Doppler echocardiography. Cardiac biomarkers such as amino-terminal pro-B-type natriuretic peptide (NT-proBNP), amino-terminal pro-A-type natriuretic peptide (NT-proANP), and cardiac troponin I (cTnI) have been studied in human and veterinary medicine as potential indicators of cardiac stress and damage. This study aimed to evaluate the concentrations of these biomarkers in dogs with Pre-PH compared to control dogs with respiratory signs but no pulmonary hypertension.

Methods
This prospective observational study included 26 client-owned dogs: 17 with Pre-PH and 9 controls. Diagnosis of Pre-PH was based on echocardiographic measurement of the right ventricular-to-right atrial pressure gradient (RV:RA PG) ≥40 mmHg in the absence of left-sided heart disease. Blood samples were collected for biomarker analysis, and correlations between biomarker concentrations and RV:RA PG were assessed.

Results
Dogs with Pre-PH had significantly higher plasma concentrations of NT-proBNP (P = 0.020), NT-proANP (P = 0.009), and cTnI (P = 0.011) compared to controls. There was a moderate positive correlation between RV:RA PG and NT-proBNP (r = 0.52), NT-proANP (r = 0.54), and cTnI (r = 0.67), indicating that higher biomarker levels were associated with increased pulmonary pressure. The presence of cor pulmonale (right ventricular hypertrophy) did not significantly affect biomarker concentrations.

Limitations
The small sample size limited the statistical power of the study. The diagnosis of Pre-PH relied solely on echocardiographic estimates rather than invasive right heart catheterization. Some potential confounders, such as systemic hypertension and renal disease, were not fully accounted for. Additionally, the underlying etiology of Pre-PH was not determined in all cases.

Conclusions
Dogs with Pre-PH exhibit elevated NT-proBNP, NT-proANP, and cTnI concentrations, with stronger correlations observed for cTnI. These findings suggest that cardiac biomarkers may aid in the identification and assessment of disease severity in dogs with Pre-PH. However, further studies are needed to validate their clinical utility and refine diagnostic thresholds.

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