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      Diagnostic utility of cardiac troponin I in cats with hypertrophic cardiomyopathy

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          Cardiac troponin I (cTnI) is useful for assessing hypertrophic cardiomyopathy (HCM) in cats.


          To measure plasma cTnI concentrations in healthy cats and evaluate the clinical utility of cTnI in determining the severity of HCM.


          Clinically healthy cats (n = 88) and cats with HCM (n = 93).


          Multicenter prospective study. Cats with HCM, including hypertrophic obstructive cardiomyopathy at various stages, were diagnosed using echocardiography. Plasma cTnI concentrations were analyzed by a commercial laboratory. Receiver‐operating characteristic curve analysis was used to evaluate the accuracy of plasma cTnI concentrations to detect HCM.


          The median cTnI concentration was 0.027 ng/mL (interquartile range, 0.012‐0.048 ng/mL) in healthy cats. Concentrations were significantly higher in diseased cats than in healthy controls, and concentrations were significantly higher in cats with heart failure than in asymptomatic cats. A plasma cTnI concentration of 0.163 ng/mL had a sensitivity of 62.0% and specificity of 100% when used to distinguish normal cats from asymptomatic HCM cats without left atrial dilatation. A cutoff of 0.234 ng/mL had high sensitivity (95.0%) and specificity (77.8%) for assessing heart failure. The areas under the receiver‐operating characteristic curves were 0.85 and 0.93, respectively.

          Conclusions and Clinical Importance

          Increased cTnI concentrations reflect the severity of HCM. If other causes of cardiac injury are ruled out, plasma cTnI concentration may be useful for predicting the severity of HCM in cats.

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          Most cited references 34

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          High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study

          Summary Background Suspected acute coronary syndrome is the commonest reason for emergency admission to hospital and is a large burden on health-care resources. Strategies to identify low-risk patients suitable for immediate discharge would have major benefits. Methods We did a prospective cohort study of 6304 consecutively enrolled patients with suspected acute coronary syndrome presenting to four secondary and tertiary care hospitals in Scotland. We measured plasma troponin concentrations at presentation using a high-sensitivity cardiac troponin I assay. In derivation and validation cohorts, we evaluated the negative predictive value of a range of troponin concentrations for the primary outcome of index myocardial infarction, or subsequent myocardial infarction or cardiac death at 30 days. This trial is registered with (number NCT01852123). Findings 782 (16%) of 4870 patients in the derivation cohort had index myocardial infarction, with a further 32 (1%) re-presenting with myocardial infarction and 75 (2%) cardiac deaths at 30 days. In patients without myocardial infarction at presentation, troponin concentrations were less than 5 ng/L in 2311 (61%) of 3799 patients, with a negative predictive value of 99·6% (95% CI 99·3–99·8) for the primary outcome. The negative predictive value was consistent across groups stratified by age, sex, risk factors, and previous cardiovascular disease. In two independent validation cohorts, troponin concentrations were less than 5 ng/L in 594 (56%) of 1061 patients, with an overall negative predictive value of 99·4% (98·8–99·9). At 1 year, these patients had a lower risk of myocardial infarction and cardiac death than did those with a troponin concentration of 5 ng/L or more (0·6% vs 3·3%; adjusted hazard ratio 0·41, 95% CI 0·21–0·80; p<0·0001). Interpretation Low plasma troponin concentrations identify two-thirds of patients at very low risk of cardiac events who could be discharged from hospital. Implementation of this approach could substantially reduce hospital admissions and have major benefits for both patients and health-care providers. Funding British Heart Foundation and Chief Scientist Office (Scotland).
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            Diagnostic efficiency of troponin T measurements in acute myocardial infarction.

            The present study was designed to evaluate the efficiency of a newly developed troponin T enzyme immunoassay for the detection of acute myocardial infarction. The study comprised 388 patients admitted with chest pain and suspected myocardial infarction and 101 patients with skeletal muscle damage and additional suspected myocardial cell damage. Troponin T was elevated to more than twice the analytical sensitivity of the assay (0.5 microgram/l) in all patients with non-Q wave (range, 1.2-5 micrograms/l) and Q wave infarction (range, 3-220 micrograms/l). Troponin T appeared in serum as early as 3 hours after onset of pain in 50% of the patients and remained elevated in all patients for more than 130 hours, revealing release kinetics of both free cytosolic and structurally bound molecules. The diagnostic efficiency of troponin T was superior to that of creatine kinase-MB (98% versus 97%) and remained at 98% until 5.5 days after admission, if patients with unstable angina were excluded from analysis. In the 79 patients with unstable angina, troponin T was elevated (range, 0.55-3.1 micrograms/l) in at least one blood sample from each of 37 patients (56%). Circulating troponin T was correlated to the presence of reversible ST segment or T wave changes on the electrocardiogram (p less than 0.005) and to the frequency of in-hospital complications. In the 101 patients with skeletal muscle damage and suspected additional cardiac muscle damage, troponin T was the most useful test; its efficiency was 89% or 94% (depending on the discriminator value used) as compared with 63% for creatine kinase-MB. Thus, the data of the study indicate that the newly developed troponin T test improves the efficiency of serodiagnostic tools for the detection of myocardial cell necrosis as compared with conventionally used cardiac enzymes.
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              Population and survival characteristics of cats with hypertrophic cardiomyopathy: 260 cases (1990-1999).

              To determine current population characteristics of, clinical findings in, and survival times for cats with hypertrophic cardiomyopathy (HCM).

                Author and article information

                J Vet Intern Med
                J. Vet. Intern. Med
                Journal of Veterinary Internal Medicine
                John Wiley and Sons Inc. (Hoboken )
                16 April 2018
                May-Jun 2018
                : 32
                : 3 ( doiID: 10.1111/jvim.2018.32.issue-3 )
                : 922-929
                [ 1 ] School of Veterinary Medicine Rakuno Gakuen University, 582 Midori‐machi, Bunkyodai Ebetsu Hokkaido Japan
                [ 2 ] Iguchi Animal Hospital, 6‐2‐34 Kamijima, Naka ward Hamamatsu Shizuoka Japan
                [ 3 ] Heisei Animal Hospital, 2‐1‐1 Futago‐cho Kasugai Aichi Japan
                [ 4 ] Ebisu Animal Hospital, 3‐3‐43 Nishitaga Taihaku ward, Sendai Miyagi Japan
                [ 5 ] Organization for Promotion of Tenure Track, University of Miyazaki, 1‐1 Gakuenkibanadai‐nishi Miyazaki Japan
                [ 6 ] Pet Clinic Hallelujah, 2544‐1 Nakabaru Kasuya‐machi, Kasuya County Fukuoka Japan
                [ 7 ] Kitade Animal Hospital, 2 Tajiri Ichishi‐cho, Tsu Mie Japan
                [ 8 ] Miyoshi Inter Animal Hospital, 27‐103 Neura Fukuya‐cho Miyoshi Aichi Japan
                [ 9 ] Katagi Animal Hospital, 565‐5 Matoba Kawagoe Saitama Japan
                [ 10 ] Kitanomori Animal Hospital, 17‐1‐35 11‐Jyou, Shin‐kotoni Kita ward, Sapporo Hokkaido Japan
                [ 11 ] Yuki Animal Hospital, 2‐99 Kiba‐cho, Minato‐ku Nagoya Aichi Japan
                [ 12 ] Department of Veterinary Medicine, Veterinary Internal Medicine, College of Bioresource Sciences Nihon University, 1866 Kameino Fujisawa Kanagawa Japan
                [ 13 ] Inaba Veterinary Hospital, 533‐2 Shimojo Fujinomiya Shizuoka Japan
                [ 14 ] Uenonomori Animal Clinic, 1‐5‐11 Yanaka Taito ward Tokyo Japan
                [ 15 ] Onodera Animal Hospital, 1‐10‐4 Chuou Rifu‐cho, Miyagi County Miyagi Japan
                [ 16 ] Hashima Animal Hospital, 2‐17 Asahira, Fukujyu‐cho Hashima, Gifu Japan
                [ 17 ] Lita Pet Clinic, 1‐170 Matsumoto‐cho Inuyama Aichi Japan
                [ 18 ] Mie Animal Medical Center, 1596 Nishihino‐cho Yokkaichi Mie Japan
                [ 19 ] Uchida Animal Hospital, 48 Shinmeishita, Shimo‐machi Nishio Aichi Japan
                Author notes
                [* ] Correspondence Yasutomo Hori, School of Veterinary Medicine, Rakuno Gakuen University, 582 Midori‐machi, Bunkyodai, Ebetsu, Hokkaido 069‐8501, Japan. Email: y-hori@
                Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

                This is an open access article under the terms of the License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                Page count
                Figures: 4, Tables: 5, Pages: 8, Words: 5296
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                May/June 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.0 mode:remove_FC converted:31.05.2018

                Veterinary medicine

                ctni, hypertrophy, biomarker, heart failure, feline


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