Biomarkers in heart failure secondary to chronic mitral valve disease in domestic dogs

Abstract

Chronic mitral valve disease (CMVD) is highly prevalent in small animal medicine, mainly in older small breed dogs. In order to follow the progression of heart failure (HF), cardiac biomarkers have been used to identify preclinical stage, progression and decompensation of the disease. The aim of this study is to establish a biomarker panel for dogs with HF secondary to CMVD and to determine the utility of new biomarkers isolated or in combination with N-terminal type A (NT-proANP) and B (NT-proBNP) natriuretic peptides to estimate short term prognosis in dogs with acute and chronic decompensation. The diagnosis of the disease will be established, staged and followed to look for indicators of upcoming decompensation, in order to provide better therapeutic guidelines. The study design is a prospective observational cross sectional clinical trial with a longitudinal arm. A total of 160 dogs will be enrolled and distributed in 5 groups according to natural CMVD stage (GC: control group, which will include 80 healthy small breed dogs with mitral valve disease predisposition, i.e., stage A; G1: 20 dogs in stage B1; G2: 20 dogs in stage B2; G3: 20 dogs in stage C e G4: 20 dogs in stage D), from the Service of Cardiology, Veterinary Teaching Hospital of the School of Veterinary Medicine and Animal Science, University of São Paulo. Data will be obtained at diagnosis and groups G2, G3 and G4 will have another sample taken at 60 days. The biomarkers to be measured are C-reactive protein, interleukins, TNF-±, Galectina-3 (Gal-3), receptor ST2 soluble fraction (sST2) and cardiac troponin I (cTnI). Dogs in more advanced stages of the disease will also have blood lactate measurement. Since there are no reference values for canine Gal-3 and sST2, these markers will be determined in the control group to obtain normal values for the study population. We hypothesize that the biomarkers levels will increase as the disease progresses. A combination of biomarkers in the different stages of CMVD may help the diagnostic and prognostic prediction, allowing clinicians to apply the results to guide treatment. (AU)