Complete the quiz to receive a CPD certificate for this module / 8.Key points about biomarkers in cardiac dogs / Sessions / Cardio Academy-Programme

Which of the following statements about cardiac troponins is INCORRECT?

They are released in response to wall stretch
Yes, this statement is incorrect; cardiac troponins are leakage markers that are released from dying myocytes and are therefore an indication of myocardial injury rather than wall stretch
An increase is suggestive of myocardial injury
They may have some potential in determining prognosis
This statement is actually correct; troponins may also have some prognostic potential because it is in the late stage of the disease process where there is a loss of functional heart muscle and it may be that that rate of loss is reflected by an elevation in troponin concentration.

Canine mitral valve disease in dogs
INCORRECT – myocardial injury and infarction can occur in canine mitral valve disease, but this condition is characterised more by wall stretch, and therefore NT pro-BNP is a better biomarker for diagnosing this condition
Feline hypertrophic cardiomyopathy
CORRECT – as this condition is more likely to be associated with myocardial infarction and injury, and therefore raised troponin levels

They are released from dying myocytes
Yes, this statement is incorrect – natriuretic peptides are neuroendocrine markers which are markers of increase wall stress
They increase with increased filling pressures and heart size
Concentrations generally go up as the disease process progresses

To help discriminate those cases which are breathless due to heart disease and those which are breathless due to respiratory disease
To determine possible prognosis and outcome
This statement is actually correct. Natriuretic peptide concentration are related to disease severity and higher levels may therefore indicate a worse prognosis.
For monitoring and to guide therapeutic decisions
CORRECT – this statement is incorrect; currently there have been no studies which have clearly shown that natriuretic peptide concentrations can be reliably used to either initiate or monitor therapy in veterinary patients although, for monitoring therapy, Natriuretic Peptides have been well used in human patients for this purpose and it may be that this becomes a future use.

BNP
CORRECT – in human medicine, BNP guided therapy has been shown to result in a better outcome (reduction in mortality)
Aldosterone
Angiotensin II
Pro Collagen