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Hemostatic biomarkers in dogs with chronic congestive heart failure
Inge Tarnow1, Torkel Falk, Anna Tidholm
1Department of Basic Animal and Veterinary Sciences, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark. int@kvl.dk
Insights
Dogs with congestive heart failure (CHF) show abnormal blood clotting markers, indicating a procoagulant state. However, these hemostatic biomarkers did not predict mortality in the study.
Area of Science:
- Veterinary Cardiology
- Hemostasis and Thrombosis
- Canine Medicine
Background:
- Chronic congestive heart failure (CHF) in humans is linked to poor prognosis due to abnormal hemostasis.
- Investigating hemostatic alterations in dogs with CHF is crucial, as myocardial microthrombosis may increase mortality.
- This study examines hemostatic biomarkers in dogs with CHF.
Purpose of the Study:
- To determine if plasma concentrations or activity of hemostatic biomarkers are altered in dogs with CHF.
- To assess if these altered hemostatic factors predict mortality in dogs with CHF.
Main Methods:
- Compared 34 dogs with CHF (dilated cardiomyopathy or degenerative valvular disease) to 23 healthy controls.
- Performed clinical examination and echocardiography on all dogs.
- Measured plasma fibrinogen, D-dimer, antithrombin activity, protein C activity, and thrombin-antithrombin complex (TAT).
Main Results:
- Dogs with CHF exhibited significantly higher fibrinogen, D-dimer, and TAT concentrations compared to controls.
- Dogs with CHF showed significantly lower antithrombin and protein C activity than controls.
- No hemostatic biomarkers were found to be associated with the risk of death.
Conclusions:
- Evidence suggests a procoagulant state in dogs suffering from CHF.
- The lack of predictive value for survival may stem from the limited sample size.
- Further research is needed to explore the presence and significance of microthrombosis in canine CHF.
Background:
Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium could contribute to increased mortality.
Hypothesis:
That plasma concentration or activity of hemostatic biomarkers is altered in dogs with CHF and that these factors predict mortality.
Animals:
Thirty-four dogs with CHF caused by either dilated cardiomyopathy (DCM, n=14) or degenerative valvular disease (CDVD, n=20) compared with 23 healthy age-matched control dogs were included in this study. Dogs with CHF were recruited from 2 referral cardiology clinics, and control dogs were owned by friends or colleagues of the investigators.
Methods:
Clinical examination and echocardiography were performed in all dogs. Plasma fibrinogen and D-dimer concentrations, antithrombin and protein C activity, and thrombin-antithrombin complex (TAT) were measured in all dogs.
Results:
Dogs with CHF had significantly higher fibrinogen (P = .04), D-dimer (P = .002), and TAT concentration (P < .0001), lower antithrombin (P < .0001) and protein C activity (P < .001) compared with control dogs. None of the hemostatic biomarkers were associated with risk of death.
Conclusions And Clinical Importance:
There is evidence of a procoagulant state in dogs with CHF. The lack of predictive value for survival might be due to the small number of dogs examined. Further studies are necessary to investigate the presence and importance of microthrombosis in dogs with CHF.
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