Evaluation of cardiac troponine i, d-dimer and nt-probnp levels with echocardiographic examinations in different stages of canine visceral leishmaniasis

A total of 35 dogs, comprising 28 with VL and 7 healthy were enrolled. Diagnosis of VL was established through dogs presenting one or some of the clinical signs in association with the disease condition, subjected to rapid ELİSA based test kits and immune fluorescence antibody test. Dogs diagnosed with VL, based on serological, clinical, hematological and biochemical findings, were classified into 4 different groups (n=7), as reported by Leishvet Group. Aforementioned research groups were as follows; 1. group: stage I (mild disease), 2. group: stage II (moderate disease), 3. group: stage III (severe disease), 4. group: stage IV (very severe disease) and 5. group: healthy controls. Dogs classified according to stages and to those of healthy ones were analyzed through electrocardiography at resting with 1 mV/cm amplitude and 50 mm/sn velocity, via 12 lead computerized electrocardiography as measured by records withdrawed digitally, echocardiographically by 2D M and B mode measurements. Withdrawed blood samples were analyzed according to stages and cardiac injury related hematological and biochemical parameters, and urine samples through protein/creatinine levels. Appropriate statistical analysis were used for matching evaluated data and correlation. Clinical findings were evaluated, were presented as elevated body temperature, lymphadenopathy, weight loss, onichogriphosis, hypotrichosis periocular alopecia, skin lesions and/or epistaxis with varying number of cases in different groups. There were no Ig G antibodies against Leishmaniasis in group V. In I. group IFAT values were deemed 1/64, whereas IFAT values were varying between 1/128-1/512. In group IV IFAT titers deemed 1/1024 ile 1/16000. Regarding mean (± standard deviation) WBC values among healthy control group (V.) and other groups (P=0.049), mean (± standard deviation) in terms of RBC vlaues significant difference (P=0.001) was found among stage III-stage IV and other groups. There were statistically significant differences for mean (± standart deviation) HGB values between stage I and stage III-stage IV ( =0.008), mean (± standard deviation) HCT values between stage I and other groups (P=0.001); mean (± standard deviation) MCHC values between stage I and stage II- stage IV (P=0.046). Significant differences were identified between stage I with stage IV and stage II with V. group at serum creatinine levels (P=0.008), stage I with stage IV and stage III with V. group at serum total protein levels (P=0.002), stage I with stage IV and stage IV with stage II at serum albümine levels (P=0.004) in terms of mean (± standard deviation). Regarding ECO examination of infected groups of dogs with leishmaniasis (I.-IV) mean (± standard deviation) LA/Ao value presented significant difference (P=0.003) among stage IV and other groups. Although there were insignificant individual differences regarding other parameters (FS, EF, LVIDs and LVIDd), overall evaluation did not present differences among groups. Significant differences were identified between stage I with stage IV and V. group with stage IV at serum cTnI levels (P=0.018), V. group with stage II, III and stage IV at serum D-dimer levels (P=0.005), V. group with stage III, IV and stage I with stage III, IV at serum NT-proBNP levels (P=0.000) when cardiopulmonary markers are considered in terms of mean (± standard deviation). In the control group, all the healthy subjects, UPC values were found to be below 0.1, the upper reference range. UPC values were varying between <0,1-0,3 in stage I, 0,5-1 in stage II, 2-3, in stage III, 5-10 in stage IV and <0,1 in healthy controls, respectively. In conclusion it may be suggested that establishing Leishvet Working Group serological (IFAT titers within ELISA tests), clinical and laboratory (especially TP, ALB and UPC) results, to those of dogs classified into 4 different groups (stage I to IV), echocardiographic [left atrial dilation, decrased/increased LVIDs, decrased/increased LVIDd, shortened FS and EF (systolic dysfunction)] along with CTnI, D-dimer and NT-proBNP elevations must be taken into account. Cardiac alterations supporting intravital diagnosis must be overemphasized and application of necessary additional treatment protocoles might be of beneficial.