{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T14:09:02Z","timestamp":1774361342025,"version":"3.50.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":3200,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Differentiating innocent cardiac murmurs from murmurs caused by congenital cardiac anomalies can be challenging with auscultation alone in asymptomatic puppies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis<\/jats:title>\n                    <jats:p>Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations and phonocardiograms recorded by an electronic stethoscope can differentiate innocent from pathologic cardiac murmurs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>A total of 186 client-owned asymptomatic dogs: 135 Cairn Terriers (age: 45\u2013124 days), 20 adult Cairn Terriers (age: 7.5 months to 13.5 years), and 31 puppies of various breeds (age: 29\u2013396 days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Study design is a cross-sectional survey. Each dog was auscultated, and when a cardiac murmur was heard, a phonocardiogram was recorded and an echocardiogram was performed. Plasma NT-proBNP concentrations were measured by a single laboratory by an ELISA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No significant (P = .41) difference in plasma NT-proBNP levels was found between puppies without a murmur and puppies with an innocent murmur (median 300 versus 326 pmol\/L), and between clinically healthy adult Cairn Terriers and Cairn Terrier puppies. Plasma NT-proBNP levels in puppies with a congenital heart disease were significantly (P &amp;lt; .001) higher than those in puppies with innocent murmurs (median 1,102 versus 326 pmol\/L). However, some puppies with severe pulmonic stenosis did not have increased plasma NT-proBNP levels. On phonocardiograms, innocent murmurs had a significantly (P &amp;lt; .001) shorter \u201cmurmur-to-systole duration ratio\u201d than the abnormal ones (median 66 versus 100%). The \u201cmurmur-to-S1 (first cardiac sound) amplitude ratio\u201d was significantly (P &amp;lt; .001) lower of the innocent murmurs compared with that of the abnormal ones (median 16 versus 58 %).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>Plasma NT-proBNP concentrations within the reference range do not rule out a congenital cardiac anomaly. Murmurs longer than 80% of the systole are most likely abnormal, whereas murmurs shorter than that could be either innocent or pathologic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jvim.14667","type":"journal-article","created":{"date-parts":[[2017,3,19]],"date-time":"2017-03-19T02:01:29Z","timestamp":1489888889000},"page":"661-667","source":"Crossref","is-referenced-by-count":13,"title":["N-Terminal Pro-B-Type Natriuretic Peptide and Phonocardiography in Differentiating Innocent Cardiac Murmurs from Congenital Cardiac Anomalies in Asymptomatic Puppies"],"prefix":"10.1093","volume":"31","author":[{"given":"S.M.","family":"Marinus","sequence":"first","affiliation":[{"name":"Faculty of Veterinary Medicine, Utrecht University Department of Clinical Sciences of Companion Animals, , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"van Engelen","sequence":"additional","affiliation":[{"name":"Faculty of 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