Open AccessEvaluation of Pimobendan and N‐Terminal Probrain Natriuretic Peptide in the Treatment of Pulmonary Hypertension Secondary to Degenerative Mitral Valve Disease in Dogs
Author(s) -
Atkinson K.J.,
Fine D.M.,
Thombs L.A.,
Gorelick J.J.,
Durham H.E.
Publication year - 2009
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2009.0390.x
Subject(s) - medicine , cardiology , natriuretic peptide , pulmonary hypertension , crossover study , placebo , heart failure , pathology , alternative medicine
Background: Pimobendan is a positive inotrope and vasodilator that may be useful in the treatment of pulmonary hypertension (PHT) secondary to degenerative mitral valve disease. Hypothesis: Pimobendan decreases the severity of PHT measured echocardiographically and improves quality‐of‐life scores. Changes in N‐terminal probrain natriuretic peptide (NT‐proBNP) concentrations will reflect improvement in severity of PHT. Animals: Ten client‐owned dogs with peak tricuspid regurgitant flow velocity (TRFV) ≥3.5 m/s. Methods: Prospective short‐term, double‐blinded, crossover design, with a long‐term, open‐label component. Short term, dogs were randomly allocated to receive either placebo or pimobendan (0.18–0.3 mg/kg PO q12 h) for 14 days. After a 1‐week washout, they received the alternative treatment for 14 days, followed by pimobendan open‐label for 8 weeks. Results: Short‐term comparison: peak TRFV decreased in all dogs on pimobendan compared with placebo from a median of 4.40 (range, 3.2–5.6) to 3.75 (range, 2.4–4.8) m/s ( P < .0001). NT‐proBNP concentration decreased after treatment with pimobendan from a median of 2,143 (range, 450–3,981) to 1,329 (range, 123–2,411) pmol/L ( P = .0009). All dogs improved their quality‐of‐life score ( P = .006). In the long‐term comparisons, peak TRFV decreased in all dogs from a median of 4.28 (range, 3.5–5.7) to 3.52 (range, 2.4–5.0) m/s ( P < .0001). No significant changes in NT‐proBNP or quality‐of‐life scores were detected. Conclusions and Clinical Importance: Pimobendan lowered severity of measurable PHT, improved quality‐of‐life scores, and decreased NT‐proBNP concentrations short‐term. Long term, only the reduction in TRFV was maintained.