Open AccessShort‐Term Hemodynamic and Neuroendocrine Effects of Pimobendan and Benazapril in Dogs with Myxomatous Mitral Valve Disease and Congestive Heart Failure
Author(s) -
Häggström J.,
Lord P.F.,
Höglund K.,
Ljungvall I.,
Jöns O.,
Kvart C.,
Hansson K.
Publication year - 2013
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/jvim.12217
Subject(s) - medicine , benazepril , heart failure , cardiology , ejection fraction , aldosterone , natriuretic peptide , furosemide , blood pressure
Background Pimobendan and benazepril are frequently used with diuretics to treat dogs in congestive heart failure ( CHF ) caused by myxomatous mitral valve disease ( MMVD ). Aim To compare the short‐term effects of pimobendan versus benazepril on pump function, heart size, and neuroendocrine profile in dogs with CHF caused by MMVD . Animals Sixteen client‐owned dogs. Material and methods Seven‐day prospective single‐blinded study of dogs stabilized on furosemide monotherapy, randomized to pimobendan (0.4–0.6 mg/kg/day) or benazepril (0.25–1.0 mg/kg/day). Dogs had first‐pass radionuclide angiocardiography, and heart size was measured by radiography and echocardiography. Circulating neuroendocrine hormones were measured. Results Baseline variables did not differ between treatment groups. Greater decreases in the pimobendan than in the benazepril group were found for heart rate ( P = .001), heart rate‐normalized pulmonary transit time ( P = .02), left atrial size ( P = .03), and systolic and diastolic left ventricular diameters ( P < .001 and P = .03, respectively) and volumes ( P < .001 and P = .02, respectively), whereas ejection fraction increased more ( P = .02) in the pimobendan group. Of the neuroendocrine hormones, only N‐terminal proatrial natriuretic peptide (NT‐ProANP) differed ( P = .04) between groups. Within groups, plasma aldosterone increased ( P = .01), and NT‐proANP ( P = .01) and NT‐proB‐type ( P = .02) natriuretic peptide decreased in the pimobendan group, and NT‐proANP ( P = .02) and plasma vasopressin ( P = .01) decreased in the benazepril group. Conclusions and Clinical Importance Pimobendan improves short‐term cardiac function more than benazepril in dogs with CHF caused by MMVD . Pimobendan treatment enables the heart to work at smaller end‐systolic and diastolic dimensions while maintaining adequate forward stroke volume. Some of the treatment responses found in neuroendocrine profile might have therapeutic relevance.