Short-term follow-up of exercise training program and beta-blocker treatment on quality of life in dogs with naturally acquired chronic mitral valve disease

Abstract

This study aimed to evaluate the effects of carvedilol treatment and a regimen of supervised aerobic exercise training on quality of life and other clinical, echocardiographic, and biochemical variables in a group of client-owned dogs with chronic mitral valve disease (CMVD). Ten healthy dogs (control) and 36 CMVD dogs were studied, with the latter group divided into 3 subgroups. In addition to conventional treatment (benazepril, 0.3-0.5 mg/kg once a day, and digoxin, 0.0055 mg/kg twice daily), 13 dogs received exercise training (subgroup I; 10.3±2.1 years), 10 dogs received carvedilol (0.3 mg/kg twice daily) and exercise training (subgroup II; 10.8±1.7 years), and 13 dogs received only carvedilol (subgroup III; 10.9±2.1 years). All drugs were administered orally. Clinical, laboratory, and Doppler echocardiographic variables were evaluated at baseline and after 3 and 6 months. Exercise training was conducted from months 3-6. The mean speed rate during training increased for both subgroups I and II (ANOVA, P>0.001), indicating improvement in physical conditioning at the end of the exercise period. Quality of life and functional class was improved for all subgroups at the end of the study. The N-terminal pro-brain natriuretic peptide (NT-proBNP) level increased in subgroup I from baseline to 3 months, but remained stable after training introduction (from 3 to 6 months). For subgroups II and III, NT-proBNP levels remained stable during the entire study. No difference was observed for the other variables between the three evaluation periods. The combination of carvedilol or exercise training with conventional treatment in CMVD dogs led to improvements in quality of life and functional class. Therefore, light walking in CMVD dogs must be encouraged.

Clinical use of submaximal treadmill exercise testing and assessments of cardiac biomarkers NT-proBNP and cTnI in dogs with presymptomatic mitral regurgitation

“…Still, it has been shown, that resting values of NT-proBNP vary between different breeds and also within an individual [ 47 ]. Also, baseline values decrease with initiation of exercise training [ 16 , 17 ]. For these reasons, assessing post-exercise NT-proBNP could gain similar important diagnostic and prognostic value as in human cardiac patients [ 5 , 7 ].…”

“…Being chronically activated in heart failure patients, these mechanisms do not function as effective as in healthy dogs, leading to worse adjustment to exercise and thus exercise intolerance [ 15 ]. This autonomic balance can be (partially) restored by exercise training as an adjuvant therapy [ 16 , 17 ]. In human patients, stress echocardiography has been shown to be helpful in clinical decision-making [ 2 ].…”

“…As these can differ during exercise and rest [ 4 ], findings from echocardiography at rest might be supplemented by post-exercise NT-proBNP values. Furthermore, exercise training leads to a decrease of baseline NT-proBNP values in dogs with MR of different stages [ 17 ].…”

Efeito de diferentes intensidades de exercício em esteira sobre os parâmetros eletrocardiográficos de cães hígidos

“…O aumento significativo da temperatura retal dos cães foi verificado em MPE, o qual retornou próximo ao valor basal em M30, em ambos os testes. Como não houve alteração significativa da temperatura ambiente no salão, a elevação da temperatura retal dos animais foi ocasionada exclusivamente pela maior produção de calor da musculatura esquelética durante o exercício, que excedeu a capacidade do cão em dissipá-lo, em acordo com Piccione et al (2012). Essa hipertermia transitória ocorre em consequência do aumento da intensidade do exercício e da atividade metabólica no músculo esquelético (Valberg, 2014).…”

“…Atualmente, há diversos trabalhos reportando diferentes protocolos de exercício em esteira para cães (Ferasin e Marcora, 2009;Piccione et al, 2012;Marcondes-Santos et al, 2015;Radin et al, 2015). O exercício padronizado em esteira também é amplamente recomendado para pacientes obesos que estão em programas de perda de peso (Chauvet et al, 2011;Vitger et al, 2016) e para cardiopatas, a fim de melhorar a qualidade de vida e a tolerância ao exercício (Marcondes-Santos et al, 2015 Para o estudo, foram selecionados 35 cães da raça Australian Cattle Dog, porém foram utilizados sete cães da raça Australian Cattle Dog e quatro da raça Border Collie, sendo seis machos e cinco fêmeas, com idade média de 2,4±2,0 anos, peso médio de 19,8±3,9kg e condição corporal normal. Os cães eram provenientes de proprietários do município de Lages/SC, os quais assinaram termo de consentimento para a realização deste estudo.…”