Comparative effects of amlodipine and benazepril on Left Atrial Pressure in Dogs with experimentally-induced Mitral Valve Regurgitation

Suzuki, Shuji; Fukushima, Ryuji; Ishikawa, Taisuke; Yamamoto, Yuta; Hamabe, Lina; Kim, Soomin; Yoshiyuki, Rieko; Motomura, Noboru; Tanaka, Ryou

doi:10.1186/1746-6148-8-166

Cited by 9 publications

(22 citation statements)

References 24 publications

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“…Suzuki et al [13,14] conducted comparative studies, using respectively two different doses of pimobendan and amlodipine or benazepril. In both studies, the same parameters were evaluated.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of the Echocardiographic Parameters of Dogs with Chronic Mitral Valve Regurgitation Treated with Amlodipine or Pimobendan

Kamakura

Goldfeder

Itikawa

et al. 2017

Acta Scientiae. Vet.

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Background: Chronic mitral valve regurgitation is the most common heart disease in dogs. It is caused by myxomatous mitral valve degeneration, an acquired degenerative disease that can lead to congestive heart failure. Pimobendan is a mixed action drug, with inotropic and vasodilator proprieties, widely used to treat such dogs. Amlodipine is a pure vasodilator drug used as an anti-hypertensive agent, with no inotropic effects. This study aimed to compare echocardiographic, electrocardiographic and blood pressure parameters between dogs with congestive heart failure treated with pimobendan and those treated with amlodipine in addition to conventional therapy.Materials, Methods & Results: A prospective, randomized, double-blind study was conducted in dogs with stage C chronic mitral valve regurgitation according to the 2009 American College of Veterinary Internal Medicine (ACVIM) guidelines, who weighed up to 15 kg. Randomization was performed using appropriate software and the sealed envelope technique. Blinding of the owner, the main researcher, and the person who performed the clinical analysis was guaranteed by the use of identical capsules and bottles for both pimobendan and amlodipine. Statistical analysis was performed using specialized software. Eligibility was determined by predefined inclusion and exclusion criteria. Dogs with cardiac disease other than mitral and/or tricuspid degeneration, patients already undergoing pharmacological treatment with drugs other than enalapril and furosemide, patients with systolic blood pressure below 100 mmHg, patients with chronic kidney disease in stages III or IV according to International Renal Interest Society staging system for chronic kidney disease (2009), and patients with other systemic debilitating diseases were excluded from the study. The animals were randomized into two groups based on the drug they received. Group A received pimobendan (n = 10) and group B received amlodipine (n = 11). All animals were also treated with furosemide and enalapril maleate and evaluated three times over a period of sixty days (T0, T30, T60). Changes in echodopplercardiographic and electrocardiographic parameters and systolic blood pressure were investigated. There were no significant differences in electrocardiographic parameters or systolic blood pressure between the groups at any time. Among the echocardiographic parameters, only early diastolic myocardial peak velocity (Em) and late diastolic myocardial peak velocity (Am) showed a significant difference between groups.Discussion: This was the first prospective randomized double-blind study comparing pimobendan and amlodipine in the treatment of dogs with stage C chronic mitral valve regurgitation according to the ACVIM consensus statement. The use of pimobendan in these patients has been debated because myocardial inotropism is generally preserved in them. Some authors argue that early use of the drug can even lead to deleterious effects on the heart. In the present study, the groups showed no statistically significant differences in systolic blood pressure or electrocardiographic parameters. Among the echocardiographic parameters, statistically significant differences were only observed in the speed of Em waves between groups at T0, in the speed of Em waves in the amlodipine group between T0 and T60 times, and in the speed of Am waves in the amlodipine group between T30 and T60 times. Both parameters are indices of diastolic function and may indicate a change in early myocardial relaxation. From the findings of this study, we could not conclude whether one drug was superior to the other.

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“…Suzuki et al [13,14] conducted comparative studies, using respectively two different doses of pimobendan and amlodipine or benazepril. In both studies, the same parameters were evaluated.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of the Echocardiographic Parameters of Dogs with Chronic Mitral Valve Regurgitation Treated with Amlodipine or Pimobendan

Kamakura

Goldfeder

Itikawa

et al. 2017

Acta Scientiae. Vet.

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“…El concepto de esperar a que aparezcan signos de declinación temprana de la función del ventrículo izquierdo (20,88,130) se asocia con un notable riesgo de "inesperada" disfunción del ventrículo izquierdo, y solo se admite cuando la regurgitación mitral no es lo suficientemente severa para indicar una cirugía inmediata, o el riesgo operatorio es muy alto, o las oportunidades de reparación valvular son bajas.…”

Section: Pág 131unclassified

“…temprano con síntomas mínimos tienen una supervivencia mejor que los pacientes con síntomas severos (12,20,88,130,138,190,225,226,244) .…”

Section: Pág 131unclassified

“…En el periodo del post-infarto agudo de miocardio, el músculo cardiaco sufre una adecuación a la nueva situación con cambios en la geometría del ventrículo izquierdo que puede afectar a la morfología cardiaca y/o causar lesiones graves a las estructuras de soporte de la válvula mitral, afectando a la funcionalidad del aparato valvular mitral, condicionando en algunos casos una insuficiencia mitral con válvula mitral nativa morfológicamente normal, es lo que denominamos regurgitación mitral de etiología isquémica. (8,9,14,15,16,17,19,20,21,22,27,29) El pronóstico de la enfermedad coronaria (78,82,94,98,99,102) depende de varios factores, que incluyen tanto la severidad de las lesiones de las arterias coronarias, como la extensión del área necrótica, la cantidad de miocardio viable existente, la función ventricular izquierda remanente, la presencia de isquemia residual y, la presencia ó ausencia de una regurgitación mitral como complicación derivada de la cardiopatía isquémica.…”

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“…(11,28,37,45,46,57,101,190,191,239,240,243,245,252,258,259,262).La regurgitación mitral de grado significativo se debe asociar con un desplazamiento de los músculos papilares, una dilatación del anillo mitral, y posiblemente con una reducción en las fuerzas de cierre de los velos mitrales (4,8,10,14,15,16,19,20,26,30,52,54,65,77,83,95,105,133,135,137,141) pág. 132…”

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Valor de la insuficiencia mitral previa a un primer infarto de miocardio, en el pronóstico clínico y la hemodinámica ventricular

Carbonero¹,

David²

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regurgitación mitral previa a un infarto agudo de miocardio en la función del ventrículo izquierdo y su geometría 7.4.Interrelación de la regurgitación mitral con el remodelado de aurícula izquierda y la inestabilidad eléctrica 7.5.Conexión existente entre la regurgitación mitral y la activación del sistema neurohormonal, el sistema neurovegetativo y las citoquinas 7.6.Insuficiencia mitral previa a un primer infarto agudo de miocardio y mortalidad cardiovascular 7.7.Papel pronóstico de la insuficiencia mitral previa a un primer infarto agudo de miocardio 7.8.Papel pronóstico de la fibrilación auricular 8.Limitaciones 9.Conclusiones 9.1.Conclusiones generales Anexo Definiciones

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Amlodipine decreases mitral regurgitation volume in dogs over 7 days: A study of 24 dogs with myxomatous mitral valve degeneration

Park¹,

Oh²,

Lee³

2022

Veterinary Record Open

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Background Amlodipine, a dihydropyridine calcium‐channel blocker, is currently being investigated as a treatment for myxomatous mitral valvular degeneration (MMVD). However, the effects of amlodipine on moderate or severe spontaneous MMVD, based on changes in echocardiographic indices, remain unclear. Animals Client‐owned small‐breed dogs ( n = 24) with naturally occurring MMVD of the American College of Veterinary Internal Medicine (ACVIM) stage B2 or higher. Methods Basic dog information including previous medication treatments were recorded. All subjects received amlodipine 0.1 mg/kg, administered per os, twice daily for 7 days, in addition to their existing medication. We measured systolic blood pressure, obtained x‐ray, echocardiography, blood test data before and after 1 week of amlodipine administration. Results Left ventricular end‐diastolic internal diameter, left atrial diameter and E wave reduced statistically after 1 week of amlodipine treatment (all p < 0.001). No adverse effects were reported. Conclusions These findings suggest that low‐dose amlodipine should be considered as treatment for dogs with ACVIM stage B2‒C MMVD.

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Comparative effects of amlodipine and benazepril on Left Atrial Pressure in Dogs with experimentally-induced Mitral Valve Regurgitation

Cited by 9 publications

References 24 publications

Comparative Evaluation of the Echocardiographic Parameters of Dogs with Chronic Mitral Valve Regurgitation Treated with Amlodipine or Pimobendan

Comparative Evaluation of the Echocardiographic Parameters of Dogs with Chronic Mitral Valve Regurgitation Treated with Amlodipine or Pimobendan

Valor de la insuficiencia mitral previa a un primer infarto de miocardio, en el pronóstico clínico y la hemodinámica ventricular

Amlodipine decreases mitral regurgitation volume in dogs over 7 days: A study of 24 dogs with myxomatous mitral valve degeneration

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