Effects of treatment on respiratory rate, serum natriuretic peptide concentration, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure secondary to degenerative mitral valve disease and dilated cardiomyopathy

Schober, Karsten E.; Hart, Taye M.; Stern, Joshua A.; Li, Xiaobai; Samii, Valerie F.; Zekas, Lisa J.; Scansen, Brian A.; Bonagura, John D.

doi:10.2460/javma.239.4.468

Cited by 37 publications

(37 citation statements)

References 64 publications

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“…The median AUC of resting respiratory rate was 2 breaths per minute lower in the pimobendan group, and the median AUC of heart rate was 6 beats per minute lower. Given that higher heart rate and higher resting respiratory rate tend to be associated with more advanced MMVD and the onset of CHF, the lower rates in dogs treated with pimobendan might be an indication of improved stability of these dogs even though they were considered to be preclinical at the time of recruitment to the trial.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study

Boswood

Gordon

Häggström

et al. 2017

Veterinary Internal Medicne

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BackgroundChanges in clinical variables associated with the administration of pimobendan to dogs with preclinical myxomatous mitral valve disease (MMVD) and cardiomegaly have not been described.ObjectivesTo investigate the effect of pimobendan on clinical variables and the relationship between a change in heart size and the time to congestive heart failure (CHF) or cardiac‐related death (CRD) in dogs with MMVD and cardiomegaly. To determine whether pimobendan‐treated dogs differ from dogs receiving placebo at onset of CHF.AnimalsThree hundred and fifty‐four dogs with MMVD and cardiomegaly.Materials and MethodsProspective, blinded study with dogs randomized (ratio 1:1) to pimobendan (0.4–0.6 mg/kg/d) or placebo. Clinical, laboratory, and heart‐size variables in both groups were measured and compared at different time points (day 35 and onset of CHF) and over the study duration. Relationships between short‐term changes in echocardiographic variables and time to CHF or CRD were explored.ResultsAt day 35, heart size had reduced in the pimobendan group: median change in (Δ) LVIDDN −0.06 (IQR: −0.15 to +0.02), P < 0.0001, and LA:Ao −0.08 (IQR: −0.23 to +0.03), P < 0.0001. Reduction in heart size was associated with increased time to CHF or CRD. Hazard ratio for a 0.1 increase in ΔLVIDDN was 1.26, P = 0.0003. Hazard ratio for a 0.1 increase in ΔLA:Ao was 1.14, P = 0.0002. At onset of CHF, groups were similar.Conclusions and Clinical ImportancePimobendan treatment reduces heart size. Reduced heart size is associated with improved outcome. At the onset of CHF, dogs treated with pimobendan were indistinguishable from those receiving placebo.

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Section: Discussionmentioning

confidence: 99%

Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study

Boswood

Gordon

Häggström

et al. 2017

Veterinary Internal Medicne

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“…Measurement of natriuretic peptides including canine N‐terminal pro‐brain natriuretic peptide concentration ([NT‐proBNP]) provides insights to distinguish cardiac from noncardiac respiratory distress,3, 4, 5, 6, 7, 8 assess heart disease (HD) severity,7, 9, 10, 11 predict onset of CHF,11 provide prognostic information in myxomatous mitral valve disease (MMVD),10, 11, 12, 13, 14 and dilated cardiomyopathy (DCM),15, 16 and help with treatment decisions 17…”

mentioning

confidence: 99%

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Fox

Oyama

Hezzell

et al. 2014

Veterinary Internal Medicne

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BackgroundCardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).Hypothesis/ObjectivesDetermine the utility of plasma N‐terminal pro‐brain natriuretic peptide concentration [NT‐proBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity.AnimalsClient‐owned dogs (n = 291).MethodsMulticenter, cross‐sectional, prospective investigation. Medical history, physical examination, echocardiography, and thoracic radiography classified 113 asymptomatic dogs (group 1, n = 39 without HD; group 2, n = 74 with HD), and 178 with respiratory distress (group 3, n = 104 respiratory disease, either with or without concurrent HD; group 4, n = 74 with congestive heart failure [CHF]). HD severity was graded using International Small Animal Cardiac Health Council (ISACHC) and ACVIM Consensus (ACVIM‐HD) schemes without knowledge of [NT‐proBNP] results. Receiver‐operating characteristic curve analysis assessed the capacity of [NT‐proBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NT‐proBNP] and HD severity.ResultsPlasma [NT‐proBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769–8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672–2,704 pmol/L; P < .0001). A cut‐off >2,447 pmol/L discriminated CHF from noncardiac respiratory distress (81.1% sensitivity; 73.1% specificity; area under curve, 0.84). A multivariate model comprising left atrial to aortic ratio, heart rate, left ventricular diameter, end‐systole, and ACVIM‐HD scheme most accurately associated average plasma [NT‐proBNP] with HD severity.Conclusions and Clinical ImportancePlasma [NT‐proBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NT‐BNP] increased significantly as a function of HD severity using the ACVIM‐HD classification scheme.

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“…Resting respiratory rate assessment is a sensitive and specific method for identifying CHF in dogs, and that normalization of resting respiratory rate occurs after resolution of CHF. 15,16 The positive effects of pimobendan on SRR may be related to the positive inodilatory effects of the drug. Inodilation is expected to increase forward stroke volume (e.g.…”

Section: Figurementioning

confidence: 98%

Effect of pimobendan on the incidence of arrhythmias in small breed dogs with myxomatous mitral valve degeneration

Lake-Bakaar¹,

Singh²,

Kass³

et al. 2015

Journal of Veterinary Cardiology

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Effects of treatment on respiratory rate, serum natriuretic peptide concentration, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure secondary to degenerative mitral valve disease and dilated cardiomyopathy

Cited by 37 publications

References 64 publications

Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study

Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Effect of pimobendan on the incidence of arrhythmias in small breed dogs with myxomatous mitral valve degeneration

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