MacDonald Kristin A, Kittleson Mark D, Larson Richard F, Kass Philip, Klose Tyler, Wisner Erik R
Department of Veterinary Medicine and Epidemiology, University of California, Davis 95616, USA.
J Vet Intern Med. 2006 Sep-Oct;20(5):1093-105. doi: 10.1892/0891-6640(2006)20[1093:teorol]2.0.co;2.
Hypertrophic cardiomyopathy (HCM) is the most common heart disease of cats, resulting in left ventricular (LV) hypertrophy, myocardial fibrosis, and diastolic dysfunction.
Ramipril will reduce LV mass, improve diastolic function, and reduce myocardial fibrosis in cats with HCM without congestive heart failure (CHF).
This prospective, blinded, placebo-controlled study included 26 Maine Coon and Maine Coon cross-bred cats with familial HCM but without CHF.
Cats were matched for LV mass index (LVMI) and were randomized to receive ramipril (0.5 mg/kg) or placebo q24h for 1 year, with investigators blinded. Plasma brain natriuretic peptide (BNP) concentration, plasma aldosterone concentration, Doppler tissue imaging (DTI), and systolic blood pressure were measured at baseline and every 3 months for 1 year. Cardiac magnetic resonance imaging (cMRI) was performed to quantify LV mass and myocardial fibrosis by delayed enhancement (DE) cMRI at baseline and 6 and 12 months. Plasma angiotensin-converting enzyme (ACE) activity was measured on 16 cats 1 hour after PO administration.
Plasma ACE activity was adequately suppressed (97%) in cats treated with ramipril. LV mass, LVMI, DTI, DE, blood pressure, plasma BNP, and plasma aldosterone were not different in cats treated with ramipril compared with placebo (P = .85, P = .94, P = .91, P = .89, P = .28, P = .18, and P = .25, respectively).
Treatment of Maine Coon cats with HCM without CHF with ramipril did not change LV mass, improve diastolic function, alter DE, or alter plasma BNP or aldosterone concentrations in a relevant manner.
肥厚型心肌病（HCM）是猫最常见的心脏病，可导致左心室（LV）肥厚、心肌纤维化和舒张功能障碍。
雷米普利将减轻HCM且无充血性心力衰竭（CHF）的猫的左心室质量，改善舒张功能，并减少心肌纤维化。
这项前瞻性、双盲、安慰剂对照研究纳入了26只患有家族性HCM但无CHF的缅因猫和缅因猫杂交品种猫。
猫根据左心室质量指数（LVMI）进行匹配，并随机分为接受雷米普利（0.5mg/kg）或安慰剂，每24小时一次，持续1年，研究人员保持盲态。在基线时以及1年中每3个月测量血浆脑钠肽（BNP）浓度、血浆醛固酮浓度、多普勒组织成像（DTI）和收缩压。在基线、6个月和12个月时进行心脏磁共振成像（cMRI），通过延迟强化（DE）cMRI定量左心室质量和心肌纤维化。对16只猫口服给药1小时后测量血浆血管紧张素转换酶（ACE）活性。
接受雷米普利治疗的猫的血浆ACE活性得到充分抑制（97%）。与安慰剂相比，接受雷米普利治疗的猫的左心室质量、LVMI、DTI、DE、血压、血浆BNP和血浆醛固酮无差异（P分别为0.85、0.94、0.91、0.89、0.28、0.18和0.25）。
用雷米普利治疗无CHF的HCM缅因猫，并未以相关方式改变左心室质量、改善舒张功能、改变DE或改变血浆BNP或醛固酮浓度。
