Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan.
J Vet Intern Med. 2010 Mar-Apr;24(2):342-7. doi: 10.1111/j.1939-1676.2009.0455.x.
Despite many epidemiological reports concerning the efficacy of angiotensin-converting enzyme (ACE) inhibitors in dogs with mitral regurgitation (MR), the hemodynamic effects of ACE inhibitor administration have not been fully evaluated.
To document left atrial pressure (LAP) in dogs with MR administered ACE inhibitors, in order to obtain interesting information about daily LAP changes with administration of ACE inhibitors.
Five healthy Beagle dogs weighing 9.8 to 14.2 kg (2 males and 3 females; aged 2 years).
Experimental, crossover, and interventional study. Chordae tendineae rupture was induced, and a radiotelemetry transmitter catheter was inserted into the left atrium. LAP was recorded for 72 consecutive hours during which each of 3 ACE inhibitors--nalapril (0.5 mg/kg/d), temocapril (0.1 mg/kg/d), and alacepril (3.0 mg/kg/d)--were administered in a crossover study.
Averaged diurnal LAP was significantly, but slightly reduced by alacepril (P = .03, 19.03 +/- 3.01-18.24 +/- 3.07 mmHg). The nightly drops in LAP caused by alacepril and enalapril were significantly higher than the daily drops (P = .03, -0.98 +/- 0.19 to -0.07 +/- 0.25 mmHg, and P = .03, -0.54 +/- 0.21-0.02 +/- 0.17 mmHg, respectively), despite the fact that the oral administrations were given in the morning. Systolic blood pressure (122.7 +/- 14.4-117.4 +/- 13.1 mmHg, P = .04) and systemic vascular resistance (5800 +/- 2685-5144 +/- 2077 dyne x s/cm5, P = .03) were decreased by ACE inhibitors.
ACE inhibitors decrease LAP minimally, despite reductions in left ventricular afterload. ACE inhibitors should not be used to decrease LAP.
尽管有许多关于血管紧张素转换酶（ACE）抑制剂在二尖瓣反流（MR）犬中的疗效的流行病学报告，但 ACE 抑制剂给药的血液动力学效应尚未得到充分评估。
记录患有 MR 的犬在给予 ACE 抑制剂时的左心房压（LAP），以获得有关 ACE 抑制剂给药时日常 LAP 变化的有趣信息。
5 只健康比格犬，体重 9.8 至 14.2 公斤（2 只雄性和 3 只雌性；年龄 2 岁）。
实验、交叉和干预研究。腱索断裂后，将放射性遥测传送器导管插入左心房。在连续 72 小时内记录 LAP，在此期间，在交叉研究中分别给予 3 种 ACE 抑制剂（nalapril，0.5mg/kg/d；temocapril，0.1mg/kg/d；alacepril，3.0mg/kg/d）。
alacepril 使平均日间 LAP 显著降低，但幅度较小（P =.03，19.03 +/- 3.01-18.24 +/- 3.07mmHg）。alacepril 和依那普利引起的夜间 LAP 下降明显高于每日下降（P =.03，-0.98 +/- 0.19 至-0.07 +/- 0.25mmHg，和 P =.03，-0.54 +/- 0.21-0.02 +/- 0.17mmHg，分别），尽管口服给药是在早上进行的。ACE 抑制剂降低收缩压（122.7 +/- 14.4-117.4 +/- 13.1mmHg，P =.04）和全身血管阻力（5800 +/- 2685-5144 +/- 2077dyne x s/cm5，P =.03）。
尽管左心室后负荷降低，但 ACE 抑制剂仅轻微降低 LAP。不应使用 ACE 抑制剂来降低 LAP。
