William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA, USA.
J Vet Intern Med. 2011 Sep-Oct;25(5):1044-9. doi: 10.1111/j.1939-1676.2011.0754.x. Epub 2011 Jul 22.
Atenolol often is used empirically in cats with hypertrophic cardiomyopathy (HCM) before the onset of heart failure, although evidence of efficacy is lacking. Cardiac biomarkers play a critical role in the early detection of subclinical cardiac disease, in the prediction of long-term prognosis, and in monitoring the response to therapy in humans.
Circulating concentrations of the biomarkers N-terminal pro-B type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) will decrease after chronic administration of atenolol PO to cats with severe HCM but no signs of heart failure.
Six Maine Coon or Maine Coon cross cats with severe HCM.
Cats were treated with atenolol (12.5 mg PO q12 h) for 30 days. No cat had left ventricular dynamic outflow tract obstruction caused by systolic anterior motion of the mitral valve. The concentrations of NT-proBNP and cTnI were assayed before and on the last day of drug administration.
There was no statistically significant change in NT-proBNP (median before, 394 pmol/L; range, 71-1,500 pmol/L; median after, 439 pmol/L; range, 24-1,500 pmol/L; P = .63) or in cTnI (median before, 0.24 ng/mL; range, 0.10-0.97 ng/mL; median after, 0.28 ng/mL; range, 0.09-1.0 ng/mL; P = .69) after administration of atenolol.
Atenolol administration did not decrease NT-proBNP or cTnI concentrations in cats with severe left ventricular hypertrophy caused by hypertrophic cardiomyopathy. These results suggest that atenolol did not decrease myocardial ischemia and myocyte death in these cats. A larger clinical trial is warranted to verify these findings.
在心力衰竭发生之前,阿替洛尔常被经验性地用于患有肥厚型心肌病(HCM)的猫,但缺乏疗效证据。心脏生物标志物在亚临床心脏疾病的早期检测、长期预后预测以及人类治疗反应监测中起着至关重要的作用。
在患有严重 HCM 但没有心力衰竭迹象的猫中,长期 PO 给予阿替洛尔后,循环中的生物标志物 N 末端 pro-B 型利钠肽(NT-proBNP)和心肌肌钙蛋白 I(cTnI)的浓度将会降低。
6 只缅因库恩或缅因库恩杂交猫患有严重 HCM。
猫接受阿替洛尔(PO,12.5 mg,q12 h)治疗 30 天。没有猫因二尖瓣收缩期前向运动导致左心室动态流出道阻塞。在药物治疗前和最后一天测定 NT-proBNP 和 cTnI 的浓度。
NT-proBNP(治疗前中位数,394 pmol/L;范围,71-1500 pmol/L;治疗后中位数,439 pmol/L;范围,24-1500 pmol/L;P =.63)或 cTnI(治疗前中位数,0.24 ng/mL;范围,0.10-0.97 ng/mL;治疗后中位数,0.28 ng/mL;范围,0.09-1.0 ng/mL;P =.69)在阿替洛尔给药后均无统计学显著变化。
阿替洛尔给药并未降低肥厚型心肌病引起的严重左心室肥厚猫的 NT-proBNP 或 cTnI 浓度。这些结果表明,阿替洛尔并未减少这些猫的心肌缺血和心肌细胞死亡。需要更大的临床试验来验证这些发现。