Vollmar A C, Fox P R
Small Animal Clinic (Wissen and Bonn Germany), New York, NY.
The Animal Medical Center, New York, NY.
J Vet Intern Med. 2016 Mar-Apr;30(2):553-9. doi: 10.1111/jvim.13914. Epub 2016 Mar 3.
Dilated cardiomyopathy (DCM) is a common cause of morbidity and mortality in the Irish Wolfhound (IW). However, the benefit of medical treatment in IW dogs with preclinical DCM, atrial fibrillation (AF), or both has not been demonstrated.
Compare the time to develop congestive heart failure (CHF) or sudden death in IW dogs with preclinical DCM, AF, or both receiving monotherapy with pimobendan, methyldigoxin, or benazepril hydrochloride.
Seventy-five client-owned IW dogs.
Irish Wolfhound dogs were prospectively randomized to receive pimobendan (Vetmedin®), benazepril HCl (Fortekor®), or methyldigoxin (Lanitop®) monotherapy in a 1:1:1 ratio in a blinded clinical trial. The prospectively defined composite primary endpoint was onset of CHF or sudden death. To assure stringent evaluation of treatment effect, data from dogs complying with the study protocol were analyzed.
Sixty-six IW fulfilling the study protocol included 39 males, 27 females; median (interquartile range) age, 4.0 years (3.0-5.0 years) and weight, 70.0 kg (63.0-75.0 kg). Primary endpoint was reached in 5 of 23 (21.7%) IW receiving pimobendan, 11 of 22 (50.0%) receiving benazepril HCl, and 9 of 21 (42.9%) receiving methyldigoxin. Median time to primary endpoint was significantly longer for pimobendan (1,991 days; 65.4 months) compared to methyldigoxin (1,263 days; 41.5 months; P = .031) or benazepril HCl-(997 days; 32.8 months; P = .008) treated dogs.
In IW dogs with preclinical DCM, AF or both, pimobendan monotherapy significantly prolonged time to onset of CHF or sudden death than did monotherapy with benazepril HCl or methyldigoxin.
扩张型心肌病(DCM)是爱尔兰猎狼犬(IW)发病和死亡的常见原因。然而,药物治疗对患有临床前期DCM、心房颤动(AF)或两者皆有的IW犬的益处尚未得到证实。
比较接受匹莫苯丹、甲地高辛或盐酸贝那普利单一疗法的临床前期DCM、AF或两者皆有的IW犬发生充血性心力衰竭(CHF)或猝死的时间。
75只客户拥有的IW犬。
在一项盲法临床试验中,爱尔兰猎狼犬被前瞻性地随机分为接受匹莫苯丹(Vetmedin®)、盐酸贝那普利(Fortekor®)或甲地高辛(Lanitop®)单一疗法,比例为1:1:1。前瞻性定义的复合主要终点是CHF发作或猝死。为确保对治疗效果进行严格评估,分析了符合研究方案的犬的数据。
66只符合研究方案的IW犬包括39只雄性、27只雌性;中位(四分位间距)年龄为4.0岁(3.0 - 5.0岁),体重为70.0 kg(63.0 - 75.0 kg)。接受匹莫苯丹治疗的23只IW犬中有5只(21.7%)达到主要终点,接受盐酸贝那普利治疗的22只中有11只(50.0%),接受甲地高辛治疗的21只中有9只(42.9%)。与接受甲地高辛治疗的犬(1263天;41.5个月;P = 0.031)或盐酸贝那普利治疗的犬(997天;32.8个月;P = 0.008)相比,匹莫苯丹治疗的犬达到主要终点的中位时间显著更长。
在患有临床前期DCM、AF或两者皆有的IW犬中,匹莫苯丹单一疗法比盐酸贝那普利或甲地高辛单一疗法显著延长了CHF发作或猝死的时间。