Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan.
Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan.
J Vet Cardiol. 2020 Dec;32:16-27. doi: 10.1016/j.jvc.2020.09.003. Epub 2020 Sep 19.
Pulmonary hypertension (PH) is a progressive and potentially life-threatening disease. Several drugs are used for the treatment of dogs with precapillary PH. Pimobendan is an inotropic drug with phosphodiesterase 3 inhibitory and calcium-sensitizing effects. Pimobendan administration improved right ventricular (RV) function and lowered pulmonary arterial pressure in some human patients with precapillary PH. However, the efficacy of pimobendan in dogs with precapillary PH is unknown.
ANIMALS, MATERIAL, AND METHODS: An implantable port device was percutaneously placed in the cranial vena cava of five laboratory beagles. Chronic embolic precapillary PH was induced via the repeated injection of microspheres every 1-2 days. Microsphere injection was continued until systolic pulmonary arterial pressure reached 50 mmHg. Right heart catheterization and echocardiography were performed at baseline and after injections of placebo and pimobendan (0.15 mg/kg).
Repeated injections of microspheres caused an increase in pulmonary vascular resistance, a decrease in stroke volume, RV dilation, left ventricular (LV) and RV dysfunction, and RV dyssynchrony as assessed using echocardiography. Compared with placebo, pimobendan improved LV and RV function based on the LV Tei index from 0.48 to 0.38 (p=0.002) and the RV Tei index from 0.76 to 0.61 (p=0.008), as well as the stroke volume index from 29.4 to 36.7 ml/m (p=0.012), respectively.
In dog models of chronic PH, intravenous pimobendan effectively improved RV and LV function and increased stroke volume. However, pimobendan administration did not decrease pulmonary arterial pressure or produce hypotension.
肺动脉高压(PH)是一种进行性的、潜在致命的疾病。几种药物被用于治疗前毛细血管 PH 的犬。匹莫苯丹是一种具有磷酸二酯酶 3 抑制和钙增敏作用的正性肌力药物。匹莫苯丹在一些前毛细血管 PH 的人类患者中可改善右心室(RV)功能和降低肺动脉压。然而,匹莫苯丹在前毛细血管 PH 的犬中的疗效尚不清楚。
动物、材料和方法:通过经皮将植入式端口装置放置在五只实验室比格犬的头腔静脉中。通过每天 1-2 次重复注射微球来诱导慢性栓塞前毛细血管 PH。微球注射持续到收缩压肺动脉压达到 50mmHg 为止。在基线和注射安慰剂和匹莫苯丹(0.15mg/kg)后进行右心导管检查和超声心动图检查。
重复注射微球导致肺血管阻力增加、每搏量减少、RV 扩张、LV 和 RV 功能障碍以及 RV 不同步,通过超声心动图评估。与安慰剂相比,匹莫苯丹改善了 LV 和 RV 功能,LVTei 指数从 0.48 降至 0.38(p=0.002),RVTei 指数从 0.76 降至 0.61(p=0.008),以及每搏量指数从 29.4 增加到 36.7ml/m(p=0.012)。
在慢性 PH 的犬模型中,静脉内匹莫苯丹有效改善 RV 和 LV 功能并增加每搏量。然而,匹莫苯丹给药并没有降低肺动脉压或产生低血压。