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标准剂量和高剂量匹莫苯丹对美国兽医内科学院 B2 级黏液样二尖瓣疾病犬的肾脏和心脏功能选择指标的影响。

Effect of standard-dose and high-dose pimobendan on select indices of renal and cardiac function in dogs with American College of Veterinary Internal Medicine stage B2 myxomatous mitral valve disease.

机构信息

Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA.

Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA.

出版信息

J Vet Intern Med. 2022 Nov;36(6):1892-1899. doi: 10.1111/jvim.16537. Epub 2022 Sep 13.

Abstract

BACKGROUND

Pimobendan might have favorable effects on renal function but this has not been well-studied in dogs with myxomatous mitral valve disease (MMVD).

OBJECTIVES

Determine the effects of standard-dose (SD_pimo) and high-dose pimobendan (HD_pimo) on glomerular filtration rate (GFR) and cardiac size and function in dogs with preclinical MMVD.

ANIMALS

Thirty nonazotemic dogs with stage B2 MMVD.

METHODS

Prospective, randomized, double-blinded, placebo-controlled clinical study. Dogs had an echocardiographic examination, assessment of GFR (iohexol clearance), N-terminal probrain natriuretic peptide (NT-proBNP), and quality of life (QOL) score at baseline and 7 to 10 days after placebo (n = 6), SD_pimo 0.2 to 0.3 mg/kg q12 (n = 12), or HD_pimo 0.5 to 0.6 mg/kg q12h (n = 12).

RESULTS

No significant differences in GFR or QOL scores were detected between groups (P .07). After HD_pimo, the mean [SD] percent change of NT_proBNP (-46.1 [20.2]%), left atrial volume (LAV; -27.1 [16.9]%), left ventricular end-diastolic volume (EDV; -21.8 [15.0]%), and end-systolic volume (ESV; -55.0 [20.7]%) were significantly different (P .004) from placebo (0.5 [19.9]%, 1.3 [15.6]%, -0.2 [8.2]%, -7.3 [35.6]%, respectively) but not the percent change after SD_pimo (-36.6 [16.1]%, -22.7 [14.9]%, -16.7 [12.5]%, -41.6 [14.8]%, respectively; P > .05). After SD_pimo, percent change of NT_proBNP, LAV, EDV, and ESV were significantly different from placebo (P < .05).

CONCLUSIONS AND CLINICAL IMPORTANCE

Results suggest that pimobendan (SD_pimo or HD_pimo) might not affect renal function in nonazotemic dogs with stage B2 MMVD. High-dose pimobendan did not demonstrate advantages over SD_pimo within the constraints of our study.

摘要

背景

匹莫苯丹可能对肾功能有有利影响,但在患有黏液瘤性二尖瓣疾病(MMVD)的犬中尚未得到充分研究。

目的

确定标准剂量(SD_pimo)和高剂量匹莫苯丹(HD_pimo)对临床前 MMVD 犬肾小球滤过率(GFR)和心脏大小及功能的影响。

动物

30 只非氮血症性 B2 期 MMVD 犬。

方法

前瞻性、随机、双盲、安慰剂对照的临床研究。犬在基线时和安慰剂后 7 至 10 天(n = 6)进行超声心动图检查、GFR(碘海醇清除率)、N 端脑利钠肽前体(NT-proBNP)和生活质量(QOL)评分评估,并接受 SD_pimo 0.2 至 0.3 mg/kg q12(n = 12)或 HD_pimo 0.5 至 0.6 mg/kg q12h(n = 12)治疗。

结果

各组间 GFR 或 QOL 评分无显著差异(P.07)。与安慰剂相比,HD_pimo 后 NT-proBNP(-46.1 [20.2]%)、左心房容积(LAV;-27.1 [16.9]%)、左心室舒张末期容积(EDV;-21.8 [15.0]%)和收缩末期容积(ESV;-55.0 [20.7]%)的平均[标准差]变化百分比显著不同(P .004),但与 SD_pimo 相比无显著差异(-36.6 [16.1]%、-22.7 [14.9]%、-16.7 [12.5]%、-41.6 [14.8]%;P .05)。SD_pimo 后,NT-proBNP、LAV、EDV 和 ESV 的百分比变化与安慰剂相比有显著差异(P .05)。

结论和临床意义

结果表明,匹莫苯丹(SD_pimo 或 HD_pimo)可能不会影响 B2 期 MMVD 非氮血症犬的肾功能。在我们的研究范围内,高剂量匹莫苯丹并未显示优于 SD_pimo 的优势。

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Clinical utility of estimation of glomerular filtration rate in dogs.犬肾小球滤过率评估的临床实用性。
J Vet Intern Med. 2020 Jan;34(1):195-205. doi: 10.1111/jvim.15561. Epub 2019 Aug 2.

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