Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA.
Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA.
J Vet Cardiol. 2023 Aug;48:19-30. doi: 10.1016/j.jvc.2023.05.003. Epub 2023 May 6.
INTRODUCTION/OBJECTIVES: Dogs with severe subaortic stenosis (SAS) are at risk of dying suddenly from fatal arrhythmias. Survival is not improved when treated with pure beta-adrenergic receptor (β)-blockers; however, the effect of other antiarrhythmic drugs on survival is unknown. Sotalol is both a β-blocker and a class III antiarrhythmic drug; the combination of these differing mechanisms may provide benefit to dogs with severe SAS. The primary objective of this study was to compare survival in dogs with severe SAS that were treated with either sotalol or atenolol. The secondary objective was to evaluate the effect of pressure gradient (PG), age, breed, and aortic regurgitation on survival.
Forty-three client-owned dogs.
Retrospective cohort study. Medical records of dogs diagnosed with severe SAS (PG ≥ 80 mmHg) between 2003 and 2020 were reviewed.
No statistical difference was identified in survival time between dogs treated with sotalol (n=14) and those treated with atenolol (n=29) when evaluating all-cause mortality (p=0.172) or cardiac-related mortality (p=0.157). Of the dogs that died suddenly, survival time was significantly shorter in dogs treated with sotalol compared to those treated with atenolol (p=0.046). Multivariable analysis showed that PG (p=0.002) and treatment with sotalol (p=0.050) negatively influenced survival in the dogs that died suddenly.
Sotalol did not have a significant effect on survival overall but may increase the risk of sudden death in dogs with severe SAS compared to atenolol.
简介/目的：患有严重主动脉瓣下狭窄（SAS）的犬有因致命性心律失常而猝死的风险。使用纯β肾上腺素能受体（β）阻滞剂治疗不会提高生存率；然而，其他抗心律失常药物对生存率的影响尚不清楚。索他洛尔既是β阻滞剂又是Ⅲ类抗心律失常药物；这些不同机制的组合可能对患有严重 SAS 的犬有益。本研究的主要目的是比较使用索他洛尔或阿替洛尔治疗的患有严重 SAS 的犬的生存率。次要目的是评估压力梯度（PG）、年龄、品种和主动脉瓣反流对生存率的影响。
43 只患犬。
回顾性队列研究。回顾了 2003 年至 2020 年间诊断为严重 SAS（PG≥80mmHg）的犬的病历。
当评估所有原因死亡率（p=0.172）或心脏相关死亡率（p=0.157）时，使用索他洛尔（n=14）和阿替洛尔（n=29）治疗的犬的生存时间无统计学差异。在突然死亡的犬中，与使用阿替洛尔治疗的犬相比，使用索他洛尔治疗的犬的生存时间明显缩短（p=0.046）。多变量分析表明，PG（p=0.002）和使用索他洛尔治疗（p=0.050）对突然死亡犬的生存有负面影响。
索他洛尔总体上对生存率没有显著影响，但与阿替洛尔相比，可能会增加患有严重 SAS 的犬突然死亡的风险。
