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J Vet Intern Med. 2018 Jan;32(1):72-85. doi: 10.1111/jvim.14885. Epub 2017 Dec 6.

Longitudinal Analysis of Quality of Life, Clinical, Radiographic, Echocardiographic, and Laboratory Variables in Dogs with Preclinical Myxomatous Mitral Valve Disease Receiving Pimobendan or Placebo: The EPIC Study.

Author information

1
department of Veterinary Clinical Sciences, The Royal Veterinary College, Hatfield, Hertfordshire, UK.
2
Small Animal Clinical Science, Texas A&M University, College Station, TX.
3
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
4
Clinic of Small Animal Medicine, University of Munich, Munich, Germany.
5
Medical Sciences, University of Wisconsin Madison School of Veterinary Medicine, Madison, WI.
6
Clinical Studies-Philadelphia, MJR-VHUP-Cardiology, University of Pennsylvania, Philadelphia, PA.
7
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
8
Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH.
9
Animal Care Center, Rohnert Park, CA.
10
HeartVets @ Vale Referrals, The Animal Hospital, Dursley, Gloucestershire, UK.
11
Sarah Smith Cardiology, Derby, UK.
12
Animal Medical Center, New York, NY.
13
Rocky Mountain Veterinary Cardiology, Boulder, CO.
14
Cardio Respiratory Pet Referrals Victoria, Mordialloc, Vic., Australia.
15
Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
16
Internal Medicine and Cardiology, Clinique Vétérinaire Aquivet, Eysines, France.
17
Desert Veterinary Medical Specialists, Phoenix, AZ.
18
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
19
Clinique Veterinaire Des Etangs, Villars Les Dombes, France.
20
Clinic for Small Animals Kaiserberg, Duisburg, Germany.
21
Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA.
22
Cardiology, VCA West Los Angeles, Los Angeles, CA.
23
CVCA Cardiac Care for Pets, Towson, MD.
24
Tierklinik am Sandpfad, Wiesloch, Germany.
25
Cardiology, Centre Hospitalier Vétérinaire des Cordeliers, Meaux, France.
26
Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL.
27
Medicina y Cirugía Animal, Universidad de Murcia, Murcia, Spain.
28
Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.
29
Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA.
30
Surgery 1, Azabu University, Sagamihara, Kanagawa, Japan.
31
Blue Pearl Veterinary Partners, Tampa, FL.
32
Chicago Veterinary Emergency and Specialty Center, Chicago, IL.
33
Cardiology, Clinica Veterinaria Malpensa, Gallarate, Varese, Italy.
34
Japan Animal Specialty Medical Institute Inc., JASMINE Veterinary Cardiovascular Medical Center, Yokohama, Japan.
35
Djursjukhuset Albano, Danderyd, Sweden.
36
Animal Health, Boehringer Ingelheim, Ingelheim am Rhein, Germany.

Abstract

BACKGROUND:

Changes in clinical variables associated with the administration of pimobendan to dogs with preclinical myxomatous mitral valve disease (MMVD) and cardiomegaly have not been described.

OBJECTIVES:

To investigate the effect of pimobendan on clinical variables and the relationship between a change in heart size and the time to congestive heart failure (CHF) or cardiac-related death (CRD) in dogs with MMVD and cardiomegaly. To determine whether pimobendan-treated dogs differ from dogs receiving placebo at onset of CHF.

ANIMALS:

Three hundred and fifty-four dogs with MMVD and cardiomegaly.

MATERIALS AND METHODS:

Prospective, blinded study with dogs randomized (ratio 1:1) to pimobendan (0.4-0.6 mg/kg/d) or placebo. Clinical, laboratory, and heart-size variables in both groups were measured and compared at different time points (day 35 and onset of CHF) and over the study duration. Relationships between short-term changes in echocardiographic variables and time to CHF or CRD were explored.

RESULTS:

At day 35, heart size had reduced in the pimobendan group: median change in (Δ) LVIDDN -0.06 (IQR: -0.15 to +0.02), P < 0.0001, and LA:Ao -0.08 (IQR: -0.23 to +0.03), P < 0.0001. Reduction in heart size was associated with increased time to CHF or CRD. Hazard ratio for a 0.1 increase in ΔLVIDDN was 1.26, P = 0.0003. Hazard ratio for a 0.1 increase in ΔLA:Ao was 1.14, P = 0.0002. At onset of CHF, groups were similar.

CONCLUSIONS AND CLINICAL IMPORTANCE:

Pimobendan treatment reduces heart size. Reduced heart size is associated with improved outcome. At the onset of CHF, dogs treated with pimobendan were indistinguishable from those receiving placebo.

KEYWORDS:

Cardiology; Cardiovascular; Echocardiography; Endocardiosis; Heart Failure; Mitral regurgitation

PMID:
29214723
PMCID:
PMC5787203
DOI:
10.1111/jvim.14885
[Indexed for MEDLINE]
Free PMC Article

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