DELay of Appearance of sYmptoms of Canine Degenerative Mitral Valve Disease Treated with Spironolactone and Benazepril: the DELAY Study

被引：37

作者：

Borgarelli, M. ^{[1
]}

Ferasin, L. ^{[2
]}

Lamb, K. ^{[3
]}

Bussadori, C. ^{[4
]}

Chiavegato, D. ^{[5
]}

D'Agnolo, G.

Migliorini, F. ^{[6
]}

Poggi, M. ^{[7
]}

Santilli, R. A. ^{[8
]}

Guillot, E. ^{[9
]}

Garellipaar, C. ^{[9
]}

Corneliani, R. Toschi ^{[10
]}

Farina, F. ^{[11
]}

Zani, A. ^{[12
]}

Dirven, M. ^{[13
]}

Smets, P. ^{[13
]}

Guglielmini, C. ^{[14
]}

Oliveira, P. ^{[15
]}

Di Marcello, M. ^{[16
]}

Porciello, F. ^{[17
]}

Crosara, S. ^{[18
]}

Ciaramella, P. ^{[19
]}

Piantedosi, D. ^{[19
]}

Smith, S. ^{[20
]}

Vannini, S. ^{[4
]}

Dall'Aglio, E. ^{[21
]}

Savarino, P. ^{[22
]}

Quintavalla, C. ^{[23
]}

Patteson, M. ^{[24
]}

Silva, J. ^{[4
]}

Locatelli, C. ^{[25
]}

Toaldo, M. Baron ^{[26
]}

机构：

[1] Virginia Maryland Coll Vet Med, Dept Small Anim Clin Sci, Blacksburg, VA 24061 USA

[2] Lumbry Pk Vet Specialists, Alton, Hants, England

[3] Lamb Stat Consulting & Sci Writing LLC, West St Paul, MN USA

[4] Clin Vet Gran Sasso, Milan, Italy

[5] Clin Vet Arcella, Padua, Italy

[6] Osped Vet Croce Azzura, Rome, Italy

[7] Ctr Vet Imperiese, Imperia, Italy

[8] Clin Vet Malpensa, Samarate Varese, Italy

[9] Ceva St Anim, Libourne, France

[10] Osped Vet San Francesco, Milan, Italy

[11] Ambulatorio Veterinario Parco Margherita, Naples, Italy

[12] Clin Cardiovet, Livorno, Italy

[13] Dierenkliniek Rijen, Rijen, Netherlands

[14] Univ Padua, Dipartimento Med Anim Prod & Salute, Legnaro Padova, Italy

[15] Davies Vet Specialists Ltd, Higham Gobion, Herts, England

[16] Ctr Vet Cellat, Brescia, Italy

[17] Univ Perugia, Dipartimento Med Vet, Perugia, Italy

[18] Clin Vet CMV, Varese, Italy

[19] Univ Napoli Federico II, Dipartimento Med Vet & Prod Anim, Naples, Italy

[20] Sarah Smith Cardiol Ivy Court, Willington, England

[21] Clin Vet Milano Sud, Milan, Italy

[22] Osped Didatt Vet Fac, Fac Med Vet Torino, Sez Clin Med, Turin, Italy

[23] Univ Parma, Dipartimento Sci Med Vet, Parma, Italy

[24] Anim Hosp Stinchcombe, Heartvets, Dursley, England

[25] Univ Milan, Dipartimento Med Vet, Milan, Italy

[26] Univ Bologna, Alma Mayor Studiorum, Dipartimento Sci Med Vet, Ozzano Dell Emilia, Italy

来源：

JOURNAL OF VETERINARY CARDIOLOGY | 2020年 / 27卷

关键词：

Heart; Dog; Heart failure; Therapy; NT-proBNP; CONGESTIVE-HEART-FAILURE; NATRIURETIC PEPTIDE CONCENTRATIONS; CARDIAC TROPONIN-I; ALDOSTERONE BREAKTHROUGH; SURVIVAL CHARACTERISTICS; PROGNOSTIC VARIABLES; DOGS; ENALAPRIL; ECHOCARDIOGRAPHY; ATRIAL;

D O I：

10.1016/j.jvc.2019.12.002

中图分类号：

S85 [动物医学（兽医学）];

学科分类号：

0906 ;

摘要：

Introduction: Efficacy of renin-angiotensin-aldosterone system (RAAS) blockade using angiotensin-converting enzyme inhibitors (ACEi) in dogs with preclinical myxomatous mitral valve disease (MMVD) is controversial. Hypothesis: Administration of spironolactone (2-4 mg q 24 h) and benazepril (0.25-0.5 mg q 24 h) in dogs with preclinical MMVD, not receiving any other cardiac medications, delays the onset of heart failure (HF) and cardiac-related death. Moreover, it reduces the progression of the disease as indicated by echocardiographic parameters and level of cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). Animals: 184 dogs with pre-clinical MMVD and left atrium-to-aortic root ratio (LA:Ao) >= 1.6 and normalized left ventricular end-diastolic diameter (LVEDDn) >= 1.7. Methods: This is a prospective, randomized, multicenter, single-blinded, placebo-controlled study. Primary outcome variable was time-to-onset of first occurrence of HF or cardiac death. Secondary end points included effect of treatment on progression of the disease based on echocardiographic and radiographic parameters, as well as variations of NT-proBNP and cTnI concentrations. Results: The median time to primary end point was 902 days (95% confidence interval (CI) 682-not available) for the treatment group and 1139 days (95% CI 732-NA) for the control group (p = 0.45). Vertebral heart score (p = 0.05), LA:Ao (p < 0.001), LVEDDn (p < 0.001), trans-mitral E peak velocity (p = 0.011), and NT-proBNP (p = 0.037) were lower at the end of study in the treatment group. Conclusions: This study failed in demonstrating that combined administration of spironolactone and benazepril delays onset of HF in dogs with preclinical MMVD. However, such treatment induces beneficial effects on cardiac remodeling and these results could be of clinical relevance. (C) 2020 The Authors. Published by Elsevier B.V.

引用

页码：34 / 53

页数：20

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