Efficacy of enalapril for prevention of congestive heart failure in dogs with myxomatous valve disease and asymptomatic mitral regurgitation.
We evaluated the long-term effect of early angiotensin-converting enzyme (ACE) inhibition (enalapril maleate) as monotherapy to postpone or prevent congestive heart failure (CHF) in asymptomatic dogs with mitral regurgitation (MR) attributable to myxomatous valvular disease (MVD) in a prospective, randomized, double-blinded, placebo-controlled multicenter trial involving 14 centers in Scandinavia. Two hundred twenty-nine Cavalier King Charles (CKC) Spaniels with MR attributable to MVD but no signs of CHF were randomly allocated to treatment with enalapril 0.25-0.5 mg daily (n = 116) or to placebo groups (n = 113). Each dog was evaluated by physical examination, electrocardiography, and thoracic radiography at entry and every 12 months (+/-30 days). The number of dogs developing heart failure was similar in the treatment and placebo groups (n = 50 [43%] and n = 48 [42%], respectively; P = .99). The estimated means, adjusted for censored observations, for the period from initiation of therapy to heart failure were 1,150 +/- 50 days for dogs in the treatment group and 1,130 +/- 50 days for dogs in the placebo group (P = .85). When absence or presence of cardiomegaly at the entrance of the trial was considered, there were still no differences between the treatment and placebo groups (P = .98 and .51, respectively). Multivariate analysis showed that enalapril had no significant effect on the time from initiation of therapy to heart failure (P = .86). Long-term treatment with enalapril in asymptomatic dogs with MVD and MR did not delay the onset of heart failure regardless of whether or not cardiomegaly was present at initiation of the study.
Kvart
Clarence
C
Department of Animal Physiology, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala. clarence.kvart@djfys.slu.se
Häggström
Jens
J
Pedersen
Henrik Duelund
HD
Hansson
Kerstin
K
Eriksson
Anders
A
Järvinen
Anna-Kaisa
AK
Tidholm
Anna
A
Bsenko
Karina
K
Ahlgren
Erik
E
Ilves
Mikael
M
Ablad
Björn
B
Falk
Torkel
T
Bjerkfås
Ellen
E
Gundler
Susanne
S
Lord
Peter
P
Wegeland
Gudrun
G
Adolfsson
Eva
E
Corfitzen
Jens
J
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D018572:Disease-Free Survival; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control*; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004562:Electrocardiography / Q000662:veterinary; D004656:Enalapril / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000517:prevention & control / Q000662:veterinary*; D006349:Heart Valve Diseases / Q000150:complications / Q000662:veterinary*; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000662:veterinary*; D015999:Multivariate Analysis; D010808:Physical Examination / Q000662:veterinary; D011446:Prospective Studies; D011859:Radiography; D012537:Scandinavian and Nordic Countries; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril