title: Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: a prospective, controlled, blinded, and randomized study.
abstract: BACKGROUND
  Pimobendan (PIMO) is an inodilator that may have some beneficial effects in canine degenerative mitral valve disease (MVD). However, little information is available about its cardiac effects in dogs without systolic myocardial dysfunction.
  
  
  OBJECTIVE
  Compared to benazepril (BNZ), an angiotensin-converting enzyme inhibitor, PIMO may worsen valve regurgitation in early canine MVD.
  
  
  METHODS
  Twelve Beagles with asymptomatic MVD were randomized into 2 groups (n = 6) receiving BNZ or PIMO at dosages of 0.25 mg/kg PO q24h and q12h respectively, for 512 days.
  
  
  METHODS
  The study followed a blinded, randomized, prospective, and parallel group design. After day 512, the dogs were necropsied, and cardiac histopathology was performed in a blinded manner.
  
  
  RESULTS
  A significant treatment effect was observed as soon as day 15 with increased systolic function in the PIMO group by comparison to baseline value as assessed by fractional shortening (P < .0001) and tissue Doppler variables (P = .001). Concurrently, the maximum area and peak velocity of the regurgitant jet signal increased (P < .001), whereas these variables remained stable in the BNZ group. Histologic grades of mitral valve lesions were more severe in the PIMO group than in the BNZ group. Moreover, acute focal hemorrhages, endothelial papillary hyperplasia, and infiltration of chordae tendinae with glycosaminoglycans were observed in the mitral valves of dogs from the PIMO group but not in those of the BNZ group.
  
  
  CONCLUSIONS
  PIMO has adverse cardiac functional and morphologic effects in dogs with asymptomatic MVD. Additional investigation in dogs with symptomatic MVD is now warranted.
authors: Unité de Cardiologie d'Alfort, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94 704 Maisons-Alfort, France. vchetboul@vet-alfort.fr
authors: Valérie
authors: V
authors: Chetboul
authors: Hervé P
authors: HP
authors: Lefebvre
authors: Carolina Carlos
authors: CC
authors: Sampedrano
authors: Vassiliki
authors: V
authors: Gouni
authors: Vittorio
authors: V
authors: Saponaro
authors: François
authors: F
authors: Serres
authors: Didier
authors: D
authors: Concordet
authors: Audrey P
authors: AP
authors: Nicolle
authors: Jean-Louis
authors: JL
authors: Pouchelon
mesh_terms: D000818:Animals; D001552:Benzazepines / Q000009:adverse effects* / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004311:Double-Blind Method; D004452:Echocardiography / Q000187:drug effects / Q000662:veterinary; D008944:Mitral Valve Insufficiency / Q000188:drug therapy / Q000662:veterinary*; D009206:Myocardium / Q000473:pathology; D011724:Pyridazines / Q000009:adverse effects* / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D001552:Benzazepines; D011724:Pyridazines; C041648:pimobendan; C044946:benazepril