title: Carvedilol in dogs with dilated cardiomyopathy.
abstract: BACKGROUND
  Dilated cardiomyopathy (DCM) is characterized by reduced systolic function, heightened sympathetic tone, and high morbidity and mortality. Little is known regarding the safety and efficacy of beta-blocker treatment in dogs with DCM.
  
  
  OBJECTIVE
  Carvedilol improves echocardiographic and neurohormonal variables in dogs with DCM over a 4-month treatment period.
  
  
  METHODS
  Prospective, placebo-controlled, double-blinded randomized study. Dogs with DCM underwent echocardiography, ECG, thoracic radiographs, and neurohormonal profiling, followed by titration onto carvedilol (0.3 mg/kg q12h) or placebo over a 4-week period and subsequently received 3 months of therapy. Primary study endpoints included left ventricular volume and function.
  
  
  RESULTS
  Sixteen dogs received carvedilol and 7 received placebo. At study end, 13 carvedilol dogs and 5 placebo dogs were alive. There was no difference in the mean percentage change in left ventricular volume at end-diastole (LVVd), left ventricular end-systolic volume (LVVs), and ejection fraction (EF) between treatment groups, suggesting that both groups experienced similar amounts of disease progression. Carvedilol treatment did not result in significant changes in neurohormonal activation, radiographic heart size, heart rate, or owner perceived quality-of-life. Baseline B-type natriuretic peptide (BNP) predicted dogs in the carvedilol-treated group that maintained or improved their EF over the study duration.
  
  
  CONCLUSIONS
  Carvedilol administration did not improve echocardiographic or neurohormonal indicators of heart function. The lack of effect may be related to severity of disease, carvedilol dose, or brevity of follow-up time. Statistical power of the present study was adversely affected by a high fatality rate in study dogs and small sample size.
authors.affiliation: Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA. maoyama@vet.upenn.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Oyama
authors.forename: D David
authors.initials: DD
authors.lastname: Sisson
authors.forename: Robert
authors.initials: R
authors.lastname: Prosek
authors.forename: Barret J
authors.initials: BJ
authors.lastname: Bulmer
authors.forename: Mike W
authors.initials: MW
authors.lastname: Luethy
authors.forename: Virginia Luis
authors.initials: VL
authors.lastname: Fuentes
mesh_terms: D000818:Animals; D002227:Carbazoles / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy / Q000662:veterinary*; D000077261:Carvedilol; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D011412:Propanolamines / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D002227:Carbazoles; D011412:Propanolamines; D014665:Vasodilator Agents; D000077261:Carvedilol