title: Influence of beta blockers on survival in dogs with severe subaortic stenosis.
abstract: BACKGROUND
  Subaortic stenosis (SAS) is one of the most common congenital cardiac defects in dogs. Severe SAS frequently is treated with a beta adrenergic receptor blocker (beta blocker), but this approach largely is empirical.
  
  
  OBJECTIVE
  To determine the influence of beta blocker treatment on survival time in dogs with severe SAS.
  
  
  METHODS
  Retrospective review of medical records of dogs diagnosed with severe, uncomplicated SAS (pressure gradient [PG] ≥80 mmHg) between 1999 and 2011.
  
  
  RESULTS
  Fifty dogs met the inclusion criteria. Twenty-seven dogs were treated with a beta blocker and 23 received no treatment. Median age at diagnosis was significantly greater in the untreated group (1.2 versus 0.6 years, respectively; P = .03). Median PG at diagnosis did not differ between the treated and untreated groups (127 versus 121 mmHg, respectively; P = .2). Cox proportional hazards regression was used to identify the influence of PG at diagnosis, age at diagnosis, and beta blocker treatment on survival. In the all-cause multivariate mortality analysis, only age at diagnosis (P = .02) and PG at diagnosis (P = .03) affected survival time. In the cardiac mortality analysis, only PG influenced survival time (P = .03). Treatment with a beta blocker did not influence survival time in either the all-cause (P = .93) or cardiac-cause (P = .97) mortality analyses.
  
  
  CONCLUSIONS
  Beta blocker treatment did not influence survival in dogs with severe SAS in our study, and a higher PG at diagnosis was associated with increased risk of death.
authors.affiliation: College of Veterinary Medicine, University of Missouri, Columbia, MO.
authors.forename: B D
authors.initials: BD
authors.lastname: Eason
authors.forename: D M
authors.initials: DM
authors.lastname: Fine
authors.forename: D
authors.initials: D
authors.lastname: Leeder
authors.forename: C
authors.initials: C
authors.lastname: Stauthammer
authors.forename: K
authors.initials: K
authors.lastname: Lamb
authors.forename: A H
authors.initials: AH
authors.lastname: Tobias
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000367:Age Factors; D000818:Animals; D001020:Aortic Stenosis, Subvalvular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000662:veterinary*; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D004285:Dogs; D015150:Echocardiography, Doppler / Q000662:veterinary; D005260:Female; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Atenolol; Congenital heart disease