Peer-reviewed veterinary case report
Spironolactone and benazepril delay heart failure in dogs with mitral
By Borgarelli, M et al.·Published in Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology·2020·Department Small Animal Clinical Science, United States·View original on PubMed →
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Original publication title: DELay of Appearance of sYmptoms of Canine Degenerative Mitral Valve Disease Treated with Spironolactone and Benazepril: the DELAY Study.
- Species:
- dog
Plain-English summary
A group of dogs with early signs of heart disease, specifically myxomatous mitral valve disease, were treated with spironolactone and benazepril to see if it would delay the onset of heart failure. While the treatment did not significantly delay heart failure compared to a control group, it did show positive effects on heart structure and function. The dogs receiving treatment had improved heart measurements and lower levels of certain cardiac biomarkers at the end of the study. This suggests that while the medications may not prevent heart failure, they could still help manage the condition.
People also search for: dog heart disease treatment · spironolactone for dogs · benazepril for dogs heart problems
Abstract
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.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32032923/