[논문]만성 이첨판 폐쇄부전증 이환된 견에서 피모벤단의 임상적 효과

남소정; 박인철; 현창백

만성 이첨판 폐쇄부전증 이환된 견에서 피모벤단의 임상적 효과
Clinical Efficacy of Pimobendan on Dogs with Chronic Mitral Valvular Diseases 원문보기

Journal of veterinary clinics = 한국임상수의학회지, v.26 no.1 = no.66, 2009년, pp.17 - 22

남소정 (강원대학교 수의(학부)대학 소동물 내과교실) , 박인철 (강원대학교 수의(학부)대학 방사선학 교실) , 현창백 (강원대학교 수의(학부)대학 소동물 내과교실)

초록
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피모벤단은 최근에 발견되어, 만성 이첨판 폐쇄부전증에 의한 중등도에서 심한 울혈성 심부전을 관리하는데 유용하게 사용되는 심장성 약물이다. 아직까지 개에서 피모벤단의 효능과 안전성에 대한 의견이 분분하다. 따라서 본 연구는 최적의 효능과 안전성을 알아보기 위하여 만성 이첨판 폐쇄부전증에 이환된 20마리의 개를 평가하였다. 일반적인 심장 약물 처방에 피모벤단을 추가한 뒤 삶의 질, 호흡부전, 순환부전과 심부전의 상태를 방사선과 심초음파 검사와 함께 두 달간 평가하였다. 본 연구에서는 진행된 만성 이첨판 폐쇄부전증에 이환된 개에서 피모벤단이 특별한 부작용 없이 긍정적인 치료 효과를 보이는 것으로 나타났다. 그러나 다른 심장 처방약과 피모벤단의 상호 작용 효과에 중점을 둔 연구와 이첨판 폐쇄부전증이 아닌 다른 심장질병에 의한 개와 다른 동물의 심부전에 어떠한 치료효과를 보이는지 평가하는 추가적인 연구가 필요할 것이다.

Abstract ▼ AI-Helper

Pimobendan is a recently developed cardiac drug which is useful to control moderate to severe congestive heart failure (CHF) from chronic mitral valvular diseases (CMVI). Because of controversy related to the efficacy and safety of pimobendan in dogs, the optimal efficacy and safety of pimobendan was assessed in 20 dogs with CMVI in this study. Scores for quality of life, respiratory failure, circulatory failure and heart failure were evaluated along with radiographical and echocardiographical assessments for about 2 months period after the addition of pimobendan into the regular cardiac medications. This study proved clear evidence that pimobendan had beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.

주제어

AI 본문요약
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문제 정의

Due to debate related to the efficacy and safety of pimobendan in dogs with CMVI, the optimal efficacy and safety of pimobendan was assessed in this study, to clarify the debate.

제안 방법

Right lateral and dorsoventral projections were used for thoracic radiography. Cardiomegaly was assessed with the vertebral heart scale method and the presence of pulmonary edema was scored (Table 1). For echocardiography, the diameter of left atrium, the LA/Ao ratio, the left ventricular internal diameter in diastole (LVIDd), left ventricular internal diameter in systole (LVIDs), end systolic volume index (ESVI), end diastolic volume index (EDVI) and the fractional shortening (%FS) were measured as described in elsewhere (2,20) The percent decrease in each cardiac index was calculated as follows: % decrease = [baseline value (day 0) – measured value (at day 7 and day 56) / baseline value] × 100.
enalapril or benazepril). In our study, we evaluated the quality of life, the severity of respiratory and circulatory failures, radiographical and echocardiographical parameters for CMVI after treatment of pimobendan along with other cardiac therapeutics. As noticed in earlier studies (7,16), detectable improvement of clinical scores (e.

대상 데이터

Twenty dogs (8 males and 12 females) with chronic mitral valvular disease (CMVI), weighed under 7 kg (4.25 ± 1.55 kg) were enrolled in this study.

데이터처리

Statistical analysis was performed, using one-way ANOVA within treatment group as a between-animal factor and time as a within-animal, repeated-measures factor to determine whether significant differences existed in data for quality of life and respiratory failure score, circulatory failure score, diagnostic imaging study variables (LA:Ao ratio, LA diameter, LVIDd, LVIDs, % FS, ESVI, EDVI, VHS score) over time from the baseline values. When appropriate, a post hoc multiple comparisons t-test was applied within groups, using the Bonferroni correction to keep the experimental error rate at p<0.
When appropriate, a post hoc multiple comparisons t-test was applied within groups, using the Bonferroni correction to keep the experimental error rate at p<0.05.

이론/모형

International Small Animal Cardiac Health Council (ISACHC) score was used to score the severity of heart failure (Table l).

성능/효과

In conclusion, this study provides clear evidence that pimobendan has beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.
This suggested the beneficial therapeutic effect might start from the improved left ventricular systolic function. Statistically significant improvement in other echocardiographical parameters except %FS was more clearly evident from day 56, suggesting that the beneficial therapeutic effect from pimobendan might be time-dependent, so that pimobendan should be administered for certain period of time, to achieve therapeutic effects in dogs with CMVI.
Our study limitations were that i) the study period was too short to evaluate long-term therapeutic and adverse effects in dogs with CMVI from pimobendan treatment, ii) this study was not a survival study so that we could not evaluate whether the pimobendan might decrease mortality from CMVI and might lengthen survival period after pimobendan treatment, iii) this study was not a placebo-controlled blinded study so that we could not clearly declare the significant improvement in clinical scores and echocardiographical parameters might be entirely achieved from the pimobendan alone or interactive effects with other cardiac therapeutics administered concurrently. Therefore the long-term and more controlled study is required to clarify these study limitations.

후속연구

In conclusion, this study provides clear evidence that pimobendan has beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.

참고문헌 (22)

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