Introduction

/Objectives: Whether the aldosterone antagonist spironolactone has beneficial survival effects in dogs with dilated cardiomyopathy (DCM) is not known. The primary objective of the study was to evaluate the effect of spironolactone, when added to conventional therapy, on survival time in Doberman pinschers with congestive heart failure (CHF) due to DCM.

Animals

Sixty-seven client-owned Doberman pinschers with CHF due to DCM.

Materials and Methods

The trial design was prospective, randomized, blinded, and placebo controlled. Dogs were randomized to receive 50-75 mg of spironolactone twice daily (n = 34) or a placebo (n = 33), in addition to standard CHF therapy. Follow-up visits were targeted every 1 to 6 weeks until endpoint. Quality of life questionnaire and physical examination were performed at every visit, while renal biochemistry, ECG, echocardiography, and thoracic radiography were reassessed as needed. The primary endpoint was time to cardiac death, defined as death or euthanasia from CHF or sudden death.

Results

Median time to primary endpoint in the spironolactone group (183 days) was not statistically significantly different than that for the placebo group (124 days) (p=0.254). The development of atrial fibrillation (AF) was significantly less frequent in the spironolactone group (n=7) compared to the placebo group (n=15, p=0.037).

Conclusions

While median time to cardiac death in the spironolactone group was not statistically significantly different than that in the placebo group, adding spironolactone to conventional therapy resulted in reduced occurrence of AF.

中文翻译：

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评估 Do 螺内酯在因扩张型心肌病引起的充血性心力衰竭的短毛猪中的前瞻性临床试验

介绍

/目的：醛固酮拮抗剂螺内酯是否对患有扩张型心肌病 (DCM) 的犬具有有益的生存作用尚不清楚。该研究的主要目的是评估螺内酯添加到常规治疗时对因 DCM 引起的充血性心力衰竭 (CHF) 杜宾犬生存时间的影响。

动物

67 只客户拥有的杜宾犬因 DCM 而出现瑞士法郎。

材料和方法

试验设计为前瞻性、对照、随机、盲法和安慰剂。除了标准的 CHF 治疗外，狗被随机分配接受每天两次 50-75 mg 螺内酯（n = 34）或安慰剂（n = 33）。每 1 至 6 周进行一次随访，直至终点。每次就诊时进行生活质量问卷和体格检查，同时根据需要重新评估肾脏生化、心电图、超声心动图和胸片。主要终点是心源性死亡时间，定义为因 CHF 或猝死而导致的死亡或安乐死。

结果

螺内酯组到主要终点的中位时间（183 天）与安慰剂组（124 天）没有统计学显着差异（p=0.254）。与安慰剂组（n=15，p=0.037）相比，螺内酯组（n=7）发生心房颤动（AF）的频率显着降低。

结论

虽然螺内酯组至心源性死亡的中位时间与安慰剂组相比无统计学差异，但在常规治疗中加入螺内酯可减少 AF 的发生。