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Unread 09-29-2006   #1 (permalink)
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Default Effect of ramipril on left ventricular mass, diastolic function, and neurohormones in feline hypertrophic cardiomyopathy -- Dissertation

Hypertrophic cardiomyopathy (HCM) is the most common heart disease of cats, and has been found to be an autosomal inherited defect with incomplete penetrance in Maine Coon cats. Affected cats develop concentric left ventricular hypertrophy, myocardial fibrosis, and often have diastolic dysfunction. Congestive heart failure or arterial thromboembolism are potential devastating sequelae to severe HCM. In this study, the technique of cardiac magnetic resonance imaging (cMRI) for quantification of LV mass was validated in normal cats, and used cMRI for LV mass quantification in cats affected with HCM. We also identified that gradient echo cMRI, using Simpson\'s rule, is not an effective method for identification of diastolic function compared to Doppler tissue imaging echocardiography in cats with HCM. Likewise, contrast enhancement cMRI does not appear to be a useful technique to non-invasively quantify myocardial fibrosis in cats with HCM. This study evaluated the effects of ramipril, an angiotensin converting enzyme inhibitor on left ventricular mass, diastolic function, delayed contrast enhancement cMRI, plasma neurohormones (brain natnuretic peptide and aldosterone), and systolic blood pressure. 26 cats were treated with ramipril or placebo in a blinded fashion for one year. There was no statistical or clinical difference in any measured parameters between cats treated with ramipril versus cats treated with placebo. In conclusion, while the current study lacked statistical power to find differences in the measured parameters to be statistically significant, the use of ramipril in asymptomatic cats with moderate to severe HCM does not appear to cause clinically relevant changes in left ventricular mass, diastolic function, or plasma neurohormones.


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