Effect of spironolactone on diastolic function and left ventricular mass in Maine coon cats with familial hypertrophic cardiomyopathy

Kristin A. MacDonald, Mark D Kittleson, Philip H Kass

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32 Citations (Scopus)

Abstract

Background: Myocardial fibrosis occurs in cats with hypertrophic cardiomyopathy (HCM), and is one factor that leads to diastolic dysfunction. Spironolactone (SPIR) reduces myocardial fibrosis in several models of HCM and in humans with cardiac disease. Hypothesis: SPIR will improve diastolic function and reduce left ventricular (LV) mass in Maine Coon cats with HCM. Methods: Maine Coon cats with familial HCM were included if there was concentric hypertrophy (≥6 mm end diastolic wall thickness) and decreased early lateral mitral annular velocity (Em) or summated early and late mitral annular velocity (EAsum) measured by pulsed wave tissue Dopplet imaging echocardiography. Cats were paired by Em-EAsum and randomized to receive 2 mg/kg SPIR (n = 13) or placebo (n = 13) PO q12 h for 4 months. Em-EAsum, systolic velocity, LV mass, and the ratio of left atrial to aortic diameter were measured at baseline, 2 months, and 4 months. Statistical analysis included 2-way repeated measures analysis of variance and the Student's t-test. Results: Plasma aldosterone concentration increased in cats treated with SPIR (235 ng/mL, baseline; 935 ng/mL, 2 months; 1,077 μg/mL, 4 months; P < .001 at 2 and 4 months). No significant treatment effect was identified for early or early-late summated diastolic mitral annular velocity or any other variable except plasma aldosterone concentration. Severe facial ulcerative dermatitis developed in 4 of 13 cats treated with SPIR, requiring discontinuation of the drug. Conclusion: SPIR did not improve Em or EAsum of the lateral mitral annulus or alter LV mass over 4 months. One third of cats treated with SPIR developed severe ulcerative facial dermatitis.

Original languageEnglish (US)
Pages (from-to)335-341
Number of pages7
JournalJournal of Veterinary Internal Medicine
Volume22
Issue number2
DOIs
StatePublished - Mar 2008

Fingerprint

spironolactone
Familial Hypertrophic Cardiomyopathy
Spironolactone
cardiomyopathy
Left Ventricular Function
Cats
cats
Hypertrophic Cardiomyopathy
aldosterone
Dermatitis
dermatitis
Aldosterone
fibrosis
Fibrosis
echocardiography
heart diseases
Maine coon
hypertrophy
Hypertrophy
placebos

Keywords

  • Aldosterone
  • Early mitral annular velocity
  • Mineralocorticoid receptor blocker
  • Tissue Doppler imaging
  • Ulcerative dermatitis

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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title = "Effect of spironolactone on diastolic function and left ventricular mass in Maine coon cats with familial hypertrophic cardiomyopathy",
abstract = "Background: Myocardial fibrosis occurs in cats with hypertrophic cardiomyopathy (HCM), and is one factor that leads to diastolic dysfunction. Spironolactone (SPIR) reduces myocardial fibrosis in several models of HCM and in humans with cardiac disease. Hypothesis: SPIR will improve diastolic function and reduce left ventricular (LV) mass in Maine Coon cats with HCM. Methods: Maine Coon cats with familial HCM were included if there was concentric hypertrophy (≥6 mm end diastolic wall thickness) and decreased early lateral mitral annular velocity (Em) or summated early and late mitral annular velocity (EAsum) measured by pulsed wave tissue Dopplet imaging echocardiography. Cats were paired by Em-EAsum and randomized to receive 2 mg/kg SPIR (n = 13) or placebo (n = 13) PO q12 h for 4 months. Em-EAsum, systolic velocity, LV mass, and the ratio of left atrial to aortic diameter were measured at baseline, 2 months, and 4 months. Statistical analysis included 2-way repeated measures analysis of variance and the Student's t-test. Results: Plasma aldosterone concentration increased in cats treated with SPIR (235 ng/mL, baseline; 935 ng/mL, 2 months; 1,077 μg/mL, 4 months; P < .001 at 2 and 4 months). No significant treatment effect was identified for early or early-late summated diastolic mitral annular velocity or any other variable except plasma aldosterone concentration. Severe facial ulcerative dermatitis developed in 4 of 13 cats treated with SPIR, requiring discontinuation of the drug. Conclusion: SPIR did not improve Em or EAsum of the lateral mitral annulus or alter LV mass over 4 months. One third of cats treated with SPIR developed severe ulcerative facial dermatitis.",
keywords = "Aldosterone, Early mitral annular velocity, Mineralocorticoid receptor blocker, Tissue Doppler imaging, Ulcerative dermatitis",
author = "MacDonald, {Kristin A.} and Kittleson, {Mark D} and Kass, {Philip H}",
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T1 - Effect of spironolactone on diastolic function and left ventricular mass in Maine coon cats with familial hypertrophic cardiomyopathy

AU - MacDonald, Kristin A.

AU - Kittleson, Mark D

AU - Kass, Philip H

PY - 2008/3

Y1 - 2008/3

N2 - Background: Myocardial fibrosis occurs in cats with hypertrophic cardiomyopathy (HCM), and is one factor that leads to diastolic dysfunction. Spironolactone (SPIR) reduces myocardial fibrosis in several models of HCM and in humans with cardiac disease. Hypothesis: SPIR will improve diastolic function and reduce left ventricular (LV) mass in Maine Coon cats with HCM. Methods: Maine Coon cats with familial HCM were included if there was concentric hypertrophy (≥6 mm end diastolic wall thickness) and decreased early lateral mitral annular velocity (Em) or summated early and late mitral annular velocity (EAsum) measured by pulsed wave tissue Dopplet imaging echocardiography. Cats were paired by Em-EAsum and randomized to receive 2 mg/kg SPIR (n = 13) or placebo (n = 13) PO q12 h for 4 months. Em-EAsum, systolic velocity, LV mass, and the ratio of left atrial to aortic diameter were measured at baseline, 2 months, and 4 months. Statistical analysis included 2-way repeated measures analysis of variance and the Student's t-test. Results: Plasma aldosterone concentration increased in cats treated with SPIR (235 ng/mL, baseline; 935 ng/mL, 2 months; 1,077 μg/mL, 4 months; P < .001 at 2 and 4 months). No significant treatment effect was identified for early or early-late summated diastolic mitral annular velocity or any other variable except plasma aldosterone concentration. Severe facial ulcerative dermatitis developed in 4 of 13 cats treated with SPIR, requiring discontinuation of the drug. Conclusion: SPIR did not improve Em or EAsum of the lateral mitral annulus or alter LV mass over 4 months. One third of cats treated with SPIR developed severe ulcerative facial dermatitis.

AB - Background: Myocardial fibrosis occurs in cats with hypertrophic cardiomyopathy (HCM), and is one factor that leads to diastolic dysfunction. Spironolactone (SPIR) reduces myocardial fibrosis in several models of HCM and in humans with cardiac disease. Hypothesis: SPIR will improve diastolic function and reduce left ventricular (LV) mass in Maine Coon cats with HCM. Methods: Maine Coon cats with familial HCM were included if there was concentric hypertrophy (≥6 mm end diastolic wall thickness) and decreased early lateral mitral annular velocity (Em) or summated early and late mitral annular velocity (EAsum) measured by pulsed wave tissue Dopplet imaging echocardiography. Cats were paired by Em-EAsum and randomized to receive 2 mg/kg SPIR (n = 13) or placebo (n = 13) PO q12 h for 4 months. Em-EAsum, systolic velocity, LV mass, and the ratio of left atrial to aortic diameter were measured at baseline, 2 months, and 4 months. Statistical analysis included 2-way repeated measures analysis of variance and the Student's t-test. Results: Plasma aldosterone concentration increased in cats treated with SPIR (235 ng/mL, baseline; 935 ng/mL, 2 months; 1,077 μg/mL, 4 months; P < .001 at 2 and 4 months). No significant treatment effect was identified for early or early-late summated diastolic mitral annular velocity or any other variable except plasma aldosterone concentration. Severe facial ulcerative dermatitis developed in 4 of 13 cats treated with SPIR, requiring discontinuation of the drug. Conclusion: SPIR did not improve Em or EAsum of the lateral mitral annulus or alter LV mass over 4 months. One third of cats treated with SPIR developed severe ulcerative facial dermatitis.

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