Benazepril於慢性退行性心臟瓣膜疾病患犬之臨床療效

Abstract

中文摘要 Benazepril屬於血管加壓素轉化酶抑制劑，有抑制腎素－血管加壓素－醛固酮系統的能力，已被廣泛使用在人和犬的高血壓、心臟病及腎臟病。經臨床研究證實，benazepril對於鬱血性心衰竭患犬有改善臨床症狀和增加運動耐受度的效果，並可改善血液動力學參數及延長存活時間。另外，benazepril可減緩慢性腎臟病的惡化。此論文包含三個研究，評估benazepril對於慢性退行性瓣膜疾病引起的心衰竭之患犬在於血壓、心臟超音波學指數及放射線學心臟大小指數的臨床療效。第一個研究的結果指出，benazepril不影響全身血壓，但具有改善臨床症狀的效果。低血壓為benazepril最常見也最被關注的副作用，此研究結果表示benazepril可被安全的使用，不會有造成低血壓的副作用。第二個研究的結果顯示，benazepril具有改善心臟內血液循環及心臟收縮力的效果，並對於縮小過大的心臟也有一定療效。心臟病患犬常有心臟內血液滯留造成之心臟擴大的情況，本研究結果表示benazepril藉由使心臟輸出的壓力減低來增進心臟內及心臟周邊血液循環的效果。第三個研究的結果顯示，benazepril不影響左心室肌肉局部的舒張或收縮及形變的情況。心臟肌肉在心衰竭時會有重塑的病變，此研究結果表示benazepril可減緩此心肌重塑的病變。

Abstract Benazepril, an angiotensin converting enzyme inhibitor, potently suppresses renin-angiotensin-aldosterone system, and is widely used in humans and dogs with hypertension, cardiac diseases, and renal diseases. In clinical studies, benazepril has been proven to have beneficial effect on hemodynamic parameters, clinical conditions, exercise endurance and survival times in dogs with congestive heart failure. Moreover, effect of benazepril on slowing down the progression of renal disease in patients with chronic renal insufficiency has been demonstrated. This thesis includes 3 studies, examinating clinical efficacy of benazpril on systemic blood pressure, conventional echocardiographic indices, speckle tracking echocardiographic variables and radiographic heart scale in small breed dogs with mild to severe heart failure caused by chronic degenerative valvular disease. Result of the first parf of study showed that benazepril improved clinical condition but did not change systemic blood pressure. Result of the second part of study indicated that benazepril had significant effect on improving left atrial indices, end-systolic ventricular indices, and ventricular contractility assessing using M-mode echocardiography, and on reducing radiographic heart scale. Result of the third part of study revealed that benazepril did not have beneficial effect on improving left ventricular segmental myocardial systolic and diastolic function.