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Left ventricular outflow tract pressure gradient changes after carvedilol-disopyramide cotherapy in a cat with

Y Hori1, E Fujimoto1, Y Nishikawa1

  • 1School of Veterinary Medicine, Rakuno Gakuen University, 582 Midori-machi, Bunkyodai, Ebetsu, Hokkaido 069-8501, Japan.

Journal of Veterinary Cardiology : the Official Journal of the European Society of Veterinary Cardiology
|May 29, 2020
PubMed

Insights

Disopyramide may help cats with hypertrophic obstructive cardiomyopathy (HOCM) when beta-blockers are insufficient. This case study shows disopyramide relieved left ventricular outflow tract (LVOT) obstruction in a cat, indicating potential for feline HOCM treatment.

Area of Science:

  • Veterinary Cardiology
  • Pharmacology

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a significant cardiac disease in cats.
  • Disopyramide is effective in reducing left ventricular outflow tract (LVOT) pressure gradients in humans with HOCM.
  • The efficacy of disopyramide in feline HOCM has not been previously reported.

Observation:

  • A 10-month-old Norwegian Forest cat presented with HOCM, characterized by significant LVOT obstruction (flow velocity 5.6 m/s) and elevated N-terminal pro B-type natriuretic peptide (NT-proBNP).
  • Initial treatment with carvedilol resulted in partial improvement, with LVOT flow velocity decreasing to 4.8 m/s and NT-proBNP to 870 pmol/L.
  • Addition of disopyramide to carvedilol therapy led to a marked reduction in LVOT obstruction (0.7 m/s) and NT-proBNP (499 pmol/L) without observed adverse effects.

Findings:

  • Cotherapy with carvedilol and disopyramide effectively resolved left ventricular outflow tract obstruction in a feline patient with HOCM.
  • Disopyramide administration resulted in the disappearance of systolic anterior motion of the mitral valve leaflets.
  • The combination therapy demonstrated a significant decrease in both LVOT flow velocity and NT-proBNP levels, suggesting improved cardiac function and reduced myocardial strain.

Implications:

  • Disopyramide may be a valuable therapeutic option for feline HOCM, particularly in cases with an incomplete response to beta-blocker therapy.
  • This case report highlights the potential of disopyramide to alleviate LVOT obstruction in cats, warranting further investigation.
  • Larger-scale studies are necessary to establish the definitive efficacy and safety profile of disopyramide for treating moderate to severe HOCM in cats.

Keywords:
B-type natriuretic peptideBeta-blockerSodium channel blockerSystolic anterior motion

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