Update on feline hypertrophic cardiomyopathy
Authorship
P.H.P.
Bachelor in Veterinary
P.H.P.
Bachelor in Veterinary
Defense date
02.17.2025 16:00
02.17.2025 16:00
Summary
Hypertrophic Cardiomyopathy (HCM) is one of the most common heart diseases in cats. It is characterized by concentric thickening of the left ventricle. Although it is often subclinical, it can progress to cause heart failure or arterial thromboembolism. In most cases, the underlying cause is unknown. However, mutations in the MYBPC3 and MYH7 genes have been identified as associated with the condition. The most common clinical signs include respiratory distress, presenting as dyspnea and tachypnea, hind limb paralysis, and heart murmurs detected during auscultation. While echocardiography is the gold standard for diagnosis, physical examination, radiography, and the measurement of cardiac biomarkers such as NT-proBNP and cTnI can provide valuable information and help raise suspicion of the disease. The treatment of feline HCM involves a range of pharmacological options aimed at relieving symptoms and preventing complications. Treatment strategies depend on the disease stage and the clinical signs exhibited by the patient. Antiarrhythmic drugs such as ivabradine and atenolol are used to reduce heart rate and improve diastolic function. Spironolactone is employed to lower blood pressure and reduce cardiac workload, while angiotensin-converting enzyme inhibitors (ACE inhibitors) like enalapril and benazepril help decrease afterload and enhance ventricular function. From stage B2 onwards, preventing arterial thromboembolism in cats with enlarged left atria becomes critical, as thrombus formation is associated with high mortality. Anticoagulants such as clopidogrel and rivaroxaban are recommended for this purpose. In cases of congestive heart failure (stages C and D), diuretics like furosemide or torsemide are used to alleviate pulmonary edema. However, the effectiveness of certain medications remains uncertain. For example, pimobendan has shown benefits in some studies but may be harmful in cases of left ventricular outflow tract obstruction (LVOTO) or lead to arrhythmias. Drugs such as digoxin, aspirin, verapamil, and diltiazem are no longer commonly used due to adverse effects, toxicity, or the availability of more effective alternatives. Emerging therapies, including drugs like rapamycin and aficamten, are now being explored. These treatments represent a novel approach, addressing the root cause of the disease by preventing and even reversing cardiac hypertrophy, thus opening the door to new therapeutic possibilities.
Hypertrophic Cardiomyopathy (HCM) is one of the most common heart diseases in cats. It is characterized by concentric thickening of the left ventricle. Although it is often subclinical, it can progress to cause heart failure or arterial thromboembolism. In most cases, the underlying cause is unknown. However, mutations in the MYBPC3 and MYH7 genes have been identified as associated with the condition. The most common clinical signs include respiratory distress, presenting as dyspnea and tachypnea, hind limb paralysis, and heart murmurs detected during auscultation. While echocardiography is the gold standard for diagnosis, physical examination, radiography, and the measurement of cardiac biomarkers such as NT-proBNP and cTnI can provide valuable information and help raise suspicion of the disease. The treatment of feline HCM involves a range of pharmacological options aimed at relieving symptoms and preventing complications. Treatment strategies depend on the disease stage and the clinical signs exhibited by the patient. Antiarrhythmic drugs such as ivabradine and atenolol are used to reduce heart rate and improve diastolic function. Spironolactone is employed to lower blood pressure and reduce cardiac workload, while angiotensin-converting enzyme inhibitors (ACE inhibitors) like enalapril and benazepril help decrease afterload and enhance ventricular function. From stage B2 onwards, preventing arterial thromboembolism in cats with enlarged left atria becomes critical, as thrombus formation is associated with high mortality. Anticoagulants such as clopidogrel and rivaroxaban are recommended for this purpose. In cases of congestive heart failure (stages C and D), diuretics like furosemide or torsemide are used to alleviate pulmonary edema. However, the effectiveness of certain medications remains uncertain. For example, pimobendan has shown benefits in some studies but may be harmful in cases of left ventricular outflow tract obstruction (LVOTO) or lead to arrhythmias. Drugs such as digoxin, aspirin, verapamil, and diltiazem are no longer commonly used due to adverse effects, toxicity, or the availability of more effective alternatives. Emerging therapies, including drugs like rapamycin and aficamten, are now being explored. These treatments represent a novel approach, addressing the root cause of the disease by preventing and even reversing cardiac hypertrophy, thus opening the door to new therapeutic possibilities.
Direction
Santamarina Pernas, Germán (Tutorships)
Santamarina Pernas, Germán (Tutorships)
Court
FOUZ DOPACIO, RAMIRO ANTONIO (Chairman)
VILA PASTOR, MONICA (Secretary)
DE AZEVEDO GOMES, ANA MANUELA (Member)
FOUZ DOPACIO, RAMIRO ANTONIO (Chairman)
VILA PASTOR, MONICA (Secretary)
DE AZEVEDO GOMES, ANA MANUELA (Member)