Myxomatous mitral valve disease (MMVD) is the most common cause of congestive heart failure in dogs. Clinical trials have shown favorable effects on survival when dogs in heart failure secondary to MMVD are treated with angiotensin-converting enzyme inhibitors (ACE-Is). Results of the recently completed QUEST (Quality of Life and Extension of Survival Time) study, which was performed to evaluate pimobendan's effect on survival of dogs with heart failure secondary to MMVD, were presented at the 2008 ACVIM meeting. The study compared the time it took to reach the primary endpoint (spontaneous cardiac death, euthanasia for cardiac reasons, or withdrawal from the study due to treatment failure) in those dogs treated with pimobendan or with benazepril in conjunction with other standard therapy. Of the 260 small- and medium-breed dogs enrolled in the study, three quarters reached the primary endpoint. The study found dogs receiving pimobendan plus standard therapy had a longer survival time than those receiving benazepril plus standard therapy. Pimobendan was equally well tolerated as benazepril; adverse effects in dogs receiving either drug were comparable. Analysis demonstrated that the benefit of pimobendan persisted after adjusting for multiple historic, clinical, and therapeutic covariates. Further studies focusing on the effect of combined pimobendan and ACE-I therapy and addressing the importance of pimobendan in large-breed dogs with congestive heart failure secondary to MMVD are needed.
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