pimobendan....extrapolation from MVD to mitral dysplasia and tricuspid dysplasia???

RE: pimobendan....extrapolation from MVD to mitral dysplasia and tricuspid dysplasia???

Roger Wilkinson — Mon, 27 Jul 2020 18:22:36 GMT

sadly no ££ for Holter at this point :( I had to do the scan FOC

RE: pimobendan....extrapolation from MVD to mitral dysplasia and tricuspid dysplasia???

Julian Earl — Mon, 27 Jul 2020 14:27:05 GMT

A PubMed search comes up with this page which covers a lot. Alas searching for Pimendoban draws a blank. Maybe you can follow the links there rthat arecir=ted and come up with something helpful?

https://pubmed.ncbi.nlm.nih.gov/29296595/

he abstract includes this comment: Risk of cardiac death was significantly increased if syncope had occurred.

An edit: A search for the trade name does come up with this though:

https://pubmed.ncbi.nlm.nih.gov/22928748/

It might be more useful?

RE: pimobendan....extrapolation from MVD to mitral dysplasia and tricuspid dysplasia???

Dave Dickson — Mon, 27 Jul 2020 11:11:41 GMT

Huh, interesting one. I haven't done the same "experiment" but I do think pimo helps a lot in some of these cases, albeit temporarily. I think diuretics are usually the least important part of the treatment for AF/RCHF cases - not to say they don't help, but more that a combination of inotropic support and rate control usually does most of the job for you. Are you still going to Holter?

Dave

RE: pimobendan....extrapolation from MVD to mitral dysplasia and tricuspid dysplasia???

Roger Wilkinson — Wed, 15 Jul 2020 19:28:34 GMT

OK, dredging this up from the past because today I saw a Frenchie whom I first saw 3 weeks ago with tricuspid dysplasia (insufficiency and degree of stenosis judging by PHT) + AF + R CHF with voluminous ascites. I intended that she should start on torsemide + pimobendan + diltiazem + digoxin but for reasons too complicated to explain she actually ended up getting pimobendan alone.

Anyway, today I saw her planning to Holter her for mean HR and slightly alarmed to find her unorthodox medication regime......but ascites all gone (scanned her abdo) despite still in AF with comparable rate to last time.

Interesting huh.

Entertaining to debate the theoreticals of pimo in R heart disease but I'm impressed by this actual (uncontrolled, single case) evidence of benefit.

I'm presuming no one else was incompetent enough to ever engineer a similar scenario!

cardio regards

Roger

RE: pimobendan....extrapolation from MVD to mitral dysplasia and tricuspid dysplasia???

Dave Dickson — Tue, 05 Nov 2019 17:59:16 GMT

Hi Roger

I too am interested in what others do. For the record, I use pimo in both MV & TV dysplasia. I have some thoughts but I won't air them until we get some more opinions.

It's an evidence free-zone so anything goes!

Dave

P.S. See you at VCS on Friday?