Introduction/objectives

Dogs with severe subaortic stenosis (SAS) are at risk of dying suddenly from fatal arrhythmias. Survival is not improved when treated with pure beta-adrenergic receptor (β)-blockers; however, the effect of other antiarrhythmic drugs on survival is unknown. Sotalol is both a β-blocker and a class III antiarrhythmic drug; the combination of these differing mechanisms may provide benefit to dogs with severe SAS. The primary objective of this study was to compare survival in dogs with severe SAS that were treated with either sotalol or atenolol. The secondary objective was to evaluate the effect of pressure gradient (PG), age, breed, and aortic regurgitation on survival.

Animals

Forty-three client-owned dogs.

Materials and methods

Retrospective cohort study. Medical records of dogs diagnosed with severe SAS (PG ≥ 80 mmHg) between 2003 and 2020 were reviewed.

Results

No statistical difference was identified in survival time between dogs treated with sotalol (n = 14) and those treated with atenolol (n = 29) when evaluating all-cause mortality (p=0.172) or cardiac-related mortality (p=0.157). Of the dogs that died suddenly, survival time was significantly shorter in dogs treated with sotalol compared to those treated with atenolol (p=0.046). Multivariable analysis showed that PG (p=0.002) and treatment with sotalol (p=0.050) negatively influenced survival in the dogs that died suddenly.

Conclusions

Sotalol did not have a significant effect on survival overall but may increase the risk of sudden death in dogs with severe SAS compared to atenolol.

中文翻译：

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索他洛尔与阿替洛尔治疗与严重主动脉下狭窄犬生存的相关性

简介/目标

患有严重主动脉瓣下狭窄（SAS）的狗有因致命性心律失常突然死亡的风险。使用纯 β 肾上腺素能受体 (β) 阻滞剂治疗时，生存率并未得到改善；然而，其他抗心律失常药物对生存的影响尚不清楚。索他洛尔既是β受体阻滞剂，又是III类抗心律失常药；这些不同机制的结合可能会给患有严重 SAS 的狗带来好处。本研究的主要目的是比较接受索他洛尔或阿替洛尔治疗的严重 SAS 犬的生存情况。次要目标是评估压力梯度（PG）、年龄、品种和主动脉瓣关闭不全对生存的影响。

动物

四十三只客户拥有的狗。

材料和方法

回顾性队列研究。对 2003 年至 2020 年间诊断为严重 SAS（PG ≥ 80 mmHg）的狗的医疗记录进行了审查。

结果

在评估全因死亡率（p = 0.172）或心脏相关死亡率（p = 0.157）时，使用索他洛尔（n = 14）治疗的狗和使用阿替洛尔（n = 29）治疗的狗之间的生存时间没有统计学差异。在突然死亡的狗中，接受索他洛尔治疗的狗的存活时间明显短于接受阿替洛尔治疗的狗（p=0.046）。多变量分析表明，PG（p = 0.002）和索他洛尔治疗（p = 0.050）对突然死亡的狗的生存产生负面影响。

结论

与阿替洛尔相比，索他洛尔对总体生存没有显着影响，但可能会增加患有严重 SAS 的狗猝死的风险。