{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:54:11Z","timestamp":1788267251025,"version":"build-2803163510"},"reference-count":16,"publisher":"American Veterinary Medical Association (AVMA)","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"sc_a1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the safety and survival data for dogs with congestive heart failure (CHF) and myxomatous mitral valve disease (MMVD) treated chronically with sacubitril\/valsartan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was completed by identifying dogs with CHF from MMVD and a prescription for sacubitril\/valsartan over a 2.8-year period (from February 2023 to December 2025). Dogs that had surgical intervention, left atrial decompression, or an adverse event that necessitated discontinuation of sacubitril\/valsartan therapy were removed from survival analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>50 dogs with CHF and MMVD, treated with sacubitril\/valsartan (mean \u00b1 SD dosage, 18.1 \u00b1 5.4 mg\/kg, PO, q 12 h) were identified. Five dogs were removed prior to survival analysis. The median survival time after the first episode of CHF was 577 days (range, 431 to 751) for 45 dogs. The survival time in 28 stage D MMVD\u2013affected dogs, 446.5 days (283; 619), was lower than that of 17 stage C MMVD\u2013affected dogs, who had a median survival time of 1,149 (570; infinity) days. Three dogs (6%) had adverse events, suggesting that adverse events secondary to sacubitril\/valsartan were rare in this population. After initiation of sacubitril\/valsartan and titration to the target dose, the most common improvements were in energy level and exercise capacity (83% of dogs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sacubitril\/valsartan therapy in dogs appears safe and suggests median survival times that eclipse those of prior canine MMVD stage C or D CHF studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a5\">\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>This study reports a dosing schedule and clinical tolerance of sacubitril\/valsartan. It further provides important data for planning future prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/ajvr.26.02.0048","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:57:52Z","timestamp":1776265072000},"source":"Crossref","is-referenced-by-count":1,"title":["Long-term sacubitril\/valsartan is well tolerated in dogs with heart failure and myxomatous mitral valve disease and suggests excellent survival benefits"],"prefix":"10.2460","volume":"87","author":[{"given":"Justin A.","family":"Carlson","sequence":"first","affiliation":[{"name":"The Animal Cardiology Center, Brooklyn, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-5745","authenticated-orcid":true,"given":"Joshua A.","family":"Stern","sequence":"additional","affiliation":[{"name":"Office of Research and Graduate Studies, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"11","key":"B1","series-title":"N Engl J Med","first-page":"993","article-title":"Angiotensin-neprilysin inhibition versus enalapril in heart failure","author":"McMurray JJ","year":"2014","unstructured":"McMurray JJ, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993\u20131004. doi:10.1056\/NEJMoa1409077"},{"issue":"18","key":"B2","series-title":"Circulation","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","author":"Heidenreich PA","year":"2022","unstructured":"Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines. Circulation. 2022;145(18):e895\u2013e1032. doi:10.1161\/CIR.0000000000001063"},{"key":"B3","series-title":"Front Vet Sci","first-page":"700230","article-title":"Short-term effects of sacubitril\/valsartan on echocardiographic parameters in dogs with symptomatic myxomatous mitral valve disease","author":"Saengklub N","year":"2021","unstructured":"Saengklub N, Pirintr P, Nampimoon T, Kijtawornrat A, Chaiyabutr N. Short-term effects of sacubitril\/valsartan on echocardiographic parameters in dogs with symptomatic myxomatous mitral valve disease. Front Vet Sci. 2021;8:700230. doi:10.3389\/fvets.2021.700230"},{"key":"B4","series-title":"Eur J Pharm Sci","first-page":"103","article-title":"Sacubitril\/valsartan (LCZ696) significantly reduces aldosterone and increases cGMP circulating levels in a canine model of RAAS activation","author":"Mochel JP","year":"2019","unstructured":"Mochel JP, Teng CH, Peyrou M, Giraudel J, Danhof M, Rigel DF. Sacubitril\/valsartan (LCZ696) significantly reduces aldosterone and increases cGMP circulating levels in a canine model of RAAS activation. Eur J Pharm Sci. 2019;128:103\u2013111. doi:10.1016\/j.ejps.2018.11.037"},{"issue":"11","key":"B5","series-title":"J Card Fail","first-page":"987","article-title":"Effects of angiotensin-neprilysin inhibition in canines with experimentally induced cardiorenal syndrome","author":"Sabbah HN","year":"2020","unstructured":"Sabbah HN, Zhang K, Gupta RC, Xu J, Singh-Gupta V. Effects of angiotensin-neprilysin inhibition in canines with experimentally induced cardiorenal syndrome. J Card Fail. 2020;26(11):987\u2013997. doi:10.1016\/j.cardfail.2020.08.009"},{"issue":"11","key":"B6","series-title":"Int J Mol Sci","first-page":"6169","article-title":"Study on the effects of angiotensin receptor\/neprilysin inhibitors on renal haemodynamics in healthy dogs","author":"Ishizaka M","year":"2024","unstructured":"Ishizaka M, Yamamori Y, Hsu HH, Miyagawa Y, Takemura N, Ogawa-Yasumura M. Study on the effects of angiotensin receptor\/neprilysin inhibitors on renal haemodynamics in healthy dogs. Int J Mol Sci. 2024;25(11):6169. doi:10.3390\/ijms25116169"},{"key":"B7","series-title":"Front Cardiovasc Med","first-page":"1048077","article-title":"Effect of angiotensin receptor-neprilysin inhibitor on atrial electrical instability in atrial fibrillation","author":"Zhu T","year":"2022","unstructured":"Zhu T, Zhang W, Yang Q, et al. Effect of angiotensin receptor-neprilysin inhibitor on atrial electrical instability in atrial fibrillation. Front Cardiovasc Med. 2022;9:1048077. doi:10.3389\/fcvm.2022.1048077"},{"issue":"5","key":"B8","series-title":"J Vet Intern Med","first-page":"1909","article-title":"Echocardiographic quantitation of left heart size and function in 122 healthy dogs: a prospective study proposing reference intervals and assessing repeatability","author":"Visser LC","year":"2019","unstructured":"Visser LC, Ciccozzi MM, Sintov DJ, Sharpe AN. Echocardiographic quantitation of left heart size and function in 122 healthy dogs: a prospective study proposing reference intervals and assessing repeatability. J Vet Intern Med. 2019;33(5):1909\u20131920. doi:10.1111\/jvim.15562"},{"issue":"3","key":"B9","series-title":"J Vet Intern Med","first-page":"311","article-title":"Allometric scaling of M-mode cardiac measurements in normal adult dogs","author":"Cornell CC","year":"2004","unstructured":"Cornell CC, Kittleson MD, Torre PD, et al. Allometric scaling of M-mode cardiac measurements in normal adult dogs. J Vet Intern Med. 2004;18(3):311\u2013321. doi:10.1111\/j.1939-1676.2004.tb02551.x"},{"issue":"6","key":"B10","series-title":"Vet Radiol Ultrasound","first-page":"568","article-title":"Left atrial to aortic root indices using two-dimensional and m-mode echocardiography in Cavalier King Charles Spaniels with and without left atrial enlargement","author":"Hansson K","year":"2002","unstructured":"Hansson K, H\u00e4ggstr\u00f6m J, Kvart C, Lord P. Left atrial to aortic root indices using two-dimensional and m-mode echocardiography in Cavalier King Charles Spaniels with and without left atrial enlargement. Vet Radiol Ultrasound. 2002;43(6):568\u2013575. doi:10.1111\/j.1740-8261.2002.tb01051.x"},{"issue":"3","key":"B11","series-title":"J Vet Intern Med","first-page":"1127","article-title":"ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs","author":"Keene BW","year":"2019","unstructured":"Keene BW, Atkins CE, Bonagura JD, et al. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med. 2019;33(3):1127\u20131140. doi:10.1111\/jvim.15488"},{"issue":"11","key":"B12","series-title":"J Am Vet Med Assoc","first-page":"1864","article-title":"Development and evaluation of a questionnaire for assessing health-related quality of life in dogs with cardiac disease","author":"Freeman LM","year":"2005","unstructured":"Freeman LM, Rush JE, Farabaugh AE, Must A. Development and evaluation of a questionnaire for assessing health-related quality of life in dogs with cardiac disease. J Am Vet Med Assoc. 2005;226(11):1864\u20131868. doi:10.2460\/javma.2005.226.1864"},{"issue":"5","key":"B13","series-title":"J Vet Intern Med","first-page":"1555","article-title":"A prospective, randomized, double-blind, placebo-controlled pilot study of sacubitril\/valsartan (Entresto) in dogs with cardiomegaly secondary to myxomatous mitral valve disease","author":"Newhard DK","year":"2018","unstructured":"Newhard DK, Jung S, Winter RL, Duran SH. A prospective, randomized, double-blind, placebo-controlled pilot study of sacubitril\/valsartan (Entresto) in dogs with cardiomegaly secondary to myxomatous mitral valve disease. J Vet Intern Med. 2018;32(5):1555\u20131563. doi:10.1111\/jvim.15240"},{"issue":"5","key":"B14","series-title":"J Vet Intern Med","first-page":"1124","article-title":"Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study","author":"H\u00e4ggstr\u00f6m J","year":"2008","unstructured":"H\u00e4ggstr\u00f6m J, Boswood A, O\u2019Grady M, et al. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. J Vet Intern Med. 2008;22(5):1124\u20131135. doi:10.1111\/j.1939-1676.2008.0150.x"},{"issue":"2","key":"B15","series-title":"J Vet Intern Med","first-page":"258","article-title":"Chordae tendineae rupture in dogs with degenerative mitral valve disease: prevalence, survival, and prognostic factors (114 cases, 2001-2006)","author":"Serres F","year":"2007","unstructured":"Serres F, Chetboul V, Tissier R, et al. Chordae tendineae rupture in dogs with degenerative mitral valve disease: prevalence, survival, and prognostic factors (114 cases, 2001-2006). J Vet Intern Med. 2007;21(2):258\u2013264. doi:10.1892\/0891-6640(2007)21[258:ctridw]2.0.co;2"},{"key":"B16","year":"2006","unstructured":"ENACARD. Package insert. Merial Ltd; 2006."}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/87\/8\/ajvr.26.02.0048.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/87\/8\/ajvr.26.02.0048.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/87\/8\/ajvr.26.02.0048.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:25:13Z","timestamp":1785511513000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/87\/8\/ajvr.26.02.0048.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":16,"journal-issue":{"issue":"8"},"URL":"https:\/\/doi.org\/10.2460\/ajvr.26.02.0048","relation":{},"ISSN":["0002-9645","1943-5681"],"issn-type":[{"value":"0002-9645","type":"print"},{"value":"1943-5681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]}}}