Amelia Sinkin, VMD

Dr. Sinkin is a cardiology resident working under Dr. Amanda Coleman, DVM, DACVIM (Cardiology) at the University of Georgia.

Fellowship Research Project

The focus of her research is myxomatous mitral valve disease (MMVD), a condition that affects an estimated 2 - 4.9 million dogs in the United States and leads to the development of congestive heart failure in approximately 15% of affected animals. The pathogenic role of renin-angiotensin-aldosterone system (RAAS) stimulation in the development and maintenance of MMVD is well accepted. Consequently, pharmacologic RAAS blockade, most frequently attempted through the use of angiotensin-converting enzyme inhibitors (ACEi), is considered standard-of-care for the treatment of patients with congestive heart failure and administration of these drugs is associated with improvement in both clinical signs and survival time in patients.

While the clinical benefit of ACE inhibition is clear, an unexpected and undesirable phenomenon known as aldosterone “breakthrough” (ABT) can occur in some dogs impeding effective treatment. Addition of an aldosterone receptor blocker to standard congestive heart failure therapy may improve patient outcomes; however the evidence-based use of this drug in dogs has yet to be fully defined. The major objective of Dr. Sinkin’s study will be to compare the incidence of ABT in client-owned dogs with advanced MMVD treated with an ACEi (enalapril) or an angiotensin receptor blocker (telmisartan). She hypothesizes that treatment with telmisartan will be associated with a significantly lower incidence of ABT than will treatment with enalapril. The results of this study will provide veterinarians with objective information to guide the way in which they approach RAAS blockade in clinical patients.

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