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Moreover, a recent prospective study in dogs with naturally occurring mild, asymptomatic mitral valve disease treated with pimobendan demonstrated increased regurgitant fraction and induction of mitral valve lesions including acute focal hemorrhages, endothelial papillary hyperplasia, and infiltration of chordae tendinea with glycosaminoglycans

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J., Tobin, J., Stevens, T., Bellantoni, M

Extracellular Matrix (ECM) Remodeling Increases synthesis of: Collagen Elastin Glycosaminoglycans Proteoglycans Regulates metalloproteinases for balanced tissue remodeling