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The EPIC trial's report concluded: "Chronic oral administration of pimobendan to dogs with echocardiographic and radiographic evidence of cardiomegaly [enlargement] secondary to MMVD, in the absence of concurrent cardiovascular medication, results in the prolongation of the preclinical period, and is safe and well tolerated." Note that, as big a step as the EPIC trial took for promoting pimobendan, its investigators still emphasized the necessity of both "echocardiographic and radiographic [x-ray] evidence" that the dog's heart is enlarged due to MVD

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DOI: 10.1016/j.ccc.2021.03.010