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Effects of long-term monotherapy with eplerenone, a novel aldosterone blocker, on progression of left ventricular dysfunction and remodeling in dogs with heart failure.
- Source :
-
Circulation [Circulation] 2002 Dec 03; Vol. 106 (23), pp. 2967-72. - Publication Year :
- 2002
-
Abstract
- Background: In heart failure (HF), aldosterone has been implicated in the formation of reactive interstitial fibrosis, a maladaptation that contributes to left ventricular (LV) remodeling. Eplerenone is a novel selective aldosterone blocker. The present study examined the effects of long-term monotherapy with eplerenone on the progression of LV dysfunction and remodeling in dogs with chronic HF.<br />Methods and Results: HF was produced in 14 dogs by intracoronary microembolizations that were discontinued when LV ejection fraction (EF) was between 30% and 40%. Two weeks after the last embolization, dogs were randomized to 3 months of oral therapy with eplerenone (10 mg/kg twice daily, n=7) or no therapy at all (control, n=7). Hemodynamic measurements were made just before randomization and were repeated at the end of 3 months of therapy. In control dogs, LV end-diastolic and end-systolic volume increased significantly (62+/-4 versus 68+/-4 mL, P<0.001, and 38+/-3 versus 47+/-3 mL, P<0.001, respectively), and EF decreased significantly (38+/-1% versus 31+/-2%, P<0.001). In contrast, end-diastolic volume, end-systolic volume, and EF remained unchanged during the 3 months of treatment in eplerenone-treated dogs. LV end-diastolic wall stress increased significantly in control dogs but decreased significantly in eplerenone-treated dogs. Compared with control, eplerenone was associated with a 28% reduction in cardiomyocyte cross-sectional area, a 37% reduction of volume fraction of reactive interstitial fibrosis, and a 34% reduction of volume fraction of replacement fibrosis.<br />Conclusions: Our results indicate that long-term therapy with eplerenone prevents progressive LV dysfunction and attenuates LV remodeling in dogs with chronic HF.
- Subjects :
- Administration, Oral
Animals
Chronic Disease
Disease Models, Animal
Disease Progression
Dogs
Echocardiography
Enzyme Activation drug effects
Eplerenone
Fibroblast Growth Factor 2 genetics
Fibroblast Growth Factor 2 metabolism
Heart drug effects
Heart Failure complications
Heart Failure pathology
Hemodynamics drug effects
Myocardium metabolism
Myocardium pathology
RNA, Messenger metabolism
Stroke Volume drug effects
Treatment Outcome
Ventricular Dysfunction, Left complications
Ventricular Dysfunction, Left prevention & control
Heart Failure drug therapy
Mineralocorticoid Receptor Antagonists therapeutic use
Spironolactone analogs & derivatives
Spironolactone therapeutic use
Ventricular Dysfunction, Left drug therapy
Ventricular Remodeling drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4539
- Volume :
- 106
- Issue :
- 23
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 12460880
- Full Text :
- https://doi.org/10.1161/01.cir.0000039104.56479.42