Eplerenone was superior to spironolactone in improving 7-day survival, early cardiac dilation, and functional decline after experimental acute myocardial infarction in mice.
Does eplerenone or spironolactone improve cardiac repair and survival in a mouse model of acute myocardial infarction?
In a mouse model of acute myocardial infarction, eplerenone demonstrated superior efficacy over spironolactone in improving survival, cardiac function, and promoting healing via modulation of monocyte maturation and neovessel formation.
Abstract Aims The selective mineralocorticoid receptor (MR) antagonist eplerenone given early in patients with acute myocardial infarction (MI) improves clinical outcome, whereas little is known about the effectiveness of early spironolactone therapy. We aimed to compare the ability of eplerenone and spironolactone to promote cardiac repair after experimental MI. Methods and results Starting immediately after coronary artery ligation, C57BL/6J mice were treated with placebo, eplerenone, or spironolactone. At 7 days, treatment with eplerenone orspironolactone reduced thinning and expansion of healing infarct and improved early left ventricular chamber enlargement. Remarkably, eplerenone therapy resulted in significantly greater improvement than spironolactone of left ventricular contractile function and relaxation, associated with a more considerable leftward and downward shift of the pressure volume curve. Seven-day survival rate was significantly increased only in eplerenone treated mice. Moreover, eplerenone was superior to spironolactone in amelioratin neovessel formation in the injured myocardium. Optimized flow cytometry analysis of the monocyte differentiation marker Ly6C revealed predominant accumulation of Ly6Chigh monocytes/macrophages at the site of ischemic injury during the early inflammatory phase in placebo-treated mice. In contrast, MR antagonism, especially by eplerenone, led to a skewing of the monocyte/macrophage population toward a higher frequency of healing promoting Ly6Clow cells. Conclusion The MR antagonist eplerenone versus spironolactone showed superiorefficacy during the acute MI phase with more beneficial effects on survival, early cardiac dilation, and functional decline. Modulation of monocyte maturation and enhanced infarct neovessel formation appears to play a pivotal role.
Fraccarollo et al. (Tue,) conducted a other in Acute myocardial infarction. Eplerenone vs. Spironolactone and placebo was evaluated on Cardiac repair, left ventricular function, and 7-day survival. Eplerenone was superior to spironolactone in improving 7-day survival, early cardiac dilation, and functional decline after experimental acute myocardial infarction in mice.