Key result
Eplerenone administration attenuated the development of pulmonary hypertension and pathological remodeling of pulmonary arterioles, but had no direct effects on right ventricular structure or function.
Why the study?
Does eplerenone attenuate pulmonary vascular and right ventricular remodeling in mouse models of pulmonary arterial hypertension?
Does eplerenone attenuate pulmonary vascular and right ventricular remodeling in mouse models of pulmonary arterial hypertension?
In mouse models of pulmonary arterial hypertension, eplerenone attenuates pulmonary vascular remodeling but does not directly improve right ventricular structure or function.
May support eplerenone for pulmonary vascular protection in preclinical PAH; leaves open direct RV effects and clinical translation.
BACKGROUND: Aldosterone is a mineralocorticoid hormone critically involved in arterial blood pressure regulation. Although pharmacological aldosterone antagonism reduces mortality and morbidity among patients with severe left-sided heart failure, the contribution of aldosterone to the pathobiology of pulmonary arterial hypertension (PAH) and right ventricular (RV) heart failure is not fully understood. METHODS: The effects of Eplerenone (0.1% Inspra® mixed in chow) on pulmonary vascular and RV remodeling were evaluated in mice with pulmonary hypertension (PH) caused by Sugen5416 injection with concomitant chronic hypoxia (SuHx) and in a second animal model with established RV dysfunction independent from lung remodeling through surgical pulmonary artery banding. RESULTS: Preventive Eplerenone administration attenuated the development of PH and pathological remodeling of pulmonary arterioles. Therapeutic aldosterone antagonism - starting when RV dysfunction was established - normalized mineralocorticoid receptor gene expression in the right ventricle without direct effects on either RV structure (Cardiomyocyte hypertrophy, Fibrosis) or function (assessed by non-invasive echocardiography along with intra-cardiac pressure volume measurements), but significantly lowered systemic blood pressure. CONCLUSIONS: Our data indicate that aldosterone antagonism with Eplerenone attenuates pulmonary vascular rather than RV remodeling in PAH.
No takes yet. Share an insight, caveat, or question.
Boehm et al. (2018) studied Pulmonary arterial hypertension and right ventricular heart failure. Eplerenone was evaluated on Pulmonary vascular and right ventricular remodeling. Eplerenone administration attenuated the development of pulmonary hypertension and pathological remodeling of pulmonary arterioles, but had no direct effects on right ventricular structure or function.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: