International Medical Journal, Vol. 23., Iss. 2, 2017, P. 5−10.
THE EFFECT OF EPLERENONE ON THE GALECTIN-3 DYNAMICS AND THE STATE OF POST-INFARCTION REMODELING IN PATIENTS WITH RIGHT VENTRICLE MYOCARDIAL INFARCTION
Kharkiv Medical Academy of Postgraduate Education
City Clinical Hospital № 1, Sumy, Ukraine
Mainstreaming of urgent reperfusion strategy in treatment of myocardial infarction with ST−segment elevation has made it possible to achieve significant results in reducing hospital mortality. However, development and progression of heart failure is still a frequent complication of both acute period of myocardial infarction, increasing the risk of death, and a factor significantly aggravating the long−term prognosis in such patients. The key role in formation of acute myocardial dysfunction is played by activation of renin−angiotensin−aldosterone system, the effects of which consist in development of endothelial dysfunction, myocardium hypertrophy, activation of inflammation and fibrosis. Additional administration of aldosterone antagonists in patients with myocardial infarction and reduced systolic function of the left ventricle is accompanied by a significant improvement in survival rates. The study comparing the results of treatment with eplerenone and traditional therapy was performed with the purpose to evaluate the effect of selective aldosterone antagonist eplerenone on the dynamics of galectin−3 and the state of post−infarction remodeling in patients with right ventricle myocardial infarction against a background of the Q− myocardial infarction of the left ventricular posterior wall. All patients were performed Doppler echocardiography on the 4th−5th day of myocardial infarction and 6 months after it. Galectin−3 concentration was determined on the 2nd day of myocardial infarction and 6 months after it using immunoenzyme assay. Significant reduction in the size and volume of the left and right ventricle, reduction of the diameter of the left and right atria, increase in left ventricle ejection fraction and right ventricle shortening fraction were noted in the dynamics of the treatment, normalization of the left and right ventricle diastolic function was registered after 6 months of therapy. Our findings demonstrate that addition of eplerenone to standard therapy in patients with right ventricle myocardial infarction against a background of the Q−myocardial infarction left ventricle posterior wall is associated with a significant improvement of systolic function and diastolic filling of the left a significant reduction of galectin−3 concentration within the 6−month follow−up.
Key words: eplerenone, right ventricular myocardial infarction, galectin−3, myocardial remodeling, diastolic dysfunction.