Myocardial infarction models
Eplerenone improved LV remodeling in rats with LV dysfunction after
extensive MI (Fraccarollo et al., 2003). These results were confirmed by
Wang and colleagues, showing that eplerenone attenuated the cardiac
remodeling and improved the cardiac function in a mouse model of HF
after MI (Wang et al., 2004). Moreover, immediate MR blockade with
eplerenone after MI in mice induced a more rapid accumulation of
monocytes and accelerated macrophage infiltration leading to cytokine
production. The cytokine cascade contributed to the vicious circle by
recruiting and activating inflammatory cells that finally promoted an
increase in neovascularization, leading to a reduced expansion of the
healing process and improving early LV dilation and dysfunction
(Fraccarollo et al., 2008). Interestingly, eplerenone exhibited a
superior efficacy compared with spironolactone during the acute phase of
MI (Fraccarollo et al., 2015). Finerenone also exerted beneficial
effects after MI by the improvement of LV dysfunction, likely through
the maintenance of the coronary reserve and improvement of coronary
endothelial function (Gueret et al., 2016).