Acta Medica Leopoliensia (Sep 2018)

The influence of the blocker of mineralocorticoid receptors eplerenone on the dynamics of the structural-functional state of the myocardium in patients with non Q-wave myocardial infarction after 3 and 6 months of treatment

  • V.P. Ivanov,
  • O.V. Shcherbak,
  • V.Yu. Maslovskyi

DOI
https://doi.org/10.25040/aml2018.03.017
Journal volume & issue
Vol. 24, no. 3
pp. 17 – 23

Abstract

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Aim. Assessment of the dynamics of the structural and functional state of the myocardium in patients with non Q-wave myocardial infarction in 3 and 6 months depending on the use of the blocker of the mineralocorticoid receptors eplerenone. Material and Methods. We examined 77 patients (63.6% males) with non Q-wave myocardial infarction aged from 50 to 79 (mean 64.1±1.0) years. Hospital management strategy was elaborated in accordance with modern standards for the treatment of acute coronary syndrome without ST-elevation, which envisaged stratification of risk on the GRACE scale (estimated risk of mortality in the near future) and the choice of adequate procedure of the invasive strategy. The structural and functional state of the myocardium was evaluated using echocardiography, which was performed in the M-, B- and D-modes. Results and Discussion. A substantial increase in the total score of echocardiographic dynamics at the 6th month was demonstrated, as compared to the 3rd month of treatment, indicating a certain association of positive hemodynamic changes with the duration of basic treatment. An analysis of the total score of echocardiographic dynamics during the 3rd and 6th months of treatment indicated a significant increase in the indicator for all periods of observation in the eplerenone group, which showed a more convincing anti-remodeling effect in the group of patients with non-Q myocardial infarction who were administered the drug. Conclusions. The use of eplerenone in addition to basic treatment is associated with more convincing anti-remodeling and hemodynamic effects during the 3rd and 6th months of treatment. Positive hemodynamic effects of the drug exhibit a certain dependence on the duration of treatment, which is characterized by more powerful dynamics of most echocardiographic parameters on the 6th compared to the 3rd month of observation.

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