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Antiarrhythmic and Anti-Inflammatory Effects of Sacubitril/Valsartan on Post-Myocardial Infarction Scar. | LitMetric

AI Article Synopsis

  • - Sacubitril/valsartan (Sac/Val) shows better outcomes than β-blockers in reducing heart failure risks and improving myocardial scar remodeling after a myocardial infarction (MI) in pigs.
  • - In a study with 22 pigs post-MI, those treated with β-blocker plus Sac/Val exhibited significant reductions in inflammatory markers, scar mass, and specific types of collagen in the heart.
  • - The combination treatment also led to lowered risk of ventricular tachycardia, indicating a potential therapeutic benefit for heart health after MI.

Article Abstract

Background: Sacubitril/valsartan (Sac/Val) is superior to angiotensin-converting enzyme inhibitors in reducing the risk of heart failure hospitalization and cardiovascular death, but its mechanistic data on myocardial scar after myocardial infarction (MI) are lacking. The objective of this work was to assess the effects of Sac/Val on inflammation, fibrosis, electrophysiological properties, and ventricular tachycardia inducibility in post-MI scar remodeling in swine.

Methods: After MI, 22 pigs were randomized to receive β-blocker (BB; control, n=8) or BB+Sac/Val (Sac/Val, n=9). The systemic immune response was monitored. Cardiac magnetic resonance data were acquired at 2-day and 29-day post MI to assess ventricular remodeling. Programmed electrical stimulation and high-density mapping were performed at 30-day post MI to assess ventricular tachycardia inducibility. Myocardial samples were collected for histological analysis.

Results: Compared with BB, BB+Sac/Val reduced acute circulating leukocytes (=0.009) and interleukin-12 levels (=0.024) at 2-day post MI, decreased C-C chemokine receptor type 2 expression in monocytes (=0.047) at 15-day post MI, and reduced scar mass (=0.046) and border zone mass (=0.043). It also lowered the number and mass of border zone corridors (=0.009 and =0.026, respectively), scar collagen I content (=0.049), and collagen I/III ratio (=0.040). Sac/Val reduced ventricular tachycardia inducibility (=0.034) and the number of deceleration zones (=0.016).

Conclusions: After MI, compared with BB, BB+Sac/Val was associated with reduced acute systemic inflammatory markers, reduced total scar and border zone mass on late gadolinium-enhanced magnetic resonance imaging, and lower ventricular tachycardia inducibility.

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Source
http://dx.doi.org/10.1161/CIRCEP.123.012517DOI Listing

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