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).