eplerenone and Hyperplasia

Primary aldosteronism occurs in 1-10% of hypertensive patients and is classified in adenomas or bilateral adrenal hyperplasia. Computed tomography (CT) or magnetic resonance imaging can be used to discriminate these subtypes and in guiding treatment selection. This case report describes a 65-year-old man with hypertension and hypokalaemia during 25 years. Bilateral adrenal hyperplasia was diagnosed based on a CT, and an oral sodium-loading test with measurement of renin and aldosterone confirmed the diagnosis. Blood pressure and potassium in plasma was normalized during treatment with the mineralocorticoid receptor antagonist eplerenon.

Topics: Adrenal Glands; Aged; Eplerenone; Humans; Hyperplasia; Hypertension; Male; Mineralocorticoid Receptor Antagonists; Spironolactone

Topics: Angioplasty, Balloon, Coronary; Animals; Collagen; Coronary Restenosis; Disease Models, Animal; Eplerenone; Humans; Hyperplasia; Mineralocorticoid Receptor Antagonists; Spironolactone; Stents; Swine; Tunica Intima

Enhanced extracellular matrix accumulation rather than cell proliferation contributes to later stages of in-stent restenosis. Aldosterone itself has been shown to increase cardiovascular fibrosis, therefore, we studied the suppressive effects of eplerenone, a new aldosterone receptor antagonist, on neointimal hyperplasia after coronary stent implantation in swine.. Palmatz-Shatz stents were implanted in the left anterior descending artery of 36 pigs. One hundred milligrams of Eplerenone was orally administered from 1 week before, to 4 weeks after stent implantation in Group E (n=18), and vehicle was given to Group C (n=18). Pigs were sacrificed 1 or 4 weeks after stent implantation. The number of infiltrating macrophages was calculated at 1 week. Morphometrical analysis was performed to measure the area of each layer, and %area of fibrosis and mRNA for collagen I, III and TGF-beta was analyzed by RT-PCR at 4 weeks.. The number of infiltrating macrophages was less in Group E than in Group C (p<0.01). The overall size of coronary arteries at 4 weeks was similar in both groups. However, the luminal area was larger in Group E than in Group C (p<0.05), and the intimal area was smaller in Group E than in Group C (p<0.05). The %area of fibrosis was significantly less in Group E than in Group C at 4 weeks (p<0.01). In Group E, the expression of mRNA for collagen I, III and TGF-beta was significantly reduced.. Orally administered eplerenone attenuated collagen accumulation within the neointima, thereby inhibiting neointimal hyperplasia after stent implantation.

Topics: Actins; Administration, Oral; Animals; Blood Vessel Prosthesis Implantation; Collagen Type I; Collagen Type III; Coronary Restenosis; Coronary Vessels; Disease Models, Animal; Eplerenone; Fibrosis; Hyperplasia; Immunohistochemistry; Macrophages; Male; Mineralocorticoid Receptor Antagonists; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Spironolactone; Stents; Swine; Time Factors; Transforming Growth Factor beta; Tunica Intima