Grant: Project Grant

The role of the mitral valve is to prevent the blood going backward in the lungs as the heart pumps forward. In many cardiac diseases, the heart enlarges and becomes too big relatively to the valve size. The valve is distorted by the enlarging heart and can't close completely: the blood starts to go backward in the lungs instead of going forward. This condition is called "functional mitral regurgitation" and is a major complication that accelerates the heart disease, increasing deaths and hospitalisations. There is no good treatment available. After a heart attack, there is also abnormal scarring in the mitral valve, which contributes to the valve dysfunction. A substance named serotonin is released in the blood after a heart attack and we believe that it can cause this abnormal scarring. In animal studies, we have studied a drug named cyproheptadine to counteract the effects of serotonin on the valve, prevent abnormal scarring and preserve the valve function. This drug was working well in those animal experiments and was able to prevent mitral dysfunction after a heart attack. Our research goal is now to test if the beneficial effects of cyproheptadine can be applied to human. We will perform a study in patients with a recent heart attack. Half of the patients will receive cyproheptadine, and the other half will receive a placebo (inactive drug). The patients will be followed for 1 year to see if cyproheptadine is effective to prevent mitral valve regurgitation. This will be evaluated by different imaging techniques. This study will therefore be used to confirm if cyproheptadine can be a useful drug to prevent mitral valve disease in patients who had a heart attack. Preventing mitral regurgitation could help reduce the complications after heart attacks.