Supplementary Material for: The detrimental effect of pre-treatment with ivermectin on myocardial ischemia

Purpose: Ivermectin is a broad-spectrum anti-parasitic agent with potential antibacterial, antiviral and anti-cancer effects. There are limited studies on the effects of ivermectin on cardiovascular diseases, so the present study sought to determine the effects of pre-treatment with ivermectin on myocardial ischemia in both ex vivo and in vivo.
Methods: In the ex vivo part, two groups of control and treated rats with ivermectin (0.2 mg/kg) were examined for cardiac function and arrhythmias by isolated heart perfusion. In the in vivo part, four groups of: control, ivermectin (IVM), Iso (MI), and Iso + IVM 0.2 mg/kg were used. Subcutaneous injection of isoproterenol (100 mg/kg/day) for 2 consecutive days was used for the induction of myocardial infarction in male Wistar rats. Then electrocardiogram, hemodynamic factors, cardiac hypertrophy, and malondialdehyde levels were investigated.
Results: The ex vivo results showed that administration of ivermectin induces cardiac arrhythmia and decreases the left ventricular maximal rate of pressure increase (contractility) and maximal rate of pressure decline (relaxation). The isoproterenol-induced myocardial infarction model used as an in vivo model showed that cardiac hypertrophy were increased with no improvement in the hemodynamic and electrocardiogram pattern in the ivermectin-treated group in comparison to MI (Iso) group. However, the malondialdehyde level was lower in the ivermectin-treated group.
Conclusion: Ivermectin pre-treatment demonstrates detrimental effects in cardiac ischemia through exacerbation of cardiac arrhythmia, myocardial dysfunction, and increased cardiac hypertrophy. Therefore, the use of ivermectin in ischemic heart patients should be done with great caution.