Penicillin, an elixir to safeguard myocardial function in patients with rheumatic heart disease?

Valvular heart diseases occur following different evitable and inevitable etiologies. Rheumatic valvular heart disease is among preventable etiologies and is almost disappeared in developed nations. In recent literature there are few low-quality evidences available about therapeutic efficacy of penicillin in maintaining and enhancing myocardial function in patients with rheumatic heart disease. In present study we aimed to investigate importance of penicillin in maintaining myocardial function indices within normal range.

In this retrospective descriptive-analytic study we enrolled a number of 682 consecutive patients with rheumatic heart disease. Information about history of treatment with penicillin and associated details along with left ventricular ejection fraction and right ventricular systolic function were collected in a questionnaire. Finally, all data were analyzed using SPSS ver.26 software.

The study population consist of 471 (69.1%) women and 211 (30.9%) men with mean age of 51.17±12.80 years, ranged between 17 and 87. We found that there is a statistically significant association between history of penicillin treatment (P-value=0.036) and left ventricular ejection fraction. Right ventricular systolic function was affected by history of penicillin treatment (P-value=0.040) and duration of treatment (P-value=0.002).

Rather than approved prophylactic effects of penicillin; we conclude that penicillin is also highly effective as a therapeutic agent in maintaining left ventricular ejection fraction and right ventricular systolic function within normal range in patients with rheumatic heart disease.