Jun 7, 2014

Effects of spironolactone treatment in elderly women with heart failure and preserved left ventricular ejection fraction

Journal of Cardiac Failure
Karla M KurrelmeyerAnita Deswal

Abstract

Although spironolactone has been shown to decrease morbidity and mortality in patients with heart failure and reduced left ventricular ejection fraction, its role in patients with heart failure and preserved left ventricular ejection fraction (HFpEF) is not well defined. In this study we investigated the mechanisms involved when elderly women with HFpEF are treated with spironolactone. Forty-eight women with HFpEF were enrolled in a randomized placebo-controlled trial and were assigned to 25 mg spironolactone daily (n = 24) or placebo (n = 24) for 6 months. Six-minute walk distance, clinical composite score, Doppler echocardiography, and biomarkers were determined at baseline and after 3 and 6 months of therapy. Six months of spironolactone treatment stabilized clinical symptoms, as demonstrated by significant worsening of the clinical composite score in the placebo group (P = .02). In addition, spironolactone treatment improved diastolic function by significantly increasing early diastolic tissue Doppler velocity of the lateral mitral annulus (lateral e'; P = .003) and significantly reducing the mitral peak E velocity to lateral e' ratio (lateral E/e'; P = .0001). Finally, spironolactone favorably affected remodeling through a...Continue Reading

Mentioned in this Paper

Peptide Growth Factors Deficiency
Creatinine
Procollagen Type III-N-terminal peptide
Morbidity Aspects
Aldosterone Measurement
Procollagen Type I Carboxy Terminal Peptide Measurement
Troponin I
Spiro von ct
Blood Vessel
Fibrillar Collagen

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