The Role of Mineralocorticoid Receptor Antagonists in Heart Failure with Reduced Ejection Fraction

Current Pharmaceutical Design
Vasilios PapademetriouKonstantinos Stavropoulos

Abstract

Heart failure (HF) is a worldwide modern epidemic, associated with significant morbidity and mortality. Several causes have been identified for the syndrome, most of which share common pathophysiologic pathways, including neurohormonal activation. Central to the latter lies activation of the reninangiotensin- aldosterone system, and its effects on cardiovascular disease progression. The aim of this review is to summarize the pathophysiology of aldosterone and the effects of its blockage in the failing heart, as well as to provide state-of-the-art evidence, and address future perspectives regarding the use of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction. Literature was reviewed for studies that assess the pathophysiology of aldosterone in HF with reduced ejection fraction (HFrEF), and the effects of mineralocorticoid receptor antagonists (MRAs) in this condition. Several major society guidelines have synthesized the available evidence on HFrEF management, and drugs that block the renin-angiotensin-aldosterone system at different levels continue to form the key component of standard of care for these patients. Mineralocorticoid receptor antagonists are an important part of HFrEF pharmacol...Continue Reading

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Citations

Jan 1, 2018·Current Pharmaceutical Design·Konstantinos V StavropoulosCharles J Faselis
May 27, 2020·Basic Research in Cardiology·Ilona CuijpersEbba Brakenhielm

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