Document Detail

Aldosterone receptor antagonists--how cardiovascular actions may explain their beneficial effects in heart failure.
MedLine Citation:
PMID:  20444035     Owner:  NLM     Status:  MEDLINE    
Historically, aldosterone receptor antagonists (ARA) have been classified as 'potassium sparing diuretics'. However, the positive effect of spironolactone, the most extensively studied ARA, on morbidity and mortality observed in humans suffering cardiac insufficiency could not be explained by the renal effect of the drug alone, and a pivotal clinical study has led to extensive research. Many experimental studies have demonstrated that ARA have previously unexpected beneficial effects on the cardiovascular system including reduction in remodelling of the vascular smooth muscle cells and myocytes and improvement of endothelial cell dysfunction in heart failure. These effects improve vascular compliance and slow down the progression of left ventricular dysfunction and end-organ damage. Furthermore, aldosterone receptor blockade also restores the baroreceptor reflex, improving heart rate variability in heart failure in humans. Some of these effects have been demonstrated in dog models of cardiac disease and so justified further investigation of the potential benefit of ARA in dogs with congestive heart failure (CHF). Positive effects of spironolactone on morbidity and mortality appear to have been seen in studies conducted in dogs suffering from naturally occurring CHF. In addition, eplerenone has been shown to have benefits in canine models of heart failure. The precise mechanisms by which ARA produce these beneficial effects in dogs remain to be determined but this group of drugs clearly provide therapeutic actions out-with their diuretic effects.
P Ovaert; J Elliott; F Bernay; E Guillot; T Bardon
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of veterinary pharmacology and therapeutics     Volume:  33     ISSN:  1365-2885     ISO Abbreviation:  J. Vet. Pharmacol. Ther.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-08-20     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  7910920     Medline TA:  J Vet Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  109-17     Citation Subset:  IM    
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MeSH Terms
Autonomic Nervous System / drug effects
Cardiovascular System / drug effects
Dog Diseases / drug therapy*
Heart Failure / drug therapy,  veterinary*
Mineralocorticoid Receptor Antagonists / pharmacology,  therapeutic use*
Spironolactone / analogs & derivatives*,  pharmacology,  therapeutic use*
Reg. No./Substance:
0/Mineralocorticoid Receptor Antagonists; 27O7W4T232/Spironolactone; 6995V82D0B/eplerenone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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