| Effect of aldosterone antagonism on exercise tolerance, Doppler diastolic function, and quality of life in older women with diastolic heart failure. | |
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MedLine Citation:
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PMID: 19379452 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Optimal therapy for diastolic heart failure (DHF), the most common form of heart failure in older persons, is unclear. To determine the effect of aldosterone antagonism in DHF, the authors conducted an open-label preliminary trial of spironolactone 25 mg/d in 11 women with DHF. Cardiopulmonary exercise testing, Doppler echocardiography, and a quality-of-life survey were administered at baseline and after 4 months. Peak exercise VO(2) increased by 8.3% (P=.001), the ratio of Doppler diastolic early filling velocity to mitral annulus velocity decreased by 25% (P=.02), quality-of-life score improved by 21% (P=.16 for trend), and median New York Heart Association class improved from class III to class II (P=.004). Findings from this preliminary study confirm the role of aldosterone in the pathophysiology of DHF and suggest that aldosterone antagonism may benefit such patients. These hypotheses are currently being tested in two separated National Institutes of Health-funded, randomized trials, the Spironolactone for Failure in the Elderly (SPIFFIE) and the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trials. |
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Authors:
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Kurt R Daniel; Gretchen Wells; Kathryn Stewart; Brian Moore; Dalane W Kitzman |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Congestive heart failure (Greenwich, Conn.) Volume: 15 ISSN: 1751-7133 ISO Abbreviation: Congest Heart Fail Publication Date: 2009 Mar-Apr |
Date Detail:
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Created Date: 2009-04-21 Completed Date: 2009-08-04 Revised Date: 2012-05-17 |
Medline Journal Info:
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Nlm Unique ID: 9714174 Medline TA: Congest Heart Fail Country: United States |
Other Details:
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Languages: eng Pagination: 68-74 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1045, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aldosterone Antagonists / therapeutic use* Blood Flow Velocity / drug effects Blood Pressure / drug effects Diastole / drug effects Echocardiography, Doppler / drug effects* Exercise Test / drug effects* Female Follow-Up Studies Heart Failure / drug therapy*, psychology, ultrasonography Humans Middle Aged Oxygen / blood Quality of Life / psychology* Spironolactone / therapeutic use* Ventricular Function, Left / drug effects |
| Grant Support | |
ID/Acronym/Agency:
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AG18915/AG/NIA NIH HHS; M01 RR007122-178332/RR/NCRR NIH HHS; MO1RR07122/RR/NCRR NIH HHS; P30 AG021332-089013/AG/NIA NIH HHS; P60AG10484/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37 AG018915-10/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Aldosterone Antagonists; 52-01-7/Spironolactone; 7782-44-7/Oxygen |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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