Document Detail


Effect of aldosterone antagonism on exercise tolerance, Doppler diastolic function, and quality of life in older women with diastolic heart failure.
MedLine Citation:
PMID:  19379452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kurt R Daniel; Gretchen Wells; Kathryn Stewart; Brian Moore; Dalane W Kitzman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Congestive heart failure (Greenwich, Conn.)     Volume:  15     ISSN:  1751-7133     ISO Abbreviation:  Congest Heart Fail     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-08-04     Revised Date:  2012-05-17    
Medline Journal Info:
Nlm Unique ID:  9714174     Medline TA:  Congest Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-74     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1045, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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:
0/Aldosterone Antagonists; 52-01-7/Spironolactone; 7782-44-7/Oxygen
Comments/Corrections

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