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Effects of Spironolactone Treatment in Elderly Women with Heart Failure and Preserved Left Ventricular Ejection Fraction.
MedLine Citation:
PMID:  24905296     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: 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 investigate the mechanisms involved when elderly women with HFpEF are treated with spironolactone.
METHODS AND RESULTS: Forty-eight women with HFpEF were enrolled in a randomized, placebo controlled trial and were assigned to spironolactone 25 mg 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=0.02). In addition, spironolactone treatment improved diastolic function by significantly increasing early diastolic tissue Doppler velocity of the lateral mitral annulus (lateral e') (p=0.003) and significantly reducing the mitral peak E velocity to lateral e' ratio (lateral E/e') (p=0.0001). Finally, spironolactone favorably affected remodeling through a reduction in myocardial fibrosis measured by a reduction in type III procollagen (PIIINP) levels (p=0.035). Six minute walk distance did not significantly improve with spironolactone treatment compared to placebo.
CONCLUSIONS: Spironolactone stabilizes functional capacity and symptoms and improves diastolic function possibly through its ability to suppress type III pro-collagen synthesis.
Authors:
Karla M Kurrelmeyer; Yelena Ashton; Jiaqiong Xu; Sherif F Nagueh; Guillermo Torre-Amione; Anita Deswal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-3
Journal Detail:
Title:  Journal of cardiac failure     Volume:  -     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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