| Mineralocorticoid receptor antagonist spironolactone improves left ventricular remodeling in patients with congestive heart failure and acute myocardial infarction. | |
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MedLine Citation:
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PMID: 15277727 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Randomized aldactone evolution study (RALES) and eplerenone post-AMI heart failure efficacy and survival study (EPHESUS) had shown that aldosterone blockade (AB) with standard therapy resulted in a reduction in mortality in patients with congestive heart failure (CHF) and acute myocardial infarction (AMI). However, the mechanism for the beneficial effect of AB remains unknown. To evaluate the effect of spironolactone (Spi) on left ventricular (LV) remodeling, 34 CHF patients with DCM were randomly divided into the Spi (+) or Spi (-) groups. Four months of treatment with Spi improved the LV volume and mass. To evaluate the effect of Spi on post-infarct LV remodeling, 134 patients with first anterior AMI were randomly divided into the Spi (+) or Spi (-) groups after revascularization. LV ejection fraction was significantly improved after 1 month in the Spi (+) group compared with that in the Spi (-) group. LV end-diastolic volume index was significantly suppressed in the Spi (+) group compared with that in the Spi (-) group. Transcardiac extraction of aldosterone through the heart was significantly suppressed in the Spi (+) group and was significant lower in the Spi (+) group compared with the Spi (-) group. These findings indicate that AB combined with standard therapy can prevent LV remodeling in patients with CHF and AMI, suggesting that the failing heart is the target organ of the aldosterone. |
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Authors:
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Takayoshi Tsutamoto |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Review |
Journal Detail:
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Title: Nihon yakurigaku zasshi. Folia pharmacologica Japonica Volume: 124 ISSN: 0015-5691 ISO Abbreviation: Nippon Yakurigaku Zasshi Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-07-27 Completed Date: 2004-10-25 Revised Date: 2011-07-27 |
Medline Journal Info:
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Nlm Unique ID: 0420550 Medline TA: Nihon Yakurigaku Zasshi Country: Japan |
Other Details:
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Languages: eng Pagination: 90-100 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta-Tsukinowa, Otsu 520-2192, Japan. tutamoto@belle.shiga-med.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aldosterone Antagonists / pharmacology, therapeutic use* Female Heart Failure / drug therapy*, physiopathology Humans Male Middle Aged Myocardial Infarction / physiopathology Randomized Controlled Trials as Topic Spironolactone / pharmacology, therapeutic use* Ventricular Remodeling / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Aldosterone Antagonists; 52-01-7/Spironolactone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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