Document Detail


The effects of spironolactone on atrial remodeling in patients with preserved left ventricular function after an acute myocardial infarction: a randomized follow-up study.
MedLine Citation:
PMID:  20926948     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVES: Atrial remodeling is an important part of cardiac remodeling after acute myocardial infarction (AMI). The aim of this study was to evaluate the effect of spironolactone on atria in patients with preserved left ventricular (LV) functions after AMI by using two-dimensional and tissue Doppler imaging techniques (TDI).
METHODS: The study consisted of 110 patients with AMI, successfully revascularized with percutaneous coronary intervention, ejection fraction greater than or equal to 40%, and Killip class I-II. Patients were randomized into two groups: conventional therapy (n=55) and additional spironolactone of 25 mg/day with standard conventional therapy (n=55). Echocardiography was performed in the first 48-72 h of AMI and during 6 months of follow-up. Left atrial volume index and emptying fraction were obtained. The peak regional atrial contraction velocity, the time between the onset of p-wave on the monitor ECG and the onset, peak, and the end (TE) of the atrial contraction wave on the tissue Doppler technique curve were measured.
RESULTS: The left atrial volume index and left atrium (LA) dimensions did not significantly change in either group. In the spironolactone group, left atrial emptying fraction increased compared with both baseline value (from 53.0 ± 0.16 to 57.0 ± 0.13 P=0.011) and conventional therapy group (from 50.0 ± 0.17 to 47.0 ± 0.16, P=0.013). The atrial contraction velocity did not change but the LA-TE, interatrial septum-TE, and right atrium-TE were prolonged in the conventional therapy group.
CONCLUSION: Additional spironolactone therapy provided a little benefit on LA remodeling and atrial electromechanic properties in patients with AMI and preserved LV functions.
Authors:
Mehmet Kayrak; Ahmet Bacaksiz; Mehmet A Vatankulu; Selim S Ayhan; Hatem Ari; Zeynettin Kaya; Kurtulus Ozdemir
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  21     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  477-85     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Selcuk University Meram School of Medicine Hospital, Konya, Turkey.
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