Effect of spironolactone on left ventricular ejection fraction and volumes in patients with class I or II heart failure

Am J Cardiol. 2010 Nov 1;106(9):1292-6. doi: 10.1016/j.amjcard.2010.06.052. Epub 2010 Sep 9.

Abstract

The beneficial effects of spironolactone in chronic heart failure (HF) have been demonstrated in patients with New York Heart Association (NYHA) class III to IV HF. This study examined the effect of spironolactone on left ventricular (LV) function and functional capacity of patients with mild to moderate HF (NYHA class I to II). One hundred sixty-eight patients with NYHA class I to II HF and LV ejection fraction ≤40% were randomized to spironolactone or placebo and assessed by echocardiography, gated single-photon emission computed tomography, technetium-99m sestamibi single-photon emission computed tomographic radionuclide ventriculography, and cardiopulmonary exercise testing at baseline and after 6 months of treatment. In the spironolactone group LV ejection fraction increased from 35.2 ± 0.7% to 39.1 ± 3.5% (p <0.001), with a decrease in LV end-diastolic and end-systolic volumes and myocardial mass and an improvement in LV diastolic filling pattern. Cardiopulmonary exercise testing parameters did not change. In conclusion, administration of spironolactone to patients with NYHA class I to II HF has beneficial effects on LV remodeling and diastolic function.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analysis of Variance
  • Biomarkers / blood
  • Echocardiography, Doppler
  • Exercise Test
  • Female
  • Heart Failure / diagnostic imaging
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Oxygen Consumption / physiology
  • Placebos
  • Radiopharmaceuticals
  • Single-Blind Method
  • Spironolactone / therapeutic use*
  • Stroke Volume / drug effects*
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome

Substances

  • Biomarkers
  • Mineralocorticoid Receptor Antagonists
  • Placebos
  • Radiopharmaceuticals
  • Spironolactone
  • Technetium Tc 99m Sestamibi