PMID- 10494316
OWN - NLM
STAT- MEDLINE
DCOM- 19991028
LR  - 20131121
IS  - 0028-2162 (Print)
IS  - 0028-2162 (Linking)
VI  - 143
IP  - 34
DP  - 1999 Aug 21
TI  - [Anti-aldosterone therapy in severe heart failure].
PG  - 1724-6
AB  - The mortality rate among patients with severe heart failure is still very high 
      despite treatment with loop diuretics and angiotensin-converting enzyme (ACE) 
      inhibitors. The 'randomized aldactone evaluation study' (RALES) has shown that 25 
      mg spironolactone added to this treatment was safe and reduced all-cause 
      mortality by 30% in patients with severe (previous New York Heart Association 
      (NYHA) functional class IV) heart failure due to systolic left ventricular 
      dysfunction. Blockade of aldosterone in these patients may be necessary to 
      overcome so-called aldosterone escape during chronic ACE-inhibition. The 
      beneficial effects of spironolactone may relate to enhanced diuresis, 
      anti-arrhythmogenic properties and direct effects on the myocardium and blood 
      vessels. At present, addition of spironolactone may be appropriate for patients 
      with severe heart failure, whereas patients with moderate heart failure may 
      benefit more from beta-blockade.
FAU - van Guldener, C
AU  - van Guldener C
AD  - Academisch Ziekenhuis Vrije Universiteit, afd. Inwendige Geneeskunde, Amsterdam.
FAU - Donker, A J
AU  - Donker AJ
LA  - dut
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Anti-aldosterontherapie bij ernstig hartfalen.
PL  - Netherlands
TA  - Ned Tijdschr Geneeskd
JT  - Nederlands tijdschrift voor geneeskunde
JID - 0400770
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Diuretics)
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 27O7W4T232 (Spironolactone)
SB  - IM
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Antihypertensive Agents/*therapeutic use
MH  - Diuretics/therapeutic use
MH  - Drug Therapy, Combination
MH  - Heart Failure/*drug therapy/etiology/mortality
MH  - Humans
MH  - Mineralocorticoid Receptor Antagonists/administration & dosage/*therapeutic use
MH  - Spironolactone/administration & dosage/*therapeutic use
MH  - Survival Rate
RF  - 9
EDAT- 1999/09/24 00:00
MHDA- 1999/09/24 00:01
CRDT- 1999/09/24 00:00
PHST- 1999/09/24 00:00 [pubmed]
PHST- 1999/09/24 00:01 [medline]
PHST- 1999/09/24 00:00 [entrez]
PST - ppublish
SO  - Ned Tijdschr Geneeskd. 1999 Aug 21;143(34):1724-6.