PMID- 12368364
OWN - NLM
STAT- MEDLINE
DCOM- 20021030
LR  - 20220310
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 43
IP  - 10
DP  - 2002 Oct
TI  - Spironolactone improves cardiac sympathetic nerve activity and symptoms in 
      patients with congestive heart failure.
PG  - 1279-85
AB  - We evaluated whether spironolactone would improve cardiac sympathetic nerve 
      activity and symptoms in patients with congestive heart failure (CHF). METHODS: 
      Thirty patients with CHF (left ventricular ejection fraction [LVEF] < 40%; mean, 
      30% +/- 9%) were treated with an angiotensin-converting enzyme inhibitor, a loop 
      diuretic, and, in most cases, digoxin. Fifteen patients (group A) were assigned 
      to additionally receive spironolactone (12.5-50 mg/day), and the remaining 15 
      patients (group B) continued their current regimen. Patients were studied before 
      and 6 mo after treatment. The delayed heart-to-mediastinum count ratio (H/M 
      ratio), delayed total defect score (TDS), and washout rate (WR) were determined 
      from (123)I-meta-iodobenzylguanidine (MIBG) images. LVEF was determined by 
      echocardiography, and New York Heart Association (NYHA) functional class was 
      estimated. RESULTS: Before treatment, LVEF, TDS, H/M ratio, WR, and NYHA 
      functional class were similar in both groups. With treatment, LVEF did not 
      significantly improve in either group. However, after treatment in group A, TDS 
      decreased from 37 +/- 9 to 25 +/- 13 (P = 0.0001), H/M ratio increased from 1.62 
      +/- 0.20 to 1.83 +/- 0.27 (P < 0.0001), and WR decreased from 51 +/- 9 to 40 +/- 
      15 (P < 0.001). In group B, these parameters did not significantly change. NYHA 
      functional class improved in both groups (in group A, from 3.3 +/- 0.5 to 1.7 +/- 
      0.5 [P < 0.0001]; in group B, from 3.3 +/- 0.5 to 2.4 +/- 0.6 [P = 0.01]); this 
      was a significantly greater improvement in group A than in group B (P < 0.01). 
      CONCLUSION: Spironolactone improves cardiac sympathetic nerve activity and 
      symptoms in patients with CHF.
FAU - Kasama, Shu
AU  - Kasama S
AD  - Second Department of Internal Medicine, Gunma University School of Medicine, 
      Maebashi, Japan. s-kasama@bay.wind.ne.jp
FAU - Toyama, Takuji
AU  - Toyama T
FAU - Kumakura, Hisao
AU  - Kumakura H
FAU - Takayama, Yoshiaki
AU  - Takayama Y
FAU - Ichikawa, Shuichi
AU  - Ichikawa S
FAU - Suzuki, Tadashi
AU  - Suzuki T
FAU - Kurabayashi, Masahiko
AU  - Kurabayashi M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Diuretics)
RN  - 0 (Iodine Radioisotopes)
RN  - 0 (Radiopharmaceuticals)
RN  - 27O7W4T232 (Spironolactone)
RN  - 35MRW7B4AD (3-Iodobenzylguanidine)
RN  - 4964P6T9RB (Aldosterone)
RN  - 73K4184T59 (Digoxin)
SB  - IM
MH  - 3-Iodobenzylguanidine
MH  - Aged
MH  - Aldosterone/physiology
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Digoxin/therapeutic use
MH  - Diuretics/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Heart/diagnostic imaging/*innervation
MH  - Heart Failure/diagnostic imaging/*drug therapy
MH  - Humans
MH  - Iodine Radioisotopes
MH  - Male
MH  - Radionuclide Imaging
MH  - Radiopharmaceuticals
MH  - Spironolactone/*therapeutic use
MH  - Stroke Volume
MH  - Sympathetic Nervous System/*drug effects
EDAT- 2002/10/09 04:00
MHDA- 2002/11/01 04:00
CRDT- 2002/10/09 04:00
PHST- 2002/10/09 04:00 [pubmed]
PHST- 2002/11/01 04:00 [medline]
PHST- 2002/10/09 04:00 [entrez]
PST - ppublish
SO  - J Nucl Med. 2002 Oct;43(10):1279-85.