PMID- 17126073
OWN - NLM
STAT- MEDLINE
DCOM- 20071113
LR  - 20131121
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 9
IP  - 4
DP  - 2007 Apr
TI  - Effects of aldosterone receptor blockade in patients with mild-moderate heart 
      failure taking a beta-blocker.
PG  - 429-34
AB  - AIMS: Spironolactone improves prognosis in severe heart failure (HF). We 
      investigated its effects in patients with mild-moderate HF treated with an ACE 
      inhibitor and beta-blocker. METHODS AND RESULTS: Randomised, double-blind, 
      parallel-group, 3-month comparison of placebo and spironolactone (25 mg daily) in 
      40 patients in New York Heart Association (NYHA) class I (20%), II (70%) or III 
      (10%), with a left ventricular ejection fraction of <40%. The mean (standard 
      error) changes from baseline in the spironolactone and placebo groups were, 
      respectively: i) B-type natriuretic peptide (BNP) -53.4(22.2) pg/mL and 
      +3.3(12.1) pg/mL, P=0.04, ii) pro-collagen type III N-terminal amino peptide 
      (PIIINP) -0.6(0.2) micromol/L and +0.02(0.2) micromol/L, P=0.02 and iii) 
      creatinine +10.7(3.2) micromol/L and -0.3(2.6) micromol/L, P=0.01. Compared with 
      placebo, spironolactone therapy was associated with a reduction in self-reported 
      health-related quality of life: change in visual analog score: -6 (3) vs. +6 (4); 
      P=0.01. No differences were observed on other biochemical, neurohumoral, exercise 
      and autonomic function assessments. CONCLUSION: In patients with mild-moderate 
      HF, spironolactone reduced neurohumoral activation (BNP) and a marker of collagen 
      turnover (PIIINP) but impaired renal function and quality of life. The 
      benefit-risk ratio of aldosterone blockade in mild HF is uncertain and requires 
      clarification in a large randomised trial.
FAU - Berry, Colin
AU  - Berry C
AD  - Department of Cardiology, Western Infirmary, and Department of Applied 
      Physiology, University of Strathclyde, Glasgow, UK.
FAU - Murphy, Niamh F
AU  - Murphy NF
FAU - De Vito, Giuseppe
AU  - De Vito G
FAU - Galloway, Stuart
AU  - Galloway S
FAU - Seed, Alison
AU  - Seed A
FAU - Fisher, Carol
AU  - Fisher C
FAU - Sattar, Naveed
AU  - Sattar N
FAU - Vallance, Patrick
AU  - Vallance P
FAU - Hillis, W Sewart
AU  - Hillis WS
FAU - McMurray, John
AU  - McMurray J
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20061127
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 0 (Receptors, Mineralocorticoid)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 27O7W4T232 (Spironolactone)
SB  - IM
EIN - Eur J Heart Fail. 2007 Oct;9(10):1074. Murphy, Niamh [corrected to Murphy, Niamh 
      F]
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Antihypertensive Agents/*therapeutic use
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Mineralocorticoid Receptor Antagonists
MH  - Natriuretic Peptide, Brain/drug effects
MH  - Quality of Life
MH  - Receptors, Mineralocorticoid/drug effects
MH  - Severity of Illness Index
MH  - Sickness Impact Profile
MH  - Spironolactone/*therapeutic use
MH  - Stroke Volume
EDAT- 2006/11/28 09:00
MHDA- 2007/11/14 09:00
CRDT- 2006/11/28 09:00
PHST- 2006/05/30 00:00 [received]
PHST- 2006/08/21 00:00 [revised]
PHST- 2006/10/05 00:00 [accepted]
PHST- 2006/11/28 09:00 [pubmed]
PHST- 2007/11/14 09:00 [medline]
PHST- 2006/11/28 09:00 [entrez]
AID - S1388-9842(06)00296-0 [pii]
AID - 10.1016/j.ejheart.2006.10.005 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2007 Apr;9(4):429-34. doi: 10.1016/j.ejheart.2006.10.005. Epub 
      2006 Nov 27.