PMID- 26058790
OWN - NLM
STAT- MEDLINE
DCOM- 20160915
LR  - 20181113
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 104
IP  - 12
DP  - 2015 Dec
TI  - Effects of spironolactone on ventricular-arterial coupling in patients with 
      chronic systolic heart failure and mild symptoms.
PG  - 1078-87
LID - 10.1007/s00392-015-0877-5 [doi]
AB  - BACKGROUND: Several studies demonstrated that mineralocorticoid receptor 
      antagonists (MRAs) are able to prevent myocardial and vascular fibrosis, and left 
      ventricular (LV) remodeling in patients with systolic chronic heart failure (HF) 
      and mild symptoms. Ventricular-arterial coupling (VAC) should be influenced by 
      anti-fibrotic interventions. We have assessed the effects of spironolactone on 
      VAC and its components, aortic elastance (Ea) and end-systolic LV elastance 
      (Ees), in patients with HF. METHODS AND RESULTS: Changes from baseline in VAC 
      were compared between 65 patients treated with spironolactone and 32 controls not 
      receiving MRAs. All patients had HF, reduced LVEF with reduced LV ejection 
      fraction (LVEF) and New York Heart Association (NYHA) functional class I-II 
      symptoms, and underwent transthoracic echocardiography at baseline and after 
      6 months. VAC was estimated by the modified single-beat method as Ea/Ees. 
      Parameters of LV function improved after 6 month treatment with spironolactone 
      with an increase in the LVEF from 34 +/- 8 to 39 +/- 8 % (p < 0.001). Spironolactone 
      increased Ees from 1.32 +/- 0.38 to 1.57 +/- 0.42 mmHg/mL (p < 0.001) and reduced VAC 
      from 2.03 +/- 0.59 to 1.66 +/- 0.31 (p < 0.001), but did not affect Ea and V0 (LV 
      volume at end-systolic pressure of 0 mmHg). No change in any of these parameters 
      occurred in the control group. CONCLUSIONS: 6-month therapy with spironolactone 
      improved VAC mainly through its effect on Ees in patients with mild HF.
FAU - Vizzardi, Enrico
AU  - Vizzardi E
AD  - Section of Cardiovascular Diseases, Department of Medical and Surgical 
      Specialties, Radiological Sciences and Public Health, University of Study of 
      Brescia, Brescia, Italy. enrico.vizzardi@tin.it.
AD  - , Piazzale Spedali Civili 1, 25123, Brescia, Italy. enrico.vizzardi@tin.it.
FAU - Sciatti, Edoardo
AU  - Sciatti E
AD  - Section of Cardiovascular Diseases, Department of Medical and Surgical 
      Specialties, Radiological Sciences and Public Health, University of Study of 
      Brescia, Brescia, Italy.
FAU - Bonadei, Ivano
AU  - Bonadei I
AD  - Section of Cardiovascular Diseases, Department of Medical and Surgical 
      Specialties, Radiological Sciences and Public Health, University of Study of 
      Brescia, Brescia, Italy.
FAU - D'Aloia, Antonio
AU  - D'Aloia A
AD  - Section of Cardiovascular Diseases, Department of Medical and Surgical 
      Specialties, Radiological Sciences and Public Health, University of Study of 
      Brescia, Brescia, Italy.
FAU - Tartiere-Kesri, Lamia
AU  - Tartiere-Kesri L
AD  - Cardiac Rehabilitation, Leon Berard Hospital, Hyeres, France.
AD  - Cardiology Department, Sainte Musse Hospital, Toulon, France.
FAU - Tartiere, Jean-Michel
AU  - Tartiere JM
AD  - Cardiology Department, Sainte Musse Hospital, Toulon, France.
AD  - INSERM U942, Paris, France.
FAU - Cohen-Solal, Alain
AU  - Cohen-Solal A
AD  - Cardiology Department, Lariboisiere Hospital and Denis Diderot University, Paris, 
      France.
AD  - INSERM U942, Paris, France.
FAU - Metra, Marco
AU  - Metra M
AD  - Section of Cardiovascular Diseases, Department of Medical and Surgical 
      Specialties, Radiological Sciences and Public Health, University of Study of 
      Brescia, Brescia, Italy.
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20150610
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 27O7W4T232 (Spironolactone)
SB  - IM
MH  - Aged
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure, Systolic/*drug therapy/physiopathology
MH  - Heart Ventricles/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mineralocorticoid Receptor Antagonists/pharmacology/*therapeutic use
MH  - Prospective Studies
MH  - Spironolactone/pharmacology/*therapeutic use
MH  - Ventricular Dysfunction, Left/*drug therapy/physiopathology
MH  - Ventricular Function, Left/drug effects
MH  - Ventricular Remodeling/drug effects
OTO - NOTNLM
OT  - Heart failure
OT  - Mineralocorticoid receptor antagonists
OT  - Modified single-beat method
OT  - Ventricular-arterial coupling
EDAT- 2015/06/11 06:00
MHDA- 2016/09/16 06:00
CRDT- 2015/06/11 06:00
PHST- 2015/03/11 00:00 [received]
PHST- 2015/06/01 00:00 [accepted]
PHST- 2015/06/11 06:00 [entrez]
PHST- 2015/06/11 06:00 [pubmed]
PHST- 2016/09/16 06:00 [medline]
AID - 10.1007/s00392-015-0877-5 [pii]
AID - 10.1007/s00392-015-0877-5 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2015 Dec;104(12):1078-87. doi: 10.1007/s00392-015-0877-5. Epub 
      2015 Jun 10.