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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Effects of aldosterone receptor blockade in patients with mild–moderate heart failure taking a beta-blocker
Authors: De, Vito Giuseppe
Berry, Colin
Galloway, S D
Seed, Alison
Fisher, Carol
Sattar, Naveed
Vallance, Patrick
Hillis, W Stewart
McMurray, John J V
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Keywords: Aldosterone
Heart failure
Issue Date: Apr-2007
Publisher: Oxford University Press / European Society of Cardiology (previously published by Elsevier)
Citation: De Vito G, Berry C, Galloway SD, Seed A, Fisher C, Sattar N, Vallance P, Hillis WS & McMurray JJV (2007) Effects of aldosterone receptor blockade in patients with mild–moderate heart failure taking a beta-blocker, European Journal of Heart Failure, 9 (4), pp. 429-434.
Abstract: 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 b40%. 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) μmol/L and +0.02(0.2) μmol/L, P=0.02 and iii) creatinine +10.7(3.2) μmol/L and −0.3(2.6) μmol/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.
Type: Journal Article
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Affiliation: Sport
NHS Greater Glasgow & Clyde
NHS Greater Glasgow & Clyde
NHS Greater Glasgow & Clyde
University of Glasgow
NHS University College London Hospitals
NHS Greater Glasgow & Clyde
NHS Greater Glasgow & Clyde

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