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Effect of spironolactone on left ventricular ejection fraction and volumes in patients with class I or II heart

Enrico Vizzardi1, Antonio D'Aloia, Raffaele Giubbini

  • 1Department of Cardiology, University of Brescia, Italy. enrico.vizzardi@tin.it

The American Journal of Cardiology
|October 30, 2010
PubMed

Insights

Spironolactone benefits patients with mild to moderate chronic heart failure (HF) by improving left ventricular (LV) remodeling and diastolic function. This study shows positive effects on LV ejection fraction in NYHA class I to II HF patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Spironolactone is known to benefit chronic heart failure (HF) patients in NYHA class III-IV.
  • Its effects on mild to moderate HF (NYHA class I-II) require further investigation.

Purpose of the Study:

  • To investigate the impact of spironolactone on left ventricular (LV) function and capacity in patients with NYHA class I-II HF.
  • To assess changes in LV remodeling and diastolic function.

Main Methods:

  • 168 patients with NYHA class I-II HF and LV ejection fraction ≤40% were randomized to spironolactone or placebo.
  • Assessments included echocardiography, gated SPECT, radionuclide ventriculography, and cardiopulmonary exercise testing at baseline and 6 months.

Main Results:

  • Spironolactone significantly increased LV ejection fraction from 35.2% to 39.1% (p <0.001).
  • Observed were reductions in LV end-diastolic/end-systolic volumes, myocardial mass, and improved LV diastolic filling.
  • No significant changes were noted in cardiopulmonary exercise testing parameters.

Conclusions:

  • Spironolactone demonstrates beneficial effects on LV remodeling and diastolic function in patients with mild to moderate HF (NYHA class I-II).
  • Further research may explore its role in this patient population.

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