[Structural and functional changes in myocardium of patients with chronic heart failure treated with spironolactone]

The aim of the work was to study structural and functional characteristics of the left ventricle (LV) and diastolic function in patients with systolic chronic heart failure (CCF). Group 1 included 34 patients with LV systolic dysfunction (ejection fraction > 45%) treated with spironolactone (verospiron) at 25-50 mg/day. Group 2 of 30 untreated patients served as control. Echo CG was performed by routine method in the M-modal regime. Combination of diastolic (DD) and systolic (SD) dysfunction was documented in 20 (31.2%) patients, restrictive type in 27 (42.2%). Spironolactone had beneficial effect on structural and functional characteristics of myocardium. It significantly increased LV ejection fraction from 23.8 +/- 7.4% in the beginning of the study to 43.3 +/- 8.6% 12 months later (p < 0.05). During 12 month, patients with systolic CCF showed positive dynamics of LV diastolic dysfunction. The number of patients with normal LV configuration increased within 6 months after the onset of therapy from 11.7 to 26.6% (p < 0.05). However, the difference was insignificant by the end of the study. The number of patients in group 1 with eccentric hypertrophy increased from 64.7 to 75.0% after 12 months (p < 0.05) but that with concentric hypertrophy decreased The data obtained suggest the necessity of early beginning of spironolactone therapy of CCF hearing in mind its positive effect on diastolic dysfunction.