Retrospective study on the short-term efficacy of different doses of Spironolactone in patients with heart failure of...

Area of Science:

• Cardiology
• Pharmacology
• Biomedical Engineering

Background:

• Heart Failure of Ischemic Cardiomyopathy (HFIC) presents significant challenges in cardiac function and ventricular remodeling.
• Spironolactone is a key therapeutic agent, but optimal dosage for HFIC requires further investigation.

Purpose of the Study:

• To assess the comparative short-term effectiveness of low-dose (20 mg/d) versus high-dose (60 mg/d) Spironolactone in HFIC patients.
• To evaluate the impact of varying Spironolactone dosages on ventricular remodeling markers and cardiac function.

Main Methods:

• 141 HFIC patients received standard treatment plus either low-dose or high-dose Spironolactone for four weeks.
• Echocardiographic indices, NYHA classification, ventricular remodeling markers (hs-CRP, TNF-α, NT-pro BNP, Gal-3, MMP-9, TIMP-4), and 6MWD were assessed pre- and post-treatment.

Main Results:

• Both dosages improved LVEF, 6MWD, and reduced LV dimensions and NYHA grades (P<0.05).
• High-dose Spironolactone demonstrated superior improvements in clinical effectiveness and remodeling markers (P<0.05).
• Both groups maintained normal serum potassium levels.

Conclusions:

• High-dose Spironolactone (60 mg/d) is more effective than low-dose (20 mg/d) for rapid improvement in HFIC.
• High-dose Spironolactone significantly reduces ventricular remodeling and enhances cardiac function and symptoms in the short term.