Spironolactone for HF with Preserved LVEF Improves Diastolic Function — But Not Symptoms

In a randomized trial, significant echocardiographic improvements failed to translate into favorable clinical outcomes.

More than half of patients with heart failure (HF) have preserved left ventricular ejection fraction (LVEF), a condition known as diastolic HF, but effective therapy remains elusive. Investigators randomized 422 such patients (minimum age, 50; mean age, 67; 52% women) at 10 sites in Germany and Austria to receive spironolactone (25 mg daily) or placebo. All participants had chronic, stable symptoms attributable to HF, an LVEF ≥50%, echocardiographic evidence of diastolic dysfunction or electrocardiographic evidence of atrial fibrillation, and maximum exercise capacity ≤25 mL/kg/minute. Most were being treated for hypertension. Mean follow-up was 11.6 months.

Compared with the placebo group, the spironolactone group experienced significantly …

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Spironolactone for HF with Preserved LVEF Improves Diastolic Function — But Not Symptoms

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Reviewing Author