See What HealthDay Can Do For You
Contact Us

Spironolactone Benefits Exercise Tolerance in HFpEF

Improvements in exercise capacity, anaerobic threshold, and oxygen uptake efficiency

heart illustration

TUESDAY, Oct. 18, 2016 (HealthDay News) -- For patients with heart failure with preserved ejection fraction (HFpEF) with an exercise-induced increase in the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e'), spironolactone is associated with improved exercise capacity, according to a study published in the Oct. 25 issue of the Journal of the American College of Cardiology.

Wojciech Kosmala, M.D., Ph.D., from the Wroclaw Medical University in Poland, and colleagues conducted a randomized, placebo-controlled trial involving 150 subjects with exertional dyspnea. Patients were randomly allocated to six months of oral spironolactone or matching placebo. A total of 131 patients had completed therapy at follow-up (64 taking spironolactone and 67 taking placebo).

The researchers found that subjects had substantial exercise limitation at baseline. Improvements were seen in exercise capacity (P < 0.001), anaerobic threshold (P = 0.03), and oxygen uptake efficiency (P = 0.002) in the spironolactone group, with a reduction in E/e' (P < 0.001). A significant interaction was seen for spironolactone and the change in E/e' on peak oxygen uptake (P = 0.039).

"In patients with HFpEF and abnormal diastolic response to exertion, improvement in exercise E/e' mediates the beneficial effect of spironolactone on exercise capacity," the authors write. "Identification of exercise-induced increase in left ventricular filling pressure in patients with HFpEF may define a subgroup with warranting trial of spironolactone."

Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Physician's Briefing