Effect of Spironolactone on Diastolic Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction

Abstract

Heart failure (HF) with preserved ejection fraction (EF) accounts for more than 50% of the total HF population.¹ Community-based cohort studies have shown that mortality rates are similar in HF with preserved EF compared with HF with reduced EF,¹ but data from large clinical trials point toward a better outcome in HF with preserved EF. This may indicate that comorbidities that are typically excluded in trials may contribute to the poor prognosis in HF with preserved EF.^1-6 Left ventricular diastolic dysfunction and adverse cardiac remodeling are considered major underlying pathologies in HF with preserved EF.⁷ However, pharmacotherapies tested to date have not shown improvements in diastolic dysfunction, cardiac remodeling, or cardiovascular outcome.^3-6