Key result
MRAs in HFpEF improve cardiac function but reduce 6-minute walk distance by ~12m and raise potassium.
Why the study?
Does MRA treatment improve cardiac function in patients with HFpEF?
Meta-Analysis
Does MRA treatment improve cardiac function in patients with HFpEF?
Answers are grounded in this paper and cite their sources.
MRA therapy in HFpEF improves cardiac structure and function but is associated with increased serum potassium and a slight reduction in exercise capacity.
, - 1.91 to - 0.33), 6-min walk test distance (- 11.56 m, - 21 to - 2.13), systolic (- 4.75 mmHg, - 8.94 to - 0.56) and diastolic blood pressure (- 2.91 mmHg, - 4.15 to - 1.67), and increased levels of serum potassium (0.23 mmol/L, 0.19 to 0.28) when compared with placebo/control. In patients with HFpEF, MRA treatment significantly improves indices of cardiac structure and function, suggesting a decrease in left ventricular filling pressure and reverse cardiac remodeling. MRA increase serum potassium and decrease blood pressure; however, a small decrease in 6-min-walk distance is also noted. Larger prospective studies are warranted to provide definitive answers on the effect of MRA in patients with HFpEF.
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Kapelios et al. (2019) conducted a meta-analysis in Heart failure and preserved ejection fraction (HFpEF). Mineralocorticoid receptor antagonists (MRA) vs. Placebo/control was evaluated. Mineralocorticoid receptor antagonists in HFpEF patients improved indices of cardiac structure and function, but decreased 6-min walk distance (-11.56 m) and increased serum potassium (0.23 mmol/L).
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