What is the clinical evidence from this study?

Study design: RCT. Population: postinfarction heart failure (n=87). Intervention: canrenone, ramipril, or combination vs. no drug. Primary outcome: LV remodeling, LV function, fibrosis, myocardial norepinephrine, and ventricular fibrillation threshold.

What does this research mean for the field?

Canrenone attenuates left ventricular dilation, improves ventricular function, and increases the ventricular fibrillation threshold in postinfarction heart failure, with these cardioprotective effects being further enhanced by concomitant ramipril therapy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To investigate the therapeutic effects of aldosterone receptor blockade, alone and in combination with an ACE inhibitor, on cardiac remodeling and electrical stability in postinfarction heart failure.

April 30, 2003Cardiovascular ResearchOpen Access

Aldosterone receptor blockade improves left ventricular remodeling and increases ventricular fibrillation threshold in experimental heart failure

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Key result

Canrenone attenuated LV dilation, improved LV function, and increased ventricular fibrillation threshold in rats with postinfarction heart failure, with effects enhanced by concomitant ramipril.

Why the study?

Does canrenone, alone or in combination with ramipril, improve LV remodeling and ventricular fibrillation threshold in rats with postinfarction heart failure?

Population

87 rats with moderate myocardial infarction (postinfarction heart failure model induced by coronary ligation)

Comparison

Canrenone, ramipril, or a combination of the two… vs No drug (placebo)

Design

Preclinical, Randomized

Follow-up

4 weeks

Authors

ACAntonio CittadiniHeart Failure & Transplant

Discussion

Member takes

Implication

Hypothesis-generating for canrenone in post-MI HF remodeling; leaves open human translation.

Key Points

To investigate the therapeutic effects of aldosterone receptor blockade, alone and in combination with an ACE inhibitor, on cardiac remodeling and electrical stability in postinfarction heart failure.
Randomized 87 rats with moderate myocardial infarction (mean infarct size 32–34%) to receive placebo, canrenone (20 mg/kg/day), ramipril (1 mg/kg/day), or combined therapy for 4 weeks starting 1 month post-ligation.
Assessed cardiac structure and function using echocardiography, left ventricular catheterization, isolated heart preparations, morphometric histology, myocardial norepinephrine content, and SERCA-2 mRNA expression.
Canrenone attenuated left ventricular dilation, enhanced systolic and diastolic dynamics, and markedly suppressed interstitial and perivascular fibrosis, with additive improvements seen in combination with ramipril.
Canrenone significantly increased the ventricular fibrillation threshold and lowered myocardial norepinephrine content, whereas SERCA-2 mRNA expression remained unchanged across groups.

Study Design

Type

RCT (n=87)

Randomization

randomized

Structured PICO

Does canrenone, alone or in combination with ramipril, improve LV remodeling and ventricular fibrillation threshold in rats with postinfarction heart failure?

Population

87 rats with moderate myocardial infarction (postinfarction heart failure model induced by coronary ligation)

Intervention

Canrenone (20 mg/kg/day), ramipril (1 mg/kg/day), or a combination of the two drugs, initiated 1 month after coronary ligation and administered for 4 weeks

Comparator

No drug (placebo)

Outcome

LV remodeling, LV systolic and diastolic function, interstitial and perivascular fibrosis, myocardial norepinephrine, ventricular fibrillation threshold, and SERCA-2 mRNA levelssurrogate

Canrenone improves LV remodeling and increases ventricular fibrillation threshold in a rat model of postinfarction heart failure, providing a potential mechanistic explanation for the mortality benefits seen in clinical trials.

Cite This Study

Antonio Cittadini (2003) conducted an RCT in postinfarction heart failure (n=87). canrenone, ramipril, or combination vs. no drug was evaluated on LV remodeling, LV function, fibrosis, myocardial norepinephrine, and ventricular fibrillation threshold. Canrenone attenuated LV dilation, improved LV function, and increased ventricular fibrillation threshold in rats with postinfarction heart failure, with effects enhanced by concomitant ramipril.

synapsesocial.com/papers/6a15486a814bf8ec9a4e5913 https://doi.org/10.1016/s0008-6363(03)00251-7

Topics

Heart failure HFrEF treatment HFpEF management

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Bookmark

Aldosterone receptor blockade improves left ventricular remodeling and increases ventricular fibrillation threshold in experimental heart failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Aldosterone receptor blockade improves left ventricular remodeling and increases ventricular fibrillation threshold in experimental heart failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider