Key result
Spironolactone treatment in HFpEF improved exertional increase in global constructive work (P=0.002), which independently correlated with increased exercise capacity at 6 months (β=0.24; P=0.009).
Why the study?
GLS is afterload-dependent and may not adequately reflect contractility recruitment with exercise in HFpEF, prompting investigation into whether afterload-corrected myocardial work parameters associate with exercise capacity response to spironolactone.
Does spironolactone improve myocardial work parameters and exercise capacity in patients with HFpEF?
RCT (n=114)
randomized
Does spironolactone improve myocardial work parameters and exercise capacity in patients with HFpEF?
Effect estimate: β = 0.24
p-value: p=0.009
Global constructive work (GCW) is a better determinant of exercise capacity in HFpEF than global longitudinal strain (GLS), and its exertional increment correlates with improvements in functional capacity.
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Spironolactone may improve exercise capacity in HFpEF via myocardial work; extends evidence beyond LVEF to functional outcomes.
Przewłocka‐Kosmala et al. (2019) conducted an RCT in heart failure with preserved ejection fraction (HFpEF) (n=114). spironolactone vs. placebo was evaluated on Correlation between increase in exercise capacity at 6 months and change in exertional increase in global constructive work (GCW) (β = 0.24, p=0.009). Spironolactone treatment in HFpEF improved exertional increase in global constructive work (P=0.002), which independently correlated with increased exercise capacity at 6 months (β=0.24; P=0.009).
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