Key result
MRAs show potential benefit in HFpEF but current evidence remains limited and conflicting.
Why the study?
HFpEF is associated with increased hospitalization and all-cause mortality, but lacks established treatments to improve survival, while aldosterone appears to play a role in its pathogenesis.
Do mineralocorticoid receptor antagonists improve outcomes in patients with heart failure with preserved ejection fraction?
Do mineralocorticoid receptor antagonists improve outcomes in patients with heart failure with preserved ejection fraction?
Existing evidence on the use of mineralocorticoid receptor antagonists in HFpEF is limited and conflicting, highlighting the need for further studies with better patient selection.
Should not yet change HFpEF practice; leaves open MRA utility pending targeted RCTs.
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is associated with increased risk for hospitalization and all-cause mortality. Currently, there is no established treatment to improve the survival of these patients. Aldosterone appears to play a role in the pathogenesis of HFpEF. OBJECTIVE: To discuss the findings of studies that evaluated the effects of mineralocorticoid receptor (MR) antagonists on the outcome of patients with HFpEF. METHODS: PubMed was searched for relevant papers. References of retrieved articles were also evaluated for pertinent material. RESULTS: Accumulating data suggest that MR antagonists might be useful in the management of patients with HFpEF. However, existing evidence is limited and conflicting. CONCLUSIONS: More studies are needed to clearly define the therapeutic potential of MR antagonists in HFpEF. Given the heterogeneity of this disease and the low specificity of the criteria used for its diagnosis, it is also important to improve the definition of HFpEF and include appropriately selected patients in these studies.
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Papagiannis et al. (2019) conducted a review in Heart failure with preserved ejection fraction (HFpEF). Mineralocorticoid receptor antagonists was evaluated. Mineralocorticoid receptor antagonists might be useful in managing heart failure with preserved ejection fraction, but existing evidence remains limited and conflicting.
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