Long-term effect of spironolactone on cardiac structure as assessed by analysis of ultrasonic radio-frequency signals in patients with ventricular hypertrophy.
BACKGROUND
An effect of aldosterone on ventricular fibrosis has been demonstrated in animals, but remains unclear in human patients. This study aimed to investigate (1) the relationship between left ventricular (LV) fibrosis and myocardial ultrasonic texture as assessed with myocardial radio-frequency (RF) signals analyzed from the viewpoint of their waveform with chaos theory in animals and (2) serial changes in myocardial ultrasonic texture following long-term aldosterone blockade in patients with LV hypertrophy.


RESULTS
In an animal study, Sprague-Dawley rats were divided into 2 groups with and without adriamycin administration, and the relationship between the RF signals and LV fibrosis was assessed. In a clinical study, effects of 12-month-administration of spironolactone were assessed in patients with LV hypertrophy. The animal study revealed that the correlation dimension (CD) calculated from the RF signals inversely correlated with the area of fibrosis. The clinical study demonstrated an increase in CD following 6-month administration of spironolactone. The changes in CD positively correlated with those in the serum carboxy-terminal telopeptide of collagen type I.


CONCLUSIONS
Myocardial RF signals analyzed with chaos theory reflect the severity of LV fibrosis. Aldosterone blockade may alter myocardial ultrasonic texture with regression of LV fibrosis, at least partly through enhanced collagen degradation.
Nishikawa
Nagahiro
N
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Yamamoto
Kazuhiro
K
Sakata
Yasushi
Y
Mano
Toshiaki
T
Yoshida
Junichi
J
Umekawa
Seiko
S
Hori
Masatsugu
M
Yasuhara
Yuki
Y
Sonoyama
Teruyuki
T
Harada
Akimitsu
A
Masuyama
Tohru
T
D000328:Adult; D000368:Aged; D000818:Animals; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013148:Spironolactone / Q000008:administration & dosage*
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone