title: Aldosterone antagonism in an inflammatory state: evidence for myocardial protection.
abstract: BACKGROUND
  Chagas' disease is one of the most important causes of dilated cardiomyopathy in South and Central America. It is an inflammatory cardiomyopathy. We wanted to investigate whether it could have the same response to aldosterone antagonism as demonstrated before in other dilated cardiomyopathies.
  
  
  OBJECTIVE
  To evaluate the role of spironolactone in myocardial remodelling in a Chagas cardiomyopathy model.
  
  
  METHODS
  We studied 60 Sirius Hamsters divided into: control (C) infected (Inf) and Inf plus spironolactone (Infsp, 40 mg/kg/day) groups, for 11 months. Echocardiography with colour doppler was performed. Left ventricular end diastolic diameter (LVEDD), fractional shortening (FS) and corrected isovolumic relaxation time (IRT) were evaluated, as well as interstitial collagen volume fraction (ICVF) and myocardial inflammation.
  
  
  RESULTS
  The results demonstrated that survival was improved by use of spironolactone in the chronic phase (p<0.04). Body weight (BW) was C:190 g, Inf:167 g*, Infsp:198 g (*p<0.05, compared to C and Infsp), LVEDD/BW was C:0.31, Inf: 0.35*, Infsp: 0.29 (*p<0.05, compared to C and Infsp), FS was C:38, Inf: 35.5, Infsp: 38 (with no statistical difference) and IRT was C: 23 msec, Inf: 26 msec*, Infsp: 22 msec (p<0.05, compared to C and Infsp). ICVF (%) was attenuated at LV (C: 0.34+/-0.1, Inf: 1.75+/-0.7*, Infsp: 0.95+/-0.2*; *p<0.05, p<0.05).
  
  
  CONCLUSIONS
  Spironolactone attenuated the myocardial remodelling in Chagas cardiomyopathy, reduced mortality during the chronic phase and reduced inflammatory infiltration.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. carfelix@incor.usp.br
authors.forename: Felix J A
authors.initials: FJ
authors.lastname: Ramires
authors.forename: Vera M C
authors.initials: VM
authors.lastname: Salemi
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Ianni
authors.forename: Fábio
authors.initials: F
authors.lastname: Fernandes
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Martins
authors.forename: Angelina
authors.initials: A
authors.lastname: Billate
authors.forename: Edécio Cunha
authors.initials: EC
authors.lastname: Neto
authors.forename: Charles
authors.initials: C
authors.lastname: Mady
mesh_terms: D000450:Aldosterone / Q000378:metabolism; D000818:Animals; D002316:Cardiotonic Agents / Q000494:pharmacology*; D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging / Q000473:pathology*; D003094:Collagen / Q000032:analysis; D006224:Cricetinae; D004195:Disease Models, Animal; D018618:Echocardiography, Doppler, Color; D005260:Female; D008647:Mesocricetus; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology*; D009206:Myocardium / Q000737:chemistry; D013148:Spironolactone / Q000494:pharmacology*; D014349:Trypanosoma cruzi; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D002316:Cardiotonic Agents; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D003094:Collagen