title: Does spironolactone have a dose-dependent effect on left ventricular remodeling in patients with preserved left ventricular function after an acute myocardial infarction?
abstract: OBJECTIVE
  The aim of this study was to investigate the effects of spironolactone on left ventricular (LV) remodeling in patients with preserved LV function following acute myocardial infarction (AMI).
  
  
  RESULTS
  Successfully revascularized patients (n = 186) with acute ST elevation MI (STEMI) were included in the study. Patients were randomly divided into three groups, each of which was administered a different dose of spironolactone (12.5, 25 mg, or none). Echocardiography was performed within the first 3 days and at 6 months after MI. Echocardiography control was performed on 160 patients at a 6-month follow-up. The median left ventricular ejection fraction (LVEF) increased significantly in all groups, but no significant difference was observed between groups (P = 0.13). At the end of the sixth month, the myocardial performance index (MPI) had improved in each of the three groups, but no significant difference was found between groups (F = 2.00, P = 0.15). The mean LV peak systolic velocities (Sm ) increased only in the control group during the follow-up period, but there is no significant difference between groups (F = 1.79, P = 0.18). The left ventricular end-systolic volume index (LVESVI) and the left ventricular end-diastolic volume index (LVEDVI) did not change significantly compared with the basal values between groups (F = 0.05, P = 0.81 and F = 1.03, P = 0.31, respectively).
  
  
  CONCLUSIONS
  In conclusion, spironolactone dosages of up to 25 mg do not augment optimal medical treatment for LV remodeling in patients with preserved cardiac functions after AMI.
authors.affiliation: Cardiology Department, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. vatankulu@hotmail.com
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Vatankulu
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bacaksiz
authors.forename: Osman
authors.initials: O
authors.lastname: Sonmez
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Alihanoglu
authors.forename: Fatih
authors.initials: F
authors.lastname: Koc
authors.forename: Kenan
authors.initials: K
authors.lastname: Demir
authors.forename: Enes Elvin
authors.initials: EE
authors.lastname: Gul
authors.forename: Murat
authors.initials: M
authors.lastname: Turfan
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tasal
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kayrak
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazici
authors.forename: Kurtulus
authors.initials: K
authors.lastname: Ozdemir
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004305:Dose-Response Relationship, Drug; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage*; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D013148:Spironolactone / Q000008:administration & dosage*; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone