title: Evolving strategies for the use of spironolactone in cardiovascular disease.
abstract: The evolution of strategies for the use of spironolactone and its analogue, eplerenone, has, over the years, encompassed favourable modification of the natural history of symptomatic heart failure in subjects with subnormal left ventricular ejection fraction (LVEF), and mitigation of the risk of new-onset atrial fibrillation in mildly symptomatic systolic heart failure. Given the fact that these benefits might be attributable, at least in part, to mitigation of severity of diastolic dysfunction when the latter co-exists with subnormal LVEF, what needs to be explored is the possibility of similar benefits from the use of these agents in patients such as those with hypertension, and aortic valve stenosis, in whom left ventricular dysfunction is of the predominantly diastolic subtype.
authors.affiliation: Manchester Medical Society, Room 4.54 Simon Building, Brunswick Street, Manchester M13 9PL, United Kingdom. oscarjolobe@yahoo.co.uk
authors.forename: Oscar M P
authors.initials: OM
authors.lastname: Jolobe
mesh_terms: D001024:Aortic Valve Stenosis / Q000188:drug therapy*; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006947:Hyperkalemia; D006973:Hypertension / Q000188:drug therapy*; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013148:Spironolactone / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use*; D013318:Stroke Volume
chemical_list: D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone