title: Mineralcorticoid antagonists in heart failure.
abstract: Mineralocorticoid receptor antagonists (MRAs) have become mandated therapy in patients with reduced ejection fraction (systolic) heart failure (HF) across all symptom classes. These agents should also be prescribed in the early post-myocardial infarction setting in those with reduced ejection fraction and either HF symptoms or diabetes. This article explores the pathophysiological role of aldosterone, an endogenous ligand for the mineralcorticoid receptor (MR), and summarizes the clinical data supporting guideline recommendations for these agents in systolic HF. The use of MRAs in novel areas beyond systolic HF ejection is also explored. Finally, the current status of newer agents will be examined.
authors.affiliation: Cardiovascular Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, Bergamo 24127, Italy; University of Pavia, Piazzale Golgi 1, Pavia 27100, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: D'Elia
authors.affiliation: Department of Epidemiology & Preventive Medicine, Centre of Cardiovascular Research & Education (CCRE) in Therapeutics, Alfred Hospital, Monash University, Commercial Road, Melbourne, Victoria 3004, Australia. Electronic address: henry.krum@monash.edu.
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
mesh_terms: D000450:Aldosterone / Q000502:physiology; D002192:Canrenone / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone; D002192:Canrenone
keywords: Aldosterone; Heart failure; Mineralcorticoid receptor agonists