title: Emerging cardiovascular indications of mineralocorticoid receptor antagonists.
abstract: Mineralocorticoid receptor (MR) antagonism is a well-established treatment modality for patients with hypertension, heart failure, and left ventricular systolic dysfunction (LVSD) post-myocardial infarction (MI). There are emerging data showing potential benefits of MR antagonists in other cardiovascular conditions. Studies have shown association between MR activation and the development of myocardial fibrosis, coronary artery disease, metabolic syndrome, and cerebrovascular diseases. This review examines the preclinical and clinical data of MR antagonists for novel indications including heart failure with preserved ejection fraction (HFPEF), pulmonary arterial hypertension (PAH), arrhythmia, sudden cardiac death, valvular heart disease, metabolic syndrome, renal disease, and stroke. MR antagonists are not licensed for these conditions yet; however, emerging data suggest that indication for MR antagonists are likely to broaden; further studies are warranted.
authors.affiliation: Sheffield Teaching Hospitals, National Health Service (NHS) Trust, Sheffield, UK.
authors.forename: Yasir
authors.initials: Y
authors.lastname: Parviz
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK. Electronic address: javaid@doctors.net.uk.
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: Cardiovascular Centre, University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Bertram
authors.initials: B
authors.lastname: Pitt
authors.affiliation: Department of Cardiology and National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
authors.forename: David
authors.initials: D
authors.lastname: Adlam
authors.affiliation: Sheffield Teaching Hospitals, National Health Service (NHS) Trust, Sheffield, UK.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Al-Mohammad
authors.affiliation: INSERM, Centre d'Investigation Clinique and Centre Hospitalier Universitaire and the Department of Cardiology, Nancy University, Université de Lorraine, Nancy, France.
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
mesh_terms: D000818:Animals; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D006333:Heart Failure / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000517:prevention & control; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D008954:Models, Biological; D056687:Off-Label Use; D018161:Receptors, Mineralocorticoid / Q000819:agonists* / Q000737:chemistry / Q000378:metabolism; D012720:Severity of Illness Index
chemical_list: D002317:Cardiovascular Agents; D000451:Mineralocorticoid Receptor Antagonists; C561839:NR3C2 protein, human; D018161:Receptors, Mineralocorticoid
keywords: eplerenone; mineralocorticoid receptor; novel indications; spironolactone