Effect of Spironolactone on Left Ventricular Systolic and Diastolic Function in Patients With Early Stage Chronic Kidney Disease

Nicola Edwards, Charles Ferro, H Kirkwood, Colin Chue, AA Young, Paul Stewart, Richard Steeds, Jonathan Townend

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Patients with early chronic kidney disease (CKD) have an increased risk for cardiovascular disease. Aldosterone levels are elevated and might impair ventricular function through adverse myocardial and vascular proinflammatory and fibrotic effects. In the Chronic Renal Impairment in Birmingham II (CRIB II) study, it was hypothesized that mineralocorticoid receptor blockade with spironolactone in addition to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers would improve left ventricular (LV) function and markers of inflammation, ventricular stretch, and collagen turnover in early CKD. A total of 112 patients with early CKD were randomized to spironolactone 25 mg/day or placebo for 40 weeks. Ventricular function was assessed by echocardiography and cardiac magnetic resonance imaging tagging. High-sensitivity C-reactive protein, N-terminal pro-B-type natriuretic peptide, and aminoterminal propeptide of type III procollagen were measured. Spironolactone improved LV long-axis systolic function (Sm 8.2 +/- 1.4 vs 7.7 +/- 1.3 cm/s, p
Original languageEnglish
Pages (from-to)1505-1511
Number of pages7
JournalThe American Journal of Cardiology
Volume106
Issue number10
DOIs
Publication statusPublished - 1 Nov 2010

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