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(Hypertension. 2007;50:461.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Promise of Mineralocorticoid Receptor Blockade in Asymptomatic Left Ventricular Dysfunction

Bertram Pitt

From the University of Michigan School of Medicine, Ann Arbor.

Correspondence to Bertram Pitt, Cardiovascular Center, University Hospital, 1500 East Medical Center Dr, Ann Arbor, MI 49109. E-mail bpitt@umich.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Mineralocorticoid receptor blockade (MRB) has been shown to improve survival and reduce hospitalizations for heart failure (HF) in patients with chronic severe HF (New York Heart Association class III to IV) because of systolic left ventricular dysfunction¹ and in patients with myocardial infarction complicated by systolic left ventricular dysfunction and HF.² The role of MRB in patients with mild-to-moderate HF (New York Heart Association class II) because of systolic left ventricular dysfunction is currently under investigation in a large-scale prospective, randomized study (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure [EMPHASIS-HF]). MRB has also been shown to improve echocardiographic indices of diastolic function in patients with diastolic HF and is currently under investigation in a large-scale prospective, randomized study in patients with HF and preserved left ventricular function, Treatment of Preserved Cardiac function heart failure with an Aldosterone anTagonist (TOPCAT).

Costello-Boerrigter et al,³ in this issue of Hypertension, shift our focus to the potential role of MRB in asymptomatic left ventricular dysfunction (ALVD). The Studies Of Left Ventricular Dysfunction (SOLVD) prevention trial has shown the benefit of an angiotensin-converting enzyme (ACE) inhibitor and a ß-adrenergic receptor blocking agent to improve survival and to reduce hospitalizations for HF in patients with ALVD.⁴ There is, however, reason to believe that MRB will add to the beneficial effects of an ACE inhibitor and/or an angiotensin receptor blocker and a ß-adrenergic receptor blocking agent. Although an ACE inhibitor and/or an angiotensin receptor blocker can transiently decrease the production of aldosterone . . . [Full Text of this Article]

Related Article:

Mineralocorticoid Escape by the Kidney But Not the Heart in Experimental Asymptomatic Left Ventricular Dysfunction

Lisa C. Costello-Boerrigter, Guido Boerrigter, Gail J. Harty, Alessandro Cataliotti, Margaret M. Redfield, and John C. Burnett, Jr
Hypertension 2007 50: 481-488. [Abstract] [Full Text] [PDF]

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