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The effects of spironolactone on atrial remodeling in patients with preserved left ventricular function after an acute myocardial infarction
- Source :
- Coronary Artery Disease. 21:477-485
- Publication Year :
- 2010
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2010.
-
Abstract
- Atrial remodeling is an important part of cardiac remodeling after acute myocardial infarction (AMI). The aim of this study was to evaluate the effect of spironolactone on atria in patients with preserved left ventricular (LV) functions after AMI by using two-dimensional and tissue Doppler imaging techniques (TDI).The study consisted of 110 patients with AMI, successfully revascularized with percutaneous coronary intervention, ejection fraction greater than or equal to 40%, and Killip class I-II. Patients were randomized into two groups: conventional therapy (n=55) and additional spironolactone of 25 mg/day with standard conventional therapy (n=55). Echocardiography was performed in the first 48-72 h of AMI and during 6 months of follow-up. Left atrial volume index and emptying fraction were obtained. The peak regional atrial contraction velocity, the time between the onset of p-wave on the monitor ECG and the onset, peak, and the end (TE) of the atrial contraction wave on the tissue Doppler technique curve were measured.The left atrial volume index and left atrium (LA) dimensions did not significantly change in either group. In the spironolactone group, left atrial emptying fraction increased compared with both baseline value (from 53.0 ± 0.16 to 57.0 ± 0.13 P=0.011) and conventional therapy group (from 50.0 ± 0.17 to 47.0 ± 0.16, P=0.013). The atrial contraction velocity did not change but the LA-TE, interatrial septum-TE, and right atrium-TE were prolonged in the conventional therapy group.Additional spironolactone therapy provided a little benefit on LA remodeling and atrial electromechanic properties in patients with AMI and preserved LV functions.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
health care facilities, manpower, and services
medicine.medical_treatment
Echocardiography, Three-Dimensional
Myocardial Infarction
Spironolactone
Ventricular Function, Left
law.invention
Electrocardiography
chemistry.chemical_compound
Randomized controlled trial
law
Angioplasty
Internal medicine
Humans
Medicine
In patient
Heart Atria
cardiovascular diseases
Myocardial infarction
Angioplasty, Balloon, Coronary
health care economics and organizations
Aged
Mineralocorticoid Receptor Antagonists
Chi-Square Distribution
medicine.diagnostic_test
Ventricular function
business.industry
Follow up studies
General Medicine
Middle Aged
Atrial Function
medicine.disease
Echocardiography, Doppler
Treatment Outcome
chemistry
cardiovascular system
Cardiology
Female
Stents
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 09546928
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Coronary Artery Disease
- Accession number :
- edsair.doi.dedup.....13f8c00ae5977cd37d3a4120c3a0a5ec