Effect of Spironolacton on Remodeling of Left Ventricular in Patients of Acute Myocardial Infarction with Preserved Ejection Fraction

Abstract

Background & Aim: Few studies have reported the effect of aldosterone receptor antagonist on myocardial remodeling after acute myocardial infarction.

Study aim to investigate the effects of spironolactone on left ventricular (LV) remodeling in patients with preserved LV function following acute ST elevation myocardial infarction (STEMI).

Materials and Methods: This was a prospective cohort study conducted at Al-Assad and Al-Mouassat University Hospitals at Damascus during the period between September 2019–September 2020. Successfully revascularized STEMI patients (n=130) were included in the study. Patients were randomly divided into three groups, each of which was administered a different dose of spironolactone (12.5 mg, 25 mg, or none). Echocardiography was performed within the first 3 days and at 6 months after MI.

Results: The mean left ventricular ejection fraction (LVEF) increased significantly in all groups, but no significant difference was observed between groups (P = 0.179). At the end of the sixth month, the myocardial performance index (MPI) had improved in each of the three groups, but no significant difference was found between groups (P= 0.23). The left ventricular end-diastolic volume (LVEDV) significantly improved in the treatment group compared with the control group at 6 months (P<0.05). No significant difference was found between the two treatment groups  regarding the improvement in LVEDV.  

Conclusion: On the basis of conventional treatment, the early administration of low-dose spironolactone (12.5 -25 mg/d) could inhibit cardiac remodeling and prevent heart failure.