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Impact of Spironolactone on Diastolic Function and Exercise Capacity in Heart Failure Patients

This randomized controlled trial evaluates the effects of spironolactone on diastolic function over one year. While diastolic function improved, there was no significant effect on exercise capacity, as measured by peak VO2, in patients with heart failure. The study highlights the dissociation between improved diastolic parameters and exercise tolerance, raising questions about spironolactone's role in heart failure management. Results showed a significant change in diastolic function metrics, with implications for treatment strategies in patients with preserved ejection fraction.

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Impact of Spironolactone on Diastolic Function and Exercise Capacity in Heart Failure Patients

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  1. Aldo-DHFRandomizedControlledTrialImproved diastolic function after 1 year of spironolactone does not improve exercise capacity Peak V• O2 E/e´ medialvelocity ratio Placebo Spironolactone P <.001 P <.001 P = .81 Change in Peak VO2, mL/min/kg Change in E/e´ P = .57 Time SinceRandomization Edelmann et al., 2013 JAMA 309(8):781-791

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