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Effect of Spironolactone on QRS Duration in Patients at Risk for Heart Failure (from the HOMAGE Trial).
Ferreira, João Pedro; Cleland, John G F; Girerd, Nicolas; Pellicori, Pierpaolo; Hazebroek, Mark R; Verdonschot, Job; Collier, Timothy J; Petutschnigg, Johannes; Clark, Andrew L; Staessen, Jan A; Heymans, Stephane; Rossignol, Patrick; Zannad, Faiez.
Afiliação
  • Ferreira JP; UnIC@RISE, Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Inserm, Centre d'Investigations Cliniques - Plurithématique 14-33, Université de Lorraine, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardio
  • Cleland JGF; British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
  • Girerd N; Inserm, Centre d'Investigations Cliniques - Plurithématique 14-33, Université de Lorraine, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
  • Pellicori P; British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
  • Hazebroek MR; Department of Cardiology, CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Verdonschot J; Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Collier TJ; London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Petutschnigg J; Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin and German Centre for Cardiovascular Research (DZHK), Berlin, Germany.
  • Clark AL; Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, United Kingdom.
  • Staessen JA; Non-profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium.
  • Heymans S; Department of Cardiology, CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Rossignol P; Inserm, Centre d'Investigations Cliniques - Plurithématique 14-33, Université de Lorraine, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
  • Zannad F; Inserm, Centre d'Investigations Cliniques - Plurithématique 14-33, Université de Lorraine, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.
Am J Cardiol ; 191: 39-42, 2023 03 15.
Article em En | MEDLINE | ID: mdl-36634548
ABSTRACT
The QRS duration can be easily obtained from a 12-lead electrocardiogram. Increased QRS duration reflects greater ventricular activation times and often ventricular dyssynchrony. Dyssynchrony causes an impairment of the global cardiac function and adversely affects the prognosis of patients with heart failure (HF). Little is known about the impact of pharmacologic therapies on the QRS duration, particularly for patients with presymptomatic HF with a preserved left ventricular (LV) ejection fraction (i.e., stage B HF with preserved ejection fraction [HFpEF]). The HOMAGE (Heart OMics in AGEing) trial enrolled patients at risk factors for developing HF and assigned them to receive either spironolactone or the usual care for approximately 9 months in a randomized manner. This analysis reports the effect of spironolactone on the QRS duration. A total of 525 patients was included in the analysis. The median (percentile25-75) QRS duration at baseline was 92 (84 to 106) ms. Spironolactone reduced the QRS duration at month 9 by -2.8, 95% confidence interval -4.6 to -1.0 ms, p = 0.003. No significant associations were found between month 9 changes in the QRS duration and corresponding changes in the LV ejection fraction, LV mass, LV end-diastolic volume, blood pressure, N-terminal pro-brain natriuretic peptide, and procollagen type I carboxy-terminal propeptide (all p >0.05). This analysis shows that for patients with stage B HFpEF, therapy with spironolactone for 9 months shortened the QRS duration, an effect that was not associated with reductions in LV mass or volume, supporting the hypothesis that spironolactone has direct beneficial effects to improve myocardial electrical activation in patients with stage B HFpEF.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Cardíaca Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Cardíaca Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article