Cor Vasa 2002, 43(1):32-36
Aldosterone receptor inhibition in the treatment of chronic heart failure
- Kardiocentrum Fakultní nemocnice Královské Vinohrady a 3. lékařské fakulty Univerzity Karlovy, Praha, Česká republika
Despite comprehensive treatment, the long-term prognosis of patients in the advanced stages of chronic heart failure is grim. An explanation for this might be the secondary increase in aldosterone levels occurring after some time even during neurohumoral activation inhibition of the renin-angiotensin-aldosterone therapy using angiotensin-converting enzyme inhibitors. Aldosterone receptor inhibition by the non-selective mineralocorticoid receptor antagonist spironolactone reduces, in patients with severe heart failure NYHA Class III and IV, total mortality and the need for hospitalization, and improves the quality of life of these patients. This was demonstrated by the RALES mortality study, published in 1999, focusing our attention on the relevance of aldosterone receptor inhibition in the treatment of cardiac insufficiency.
The paper recapitulates the causes and consequences of increased aldosterone levels in patients with advanced chronic heart failure and comments on the results of the RALES mortality study.
Keywords: Chronic heart failure; Prognosis; Aldosterone; Receptor inhibition; Spironolactone
Published: January 1, 2002 Show citation