Effects of spironolactone on heart rate variability and left ventricular systolic function in severe ischemic heart failure
Section snippets
Patients
Patients were eligible for enrollment if they had had New York Heart Association class II to IV heart failure at the time of enrollment, and if they had undergone coronary angiography and had been found unsuitable for coronary revascularization because of poor anatomy, and if their left ventricular ejection fraction was ≤35%. Patients who fulfilled these criteria and who had given written informed consent were included. Treatment with digitalis and vasodilators was allowed, but
Patients
In all, 126 patients (111 men and 15 women, mean age 60 ± 9 years [range 36 to 83]) were admitted to the study between May 1997 and December 1998. Twenty-nine patients (23%) had diabetes, 51 (40%) had hypertension, 76 (60%) had dyslipidemia, and 88 (70%) were smokers. The clinical condition of the patients was evaluated by detailed history and complete physical examination. Before the commencement of standard therapy, 70 patients (55%) were taking digoxin, 68 (54%) were taking diuretics, 35
Discussion
Our data clearly showed that, when added to standard therapy, spironolactone causes both a dramatic clinical improvement and favorable changes in TINN and pNN50. These changes were evident after the first month of therapy and continued in the long term, until the end of the follow-up period. However, we have not seen a significant change in the spectral components of HRV. We have no ready explanation for this. Maybe spectral components are much more complicated and controlled by various
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