Portal de investigação
Effect of Spironolactone on QRS Duration in Patients at Risk for Heart Failure (from the HOMAGE Trial)
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Cleland, JGF
- Girerd, N
- Pellicori, P
- Hazebroek, MR
- Verdonschot, J
- Collier, TJ
- Petutschnigg, J
- Clark, AL
- Staessen, JA
- Heymans, S
- Rossignol, P
- Zannad, F
Unidades de investigação
Abstract
The QRS duration can be easily obtained from a 12-lead electrocardiogram. Increased QRS duration reflects greater ventricular activation times and often ventricular dyssyn-chrony. 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 presymp-tomatic 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 spi-ronolactone 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% confi-dence 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 frac-tion, 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.(c) 2022 Elsev-ier Inc. All rights reserved. (Am J Cardiol 2023;191:39-42)
Dados da publicação
- ISSN/ISSNe:
- 0002-9149, 1879-1913
- Tipo:
- Article
- Páginas:
- 39-42
- Link para outro recurso:
- www.scopus.com
American Journal of Cardiology Elsevier Inc.
Citações Recebidas na Scopus: 1
Documentos
- Não há documentos
Filiações
Keywords
- Heart Failure; Humans; Spironolactone; Stroke Volume; Ventricular Function, Left; amino terminal pro brain natriuretic peptide; procollagen C proteinase; spironolactone; Procollagen Type I; spironolactone; aged; Article; cardiovascular risk; controlled study; disease classification; female; heart failure with preserved ejection fraction; heart left ventricle ejection fraction; heart left ventricle enddiastolic volume; heart left ventricle mass; human; major clinical study; male; QRS interval; sex difference; systolic blood pressure; treatment duration; heart failure; heart left ventricle function; heart stroke volume; physiology
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Citar a publicação
Ferreira JP,Cleland JGF,Girerd N,Pellicori P,Hazebroek MR,Verdonschot J,Collier TJ,Petutschnigg J,Clark AL,Staessen JA,Heymans S,Rossignol P,Zannad F. Effect of Spironolactone on QRS Duration in Patients at Risk for Heart Failure (from the HOMAGE Trial). Am. J. Cardiol. 2023. 191. p. 39-42. IF:2,800. (3).
