Evaluation of the comparative effectiveness of mineralocorticoid receptor antagonists in patients with chronic heart failure

Abstract

Purpose. To study the comparative efficacy of mineralocorticoid receptor antagonists (MCRA) on left ventricular diastolic function in patients with chronic heart failure (CHF).

Material and methods. We examined 131 patients with coronary heart disease (CHD) with functional class I-III (FC) CHF (according to NYHA). Patients were randomized into groups according to FC CHF data, according to the classification of the New York Heart Association according to the six-minute walk test (6MWT). The group of patients with FC I consisted of 31 patients, FC II - 51 and FC III - 49 patients.

Results. The study revealed that in patients with CHF, clinical disorders of diastolic function were initially identified in 98 (74.8%) patients with CHF. Long-term complex treatment of CHF patients with the inclusion of MCRA, along with a significant increase in exercise tolerance, improvement of the clinical condition of patients, contributed to the improvement of LV diastolic function - a decrease in the number of patients with LVDD to 58%, an improvement in the quality of life of patients, which were more pronounced in the group of patients taking eplerenone. In both groups, a positive dynamic of the structure of the CHF FC was achieved: the number of CHF patients with FC III decreased due to an increase in the proportion of patients with FC I-II.

Conclusion. Long-term complex treatment of CHF patients with the inclusion of MCRA, along with a significant increase in exercise tolerance, improvement of the clinical condition of patients, contributed to an improvement in LV diastolic function - a decrease in the number of patients with LVDD to 58%, and an improvement in the quality of life of patients.