Efficacy of aldosterone receptor antagonists therapy in patients wi th peripartum cardoi myopathy

HUANG Guan-gyong; ZHANG Lianying; DU Jing; ZHANG Xuesong; ZHUANG Fang

doi:10.3969/j.issn.1671-6450.2014.12.07

Abstract：Objective To evaluate the effect of aldosterone receptor antagonist spironolactone in the treatment of peri -partum cardiomyopathy (PPCM).Method Collected 72 cases of relatively stable PPCM patients, they were randomly divided into 2 groups, control group and treatment group with 36 cases in each group , they were treated with ACEI/ARB, beta bloc-kers, and trimetazidine, aspirin and other anti-heart failure treatment, the control group maintained the above treatment , treat-ment group based on the above treatment , also used of spironolactone 20 mg, 1 times a day , after 6 months of treatment , the heart rate, blood pressure, left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), N ter-minal brain precursor , electrolyte and heart function of natriuretic peptide NYHA classification were measured .Results After 6 months of treatment , 2 groups of patients ’ cardiac functional and LVEF have improved , heart rate and NT-proBNP level were decreased , and no death patients were recorded .Compared with the control group , the treatment group ’ s LVEF was in-creased ( P <0.05), heart function, blood pressure, heart rate, NT-proBNP were improved, but the difference was not sta-tistically significant ( P >0.05), and no abnormal increase of blood potassium levels were found , the treatment group’s a-symptomatic survival rate was higher than the control group , but the difference did not reach with statistical significance (85.2%vs.69.1%, Log rank χ2 =1.79, P =0.18).Conclusion Apart from standard anti heart failure drugs , aldoste-rone receptor antagonist give benefit to NYHA class II PPCM whose heart failure are relative steady .Aldosterone receptor an-tagonist enhanced cardiac systolic function , decreased onset of heart failure and do not bring serum potassium abnormal .