We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Aldosterone Inhibition in Patients With Heart Failure With Preserved Ejection Fraction

Lars H. Lund, MD, PhD1; Marcus Ståhlberg, MD, PhD1
[+] Author Affiliations
1Karolinska Institutet, Stockholm, Sweden
JAMA. 2013;310(2):205. doi:10.1001/jama.2013.7967.
Text Size: A A A
Published online


To the Editor The Aldo-DHF trial1 (similar to other trials in HF with preserved EF2,3) failed to demonstrate a benefit from neurohormonal antagonism. We are concerned about the inclusion criteria and power of the study.

Did patients in the Aldo-DHF study actually have diastolic HF? The salient inclusion criterion was diastolic dysfunction. However, this was mild (mostly grade 1) and occurred in the healthy elderly population, and therefore does not equate with diastolic HF. Nonspecific symptoms (fatigue and nocturia) and signs (eg, peripheral edema) were common, whereas specific symptoms (eg, paroxysmal nocturnal dyspnea) and signs (eg, rales) were less common or not reported. We wonder if the diastolic dysfunction criterion led to recruitment skewed toward echocardiographic rather than clinical findings.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




July 10, 2013
Frank Edelmann, MD; Rolf Wachter, MD; Burkert Pieske, MD
1Department of Cardiology and Pneumology, University of Göttingen, Göttingen, Germany
2Department of Cardiology, Medical University Graz, Graz, Austria
JAMA. 2013;310(2):205-207. doi:10.1001/jama.2013.7976.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.