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Aldosterone Inhibition in Patients With Heart Failure With Preserved Ejection Fraction

Christopher J. A. Neil, MBBS, FRACP1; Satnam Singh, MBBC, MRCP1; Michael Frenneaux, MD, FRCP, FESC1
[+] Author Affiliations
1University of Aberdeen, Aberdeen, Scotland
JAMA. 2013;310(2):204. doi:10.1001/jama.2013.7970.
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To the Editor The Aldosterone Receptor Blockade in Diastolic Heart Failure (Aldo-DHF) study1 tested the hypothesis that aldosterone inhibition with spironolactone would result in improvement in maximum exercise capacity (peak V̇o2) or diastolic function (E/e′), each a co-primary end point. Whereas resting E/e′ was reduced by spironolactone, exercise capacity was not. The method of patient selection may have contributed to a false-negative result. We believe that this study illustrates the fundamental problems with the current concept of heart failure (HF) with preserved ejection fraction (EF) and, in particular, the role of exercise in this syndrome.

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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.
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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.
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