Aldosterone Receptor Antagonism Induces Reverse Remodeling When Added to Angiotensin Receptor Blockade in Chronic Heart Failure

Aldosterone Receptor Antagonism Induces Reverse Remodeling When Added to Angiotensin Receptor Blockade in Chronic Heart Failure Anna K. Y. Chan, John E. Sanderson, Tian Wang, Wynnie Lam, Gabriel Yip, Mei Wang, Yat-Yin Lam, Yan Zhang, Leata Yeung, Eugene B. Wu, Wilson W. M. Chan, John T. H. Wong, Nina So, Cheuk-Man Yu This study evaluated the effect of combining spironolactone and angiotensin receptor blocker on left ventricular (LV) function and reverse remodeling in 51 patients with systolic heart failure. In patients randomized to this combination therapy for 1 year, there were significant increases in LV ejection fraction and reduction in LV volume and mass indices by cardiac magnetic resonance imaging. There were also improvements in systolic velocities and strain by tissue Doppler imaging and reduction in myocardial fibrosis by cyclic variation integrated backscatter. Such benefits, however, were not observed in those randomized to the control group (candesartan + placebo).