Effects of mineralocorticoid receptor antagonist spironolactone on atrial conduction and remodeling in patients with heart failure

Summary Background Spironolactone was shown to reduce mortality in patients with heart failure (HF). However, the effect of spironolactone on the incidence of atrial fibrillation remains unknown. Therefore, we examined the effects of spironolactone on atrial conduction and remodeling in patients with HF. Methods and results A total of 21 patients with HF were divided into either spironolactone group ( n  = 11) or control group ( n  = 10). The patients were followed up for 12 months. Blood examination, echocardiogram, and signal-averaged electrocardiogram were performed at study enrollment and after 3 and 12 months of treatment. In the spironolactone group, atrial natriuretic peptide tended to reduce, left atrium dimension was significantly smaller, the ratio of E wave to A wave tended to improve, and P-duration was significantly shortened. Conclusions Spironolactone improves atrial conduction and remodeling in patients with HF.