Does spironolactone reduce markers of cardiac fibrosis synthesis and improve outcomes in patients with congestive heart failure?
The survival benefit of spironolactone in congestive heart failure may be partly mediated by limiting excessive extracellular matrix turnover and cardiac fibrosis.
In patients with CHF, high baseline serum levels of markers of cardiac fibrosis synthesis are significantly associated with poor outcome and decrease during spironolactone therapy. The benefit from spironolactone was associated with higher levels of collagen synthesis markers. These results suggest that limitation of the excessive extracellular matrix turnover may be one of the various extrarenal mechanisms contributing to the beneficial effect of spironolactone in patients with CHF.
Zannad et al. (2000) studied this question.