The spironolactone renaissance

@article{Doggrell2001TheSR,
  title={The spironolactone renaissance},
  author={S. Doggrell and Lindsay Brown},
  journal={Expert Opinion on Investigational Drugs},
  year={2001},
  volume={10},
  pages={943 - 954}
}
Until recently, spironolactone was considered only as an antagonist at the aldosterone receptors of the epithelial cells of the kidney and was used clinically in the treatment of hyperaldosteronism and, occasionally, as a K+-sparing diuretic. The spironolactone renaissance started with the experimental finding that spironolactone reversed aldosterone-induced cardiac fibrosis by a cardiac action. Experimentally, spironolactone also has direct effects on blood vessels. Spironolactone reduces… Expand
View on Taylor & Francis
ncbi.nlm.nih.gov
44 Citations
Background Citations
21
Methods Citations
1

44 Citations

Citation Type

Citation Type

Aldosterone receptor blockers spironolactone and canrenone: two multivalent drugs
TLDR
Both canrenone and hydrochlorothiazide can enhance the effect of treatment with ACE inhibitors and angiotensin II receptor blockers on microalbuminuria, but ALDO receptor blockers are more active. Expand
Rapid Effects of Aldosterone and Spironolactone in the Isolated Working Rat Heart
TLDR
Examination of the hemodynamic effects of aldosterone and its receptor antagonist, spironolactone in the isolated rat heart by use of the Langendorff-Neely technique demonstrates that ald testosterone and spironOLactone have rapid, positive inotropic actions on the myocardium. Expand
Aldosterone, mineralocorticoid receptor, and heart failure
TLDR
Experimental and clinical data clearly highlight the deleterious cardiovascular effects of MR stimulation, and the importance of this receptor in cardiovascular tissue. Expand
Central mineralocorticoid receptor blockade decreases plasma TNF-alpha after coronary artery ligation in rats.
TLDR
Findings suggest that activation of MR in the central nervous system plays a critical role in regulating TNF-alpha release in heart failure rats, and some of the beneficial effect of blocking MR inHeart failure could be due at least in part to a reduction in TNF -alpha production. Expand
Should the aldosterone-receptor antagonist – eplerenone – be used after acute myocardial infarction with left ventricular dysfunction?
  • S. Doggrell
  • Medicine
  • Expert opinion on pharmacotherapy
  • 2003
TLDR
Eplerenone should probably be added to the optimal therapy for use after acute MI with LV dysfunction, provided care is taken to avoid hyperkalaemia. Expand
Determinants of spironolactone binding specificity in the mineralocorticoid receptor.
TLDR
Analysis of this model in light of the experimental data suggested that spironolactone binding specificity is not governed by amino acids in the ligand-binding pocket. Expand
Present and future pharmacotherapy for heart failure
TLDR
The pharmacotherapy currently recommended by the American College of Cardiology and the American Heart Association for heart failure is a diuretic, an angiotensin-converting enzyme inhibitor (ACEI), a β-adrenoceptor antagonist and (usually) digitalis, although digitalis does not reduce mortality. Expand
Attenuation of adverse cardiac effects in prednisolone-treated δ-sarcoglycan-deficient mice by mineralocorticoid-receptor-antagonism
TLDR
The beneficial effects of oral spironolactone on cardiac haemodynamics in Sgcd-null mice and its ability to prevent some of the adverse effects of glucocorticoids are demonstrated. Expand
Diuretic and renal effects of spironolactone and heart failure hospitalizations: a TOPCAT Americas analysis
TLDR
The effects of spironolactone on weight, diuretic use, and renal function, and their subsequent impact on outcomes are examined. Expand
Effects of Spironolactone on Corneal Allograft Survival in the Rat
TLDR
Initial results demonstrating anti-inflammatory effects of spironolactone are presented, which affected both systemic (down-regulation of CD25+ cells in spleen) and local immune response (up- regulation of IL-10 in cornea). Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 70 REFERENCES
Spironolactone inhibits the transcardiac extraction of aldosterone in patients with congestive heart failure.
TLDR
Transcardiac extraction or spillover of aldosterone (ALDO) in normal subjects and in patients with congestive heart failure is evaluated, suggesting that spironolactone blocks the effects of ALDO on the failing heart in Patients with CHF. Expand
Effects of spironolactone on heart rate variability and left ventricular systolic function in severe ischemic heart failure.
TLDR
Data imply that in patients with heart failure who are taking conventional drugs, the addition of spironolactone induces a favorable sympathovagal balance, as assessed by the triangular interpolation of the NN histogram and the percentage of differences between successive normal RR intervals differing >50 ms over a 24-hour electrocardiography, persisted in the long term. Expand
Effects of adding spironolactone to an angiotensin-converting enzyme inhibitor in chronic congestive heart failure secondary to coronary artery disease.
TLDR
The principal finding is that cardiac norepinephrine uptake as assessed by 123I-metaiodobenzylguanidine scintigraphy increased with spironolactone, which is a good result for patients with New York Heart Association II to III congestive heart failure. Expand
Effects of spironolactone on exercise capacity and neurohormonal factors in patients with heart failure treated with loop diuretics and angiotensin-converting enzyme inhibitor.
TLDR
Chronic additive treatment with spironolactone was associated with neurohormonal activation both at rest and during exercise without changing the exercise capacity of patients with mild CHF who were already on loop diuretics and ACE inhibitor therapy. Expand
Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension.
TLDR
It is concluded that spironolactone may have beneficial effects on left ventricular hypertrophy in patients with essential hypertension who are receiving an angiotensin-converting enzyme inhibitor. Expand
The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.
TLDR
Blockade of aldosterone receptors by spironolactone, in addition to standard therapy, substantially reduces the risk of both morbidity and death among patients with severe heart failure. Expand
Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure.
TLDR
Spironolactone improves endothelial dysfunction, increases NO bioactivity, and inhibits vascular Ang I/Ang II conversion in patients with heart failure, providing novel mechanisms for its beneficial effect on cardiovascular mortality. Expand
Effect of spironolactone on ventricular arrhythmias in congestive heart failure secondary to idiopathic dilated or to ischemic cardiomyopathy.
TLDR
It is suggested that aldosterone may contribute to the incidence of ventricular arrhythmia in patients with CHF, and spironolactone helps reduce this complication. Expand
Limitation of Excessive Extracellular Matrix Turnover May Contribute to Survival Benefit of Spironolactone Therapy in Patients With Congestive Heart Failure
TLDR
This study investigated the interactions between serum markers of cardiac fibrosis and the effect of spironolactone on outcome in patients with CHF, finding that at 6 months, markers decreased in the spironOLactone group but remained unchanged in the placebo group. Expand
Effect of spironolactone and its metabolites on contractile property of isolated rat aorta rings.
TLDR
The effects of spironolactone, canrenone, and potassium canrenoate on contractile properties of isolated rat aorta rings are evaluated to suggest that these drugs could act through an inhibition of voltage-dependent Ca2+ channels. Expand
...
1
2
3
4
5
...