Abstract: ［Abstract］〓Objective〖HTSS〗〓To observe the effects of different doses of spironolactone on cardiac structure and function in patients with heart failure of ischemic cardiomyopathy.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The  120 patients with ischemic heart disease and heart failure were selected as study subjects. According to the random number table method, they were divided into control group, lowdose spironolactone group, middledose spironolactone group, and largedose spironolactone group, with 30 cases in each group. The control group given conventional treatment, lowdose spironolactone group plus 10 mg spironolactone, mediumdose spironolactone group with 20 mg spironolactone, highdose spironolactone group plus 40 mg spironolactone. The left ventricular ejection fraction(LVEF), left ventricular endsystolic diamete(LVESD), left ventricular enddiastolic diameter(LVEDD), nocardial function classificationin New York Heart Association(NYHA), Nterminal proBtype natriuretic peptide(NTproBNP), cardiac troponin T(cTnT), high sensitivity Creactive protein(hsCRP), tumor necrosis factorα(TNFα), procollagen type Ⅲ nitrogen terminal peptide(PⅢNP)， 6 min walking distance and clinical efficacy were compared among different groups.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The clinical efficacy of the middledose spironolactone group was better than that of the control group, and the total treatment efficiency was higher than that of the control group(P＜005).After treatment, the levels of NTproBNP, cTnT, hsCRP, TNFα, and PⅢNP in the 4 groups were lower than before treatment.The levels of NTproBNP, hsCRP, TNFα, and PⅢNP in lowdose spironolactone group, middledose spironolactone group, and largedose spironolactone group were lower than those in the control group. The level of cTnT in the middledose spironolactone group was lower than that in the control group. The levels of NTproBNP, hsCRP, TNFα, and PⅢNP in the middledose spironolactone group were lower than those in the lowdose spironolactone group and the highdose spironolactone group(P＜005).The LVEF value and 6 min walking distance of the 4 groups were greater than before treatment. The LVESD value, LVEDD value and NYHA functional class were less than before treatment. The LVEF value and 6 min walking distance of smalldose spironolactone group, middledose spironolactone group, and largedose spironolactone group were greater than those of the control group. NYHA cardiac function was less than the control group. The LVEDD value of the middledose spironolactone group was lower than that of the control group, and the NYHA heart function of the middledose spironolactone group. The grading was smaller than that of the smalldose spironolactone group and the largedose spironolactone group, and 6 min walking distance was greater than that of the smalldose spironolactone group and the highdose spironolactone group(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Compared with the 10 mg and 40 mg dose groups, the 20 mg dose of spironolactone can effectively control the ventricular remodeling in patients with ischemic cardiomyopathy heart failure, which will benefit the improvement of cardiac function and is worthy of clinical application.

Key words: heart failure, spironolactone, ventricular remodeling