Abstract:  Objective Toinvestigatetheefficacyandsafetyofspironolactoneinsystolic
heartfailurepatientswithmildrenaldysfunction.Methods Atotalof118systolicheartfailure
patientswith mildrenaldysfunction ( glomerularfiltrationrate [ GFR ] 60-90 mL · min
-1 ·
1. 73m -2 ) wererandomlydividedintotwogroups : controlgroupincluded58cases , given
conventionaltreatment ; spironolactonegroupincluded60cases , treatedwithspironolactone20
mg
/ donthebasisofconventionaltherapy.Allpatientswereassessedwithechocardiographyfor
leftventricularejectionfraction ( LVEF ), leftventricularmassindex ( LVMI ), leftventricularend
diastolicvolumeindex ( LVMI ) andleftventricularendsystolicvolumeindex ( LVEDVI ) before
treatmentand12 monthsaftertreatment.Results Beforetreatment , twogroupsshowedno
significantdifferenceinLVEF , LVMI , LVEDVIandLVESVI ( P >0. 05 ) .In12 monthsafter
treatment , LVEF , LVMI , LVEDVIandLVESVIwereamelioratedobviouslyintwogroups
( P <0.
05 ) .Compared with control group , spironolactone group was ameliorated more
significantly ( P <0. 05 ) .Therewerenosignificantincreaseinhyperkalemia
( Kalemia>5.
5mmol
/ L ) in spironolactonegroup ( P >0. 05 ) .Therewerenoseverehyperkalemia (
Kalemia≥6.0mmol
/ L ) in
twogroups.Thereweresignificantincreaseinhypokalemia ( Kalemia<3.5mmol
/ L ) incontrol
groupcompared with spironolactone group ( P <0. 05 ) .There weresignificantincreasein
gynecomastiaormastodyniainspironolactonegroupcomparedwithcontrolgroup ( P <0. 05 ) .
25%increaseinGFRhad2patientsineachgroup , therewerenostatisticalsignificanceintwo
groups ( P <0. 05 ) .Therewerenopatientsintwogroupsrequiringdialysistreatmentbecauseof
worseningrenalfunction.Conclusion Spironolactoneinadditiontotheroutinetreatmentfor
systolicheartfailurepatients with mildrenaldysfunctioncanfurtherameliorateventricular
remodeling , decreasetheincidenceofhypokalemia.Itwassafeinrigorousmonitor.

Key words: heartfailure, systolic , renalinsufficiency , spironolactone