A retrospective study on the short-term effect of high-dose spironolactone (80\u200amg/d) on chronic congestive heart failure

Abstract

Abstract To explore the short-term effect of high-dose spironolactone (80\u200amg/d) on chronic congestive heart failure (CHF). The general clinical data of 211 patients with CHF from February 2016 to August 2019 were collected and analyzed. Patients were divided into Low-dose group (taking 40\u200amg/d spironolactone) and High-dose group (taking 80\u200amg/d spironolactone) according to the patient s previous dose of spironolactone. The changes of B-type brain natriuretic peptide (BNP), NT-pro BNP (N terminal pro B type natriuretic peptide), echocardiography, 6-minute walking test (6MWT), and comprehensive cardiac function assessment data were collected for analysis. Compared with before treatment, the blood potassium of the two groups increased significantly (P\u200a<\u200a.05), but the blood potassium did not exceed the normal range. Compared with before treatment, BNP, NT-pro BNP, LVEDD, LVEDV and NYHA grading were significantly decreased (P\u200a<\u200a.05), LVEF and 6-MWT were significantly increased (P\u200a<\u200a.05). Compared with the Low-dose group, the high-dose group BNP (117.49\u200a±\u200a50.32 vs 195.76\u200a±\u200a64.62, P\u200a<\u200a.05), NT-pro BNP (312.47\u200a±\u200a86.28 vs 578.47\u200a±\u200a76.73, P\u200a<\u200a.05), LVEDD (45.57\u200a±\u200a5.69 vs 51.96\u200a±\u200a5.41, P\u200a<.05), LVEDV (141.63\u200a±\u200a51.14 vs 189.85\u200a±\u200a62.49, P\u200a<\u200a.05) and NYHA grading (1.29\u200a±\u200a0.41 vs 1.57\u200a±\u200a0.49, P\u200a<\u200a.05) were significantly reduced, but, 6-MWT (386.57\u200a±\u200a69.72 vs 341.73\u200a±\u200a78.62, P\u200a<\u200a.05), LVEF (41.62\u200a±\u200a2.76 vs 36.02\u200a±\u200a2.18, P\u200a<\u200a.05) and total effective rate (92.68% vs 81.39%, P\u200a<\u200a.05) increased significantly. Compared with 40\u200amg spironolactone, 80\u200amg spironolactone can rapidly reduce BNP and NT-pro BNP concentration, enhance exercise tolerance, improve clinical signs and cardiac function classification, and has better efficacy.