| Objectives To evaluate the effects of spironolactone on the postinfarction collagen synthesis and the left ventricular systolic and diastolic function in patients with acute myocardial infarction (AMI).Methods 65 patients with AMI were involved in our study and randomized into two groups. Conventional group (32 patients, ages (63 + 11) years, 22 males) received angiotensin-converting enzyme inhibitor, 3 -blocker and anti-plaque agent. Spironolactone group (33 patients, ages (62+10) years, 23 males) received spironolactone 20mg twice a day in addition to conventional treatment. The serum concentrations of the carboxyterminal propeptide of type I procollagen (PICP) and the aminoterminal propeptide of type III precollagen (PIIINP) on 5th, 15th, 30th and 90th days after infarction were determined by the radioimmunologic method. Before discharge and on day 90 all patients underwent echocardiography to determine the left ventricular end-diastolic diameter (LVEDd), the left ventricular ejection fraction (LVEF) and the E/A ratio. Correlation analyses were made between the E/A ratio and the serum concentrations of PICP and PIIINP on day 90. 30 healthy people served as control group(ages (62 + 9) years, 20 males).Results The serum concentrations of PICP and PIIINP in two groups were significantly higher than those in control group on 5th, 15th, 30th and 90th days after infarction (all PO.05). On day 90 the serumconcentrations of PICP and PIIINP in spironolactone group were significantly decreased in comparison to those in conventional group (both P<0.05), the E/A ratio was significantly higher in spironolactone group than that in conventional group (.PO.01) and there were significant negative correlations between the E/A ratio and the serum concentrations of PICP and PIIINP (all PO.001).Conclusion Spironolactone may inhibit the abnormal myocardial collagen synthesis and improve the left ventricular diastolic function in patients with AMI. |
PDF Full Text Request