{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:00:11Z","timestamp":1789646411186,"version":"4.0.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,27]]},"abstract":"\n Background<\/jats:title>\n \n There has been an increasing interest in use of mineralocorticoid receptor antagonists (\n MRA<\/jats:styled-content>\n s) in patients with heart failure with preserved ejection fraction (\n HFPEF<\/jats:styled-content>\n ). However, a comprehensive evaluation of\n MRA<\/jats:styled-content>\n effects on left ventricular (\n LV<\/jats:styled-content>\n ) structure and function in these patients is lacking. In this meta\u2010analysis, we evaluated the effects of\n MRA<\/jats:styled-content>\n s on\n LV<\/jats:styled-content>\n structure and function among patients with diastolic dysfunction or\n HFPEF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods & Results<\/jats:title>\n \n Randomized, controlled clinical trials evaluating the efficacy of\n MRA<\/jats:styled-content>\n s in patients with diastolic dysfunction or\n HFPEF<\/jats:styled-content>\n were included. The primary outcome was change in E\/e\u2019, a specific measure of diastolic function. Secondary outcomes included changes in other measures of diastolic function,\n LV<\/jats:styled-content>\n structure, surrogate markers for myocardial fibrosis (carboxy\u2010terminal peptide of procollagen type I [\n PICP<\/jats:styled-content>\n ] and amino\u2010terminal peptide of pro\u2010collagen type\u2010\n II<\/jats:styled-content>\n [\n PIIINP<\/jats:styled-content>\n ]), blood pressure, and exercise tolerance. In the pooled analysis,\n MRA<\/jats:styled-content>\n use was associated with significant reduction in E\/e\u2019 (weighted mean difference [\n WMD<\/jats:styled-content>\n ] [95% confidence interval {\n CI<\/jats:styled-content>\n }]: \u22121.68 [\u22122.03 to \u22121.33];\n P<\/jats:italic>\n <0.0001) and deceleration time (\n WMD<\/jats:styled-content>\n [95%\n CI<\/jats:styled-content>\n ]: \u221212.0\u00a0ms [\u221223.3 to \u22120.7];\n P<\/jats:italic>\n =0.04) as compared with control, suggesting and improvement in diastolic function. Furthermore, blood pressure and levels of\n PIIINP<\/jats:styled-content>\n and\n PICP<\/jats:styled-content>\n were also significantly reduced with\n MRA<\/jats:styled-content>\n therapy with no significant change in\n LV<\/jats:styled-content>\n mass or dimensions.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n MRA<\/jats:styled-content>\n therapy in patients with asymptomatic diastolic dysfunction or\n HFPEF<\/jats:styled-content>\n is associated with significant improvement in diastolic function and markers of cardiac fibrosis without a significant change in\n LV<\/jats:styled-content>\n mass or dimensions.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002137","type":"journal-article","created":{"date-parts":[[2015,10,13]],"date-time":"2015-10-13T20:08:11Z","timestamp":1444766891000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["Effect of Mineralocorticoid Receptor Antagonists on Cardiac Structure and Function in Patients With Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction: A Meta\u2010Analysis and Systematic Review"],"prefix":"10.1161","volume":"4","author":[{"given":"Ambarish","family":"Pandey","sequence":"first","affiliation":[{"name":"UT Southwestern Medical Center, Dallas, TX, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Garg","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical Center, Minneapolis, MN, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A.","family":"Matulevicius","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center, Dallas, TX, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amil M.","family":"Shah","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Boston, MA, 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