{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:56:35Z","timestamp":1790834195834,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["NIH- NHLBI - K23 H093214"],"award-info":[{"award-number":["NIH- NHLBI - K23 H093214"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p>The renin\u2013angiotensin\u2013aldosterone system is implicated in the pathophysiology of pulmonary arterial hypertension. We undertook this study to determine the effects of spironolactone, a mineralocorticoid receptor blocker, on collagen metabolism in pulmonary arterial hypertension patients. After obtaining institutional review board approval and informed consent, 42 pulmonary arterial hypertension patients were prospectively enrolled and 35 patients completed the 16\u2010week randomized double\u2010blinded crossover clinical trial. Subjects received 50\u2009mg spironolactone or placebo and at the end of week 8, treatment arm was switched. Circulating levels of collagen biomarkers, brain natriuretic peptide, and aldosterone levels were measured, and six\u2010minute walk distance, liver function tests, and echocardiogram data were collected at weeks 0, 8, and 16. Mean age was 45\u2009\u00b1\u200915 years and 87% were females. At baseline, brain natriuretic peptide and aldosterone levels were 74\u2009\u00b1\u200995\u2009pg\/ml and 7\u2009\u00b1\u20098\u2009pg\/ml, respectively. There was no change in the levels of amino\u2010terminal propeptide of procollagen type III (PIIINP), MMP\u20109, TIMP\u20101, and MMP\u20109\/TIMP\u20101 ratio at weeks 8 and 16 compared to baseline values in placebo arm and treatment arm. The baseline six\u2010min walk distance was 436\u2009\u00b1\u2009115\u00a0meters at baseline and no change in walk distance was noted at weeks 8 and 16 (<jats:italic>P<\/jats:italic>\u2009=\u20090.372). None of the patients developed hyperkalemia or liver function test abnormalities at weeks 8 and 16 requiring discontinuation of study drug. Our study showed no change in collagen metabolite levels in pulmonary arterial hypertension patients treated with spironolactone. Spironolactone was safe and well tolerated by pulmonary arterial hypertension patients with no increased hyperkalemia or liver function test abnormalities.<\/jats:p>","DOI":"10.1177\/2045894019898030","type":"journal-article","created":{"date-parts":[[2020,1,29]],"date-time":"2020-01-29T10:48:57Z","timestamp":1580294937000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Spironolactone in pulmonary arterial hypertension: results of a cross\u2010over study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8984-8205","authenticated-orcid":false,"given":"Zeenat","family":"Safdar","sequence":"first","affiliation":[{"name":"Division of Pulmonary\u2010Critical Care Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adaani","family":"Frost","sequence":"additional","affiliation":[{"name":"Division of Pulmonary\u2010Critical Care Medicine Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arya","family":"Basant","sequence":"additional","affiliation":[{"name":"Division of Cardiology Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Deswal","sequence":"additional","affiliation":[{"name":"Division of Cardiology Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"O\u2019Brian Smith","sequence":"additional","affiliation":[{"name":"Division of Pediatrics Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Entman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00081302"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1470320317729919"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s000590050024"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4172\/2161-105X.1000295"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002137"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313731"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.03.013"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201203-0411OC"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs173"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00007109"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2010.12.005"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020204"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200307-957OC"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012212"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","unstructured":"Effectiveness of spironolactone added to an angiotensin\u2010converting enzyme inhibitor and a loop diuretic for severe chronic congestive heart failure (the Randomized Aldactone Evaluation Study [RALES]).Am J Cardiol1996; 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