{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:09:13Z","timestamp":1784027353543,"version":"3.55.0"},"reference-count":31,"publisher":"Bentham Science Publishers Ltd.","issue":"1","content-domain":{"domain":["eurekaselect.com"],"crossmark-restriction":true},"short-container-title":["CVP"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n<jats:title>Background:<\/jats:title>\n<jats:p>Heart failure is a major cause of morbidity and mortality globally. By the\nend of this decade, ~8 million Americans will have heart failure with an expenditure of $69.8 billion.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Objective:<\/jats:title>\n<jats:p>In this narrative review, we evaluate the benefits, potential risks and the role of mineralocorticoid\nreceptor antagonists (MRAs) in the management of both Heart Failure with Preserved\nEjection Fraction (HFpEF) and Heart Failure with Reduced Ejection Fraction (HFrEF).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods:<\/jats:title>\n<jats:p>We performed a comprehensive literature review to assess the available evidence on the\nrole of MRAs in heart failure using the online databases (PubMed, Embase, Scopus, CINAHL and\nGoogle Scholar).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results:<\/jats:title>\n<jats:p>Clinical evidence shows that MRAs such as spironolactone and eplerenone reduce mortality\nand readmissions for patients with HFrEF compared with placebo. Furthermore, one trial reported\nthat MRAs reduce heart failure hospitalization in patients with HFpEF. The American College\nof Cardiology\/American Heart Association Guidelines strongly recommend using MRA in patients\nwith reduced left ventricular ejection fraction (LVEF) with Class II-IV symptoms, estimated\nglomerular filtration rate &gt;30 ml\/min\/1.73 m2, and absence of hyperkalemia. Despite this, MRAs\nare underutilized in the management of heart failure.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions:<\/jats:title>\n<jats:p>MRAs improve outcomes in patients with both HFpEF and HFrEF but remain underutilized.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1570161119666210720120439","type":"journal-article","created":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T07:16:01Z","timestamp":1627197361000},"page":"46-51","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effect of Mineralocorticoid Receptor Antagonists in Heart Failure with Preserved Ejection Fraction and with Reduced Ejection Fraction - A Narrative Review"],"prefix":"10.2174","volume":"20","author":[{"given":"Adriana","family":"Mares","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayana","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhizith","family":"Deoker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Lehker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5131-3694","authenticated-orcid":true,"given":"Debabrata","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"ref=1","doi-asserted-by":"publisher","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","volume":"143","author":"Virani S.S.","year":"2021","unstructured":"Virani S.S.; Alonso A.; Aparicio H.J.; Benjamin E.J.; Bittencourt M.S.; Callaway C.W.; Carson A.P.; Chamberlain A.M.; Cheng S.; Delling F.N.; Elkind M.S.V.; Evenson K.R.; Ferguson J.F.; Gupta D.K.; Khan S.S.; Kissela B.M.; Knutson K.L.; Lee C.D.; Lewis T.T.; Liu J.; Loop M.S.; Lutsey P.L.; Ma J.; Mackey J.; Martin S.S.; Matchar D.B.; Mussolino M.E.; Navaneethan S.D.; Perak A.M.; Roth G.A.; Samad Z.; Satou G.M.; Schroeder E.B.; Shah S.H.; Shay C.M.; Stokes A.; VanWagner L.B.; Wang N.Y.; Tsao C.W.; Heart disease and stroke statistics-2021 update: A report from the American heart association. 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