EFFECTS OF TREATMENT WITH MINERALOCORTICOID RECEPTOR ANTAGONISTS ON CARDIOVASCULAR AND RENAL PERFORMANCE OF PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a challenging clinical condition characterized by symptoms of heart failure with preserved left ventricular ejection fraction. Recently, treatment with mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone, has been investigated as a potential therapeutic approach to improve clinical outcomes in patients with HFpEF. The aim of this study was to review the effects of MRA treatment on cardiovascular and renal performance in these patients, analyzing the impacts on cardiac function, arterial stiffness, renal function, and long-term clinical outcomes. The analysis of the evidence suggests that MRA treatment can improve arterial stiffness and diastolic function, in addition to having a protective effect on renal function, reducing albuminuria and stabilizing the progression of renal disease. However, the use of these agents requires caution due to the risk of hyperkalemia, which highlights the need for continuous monitoring of patients. The results indicate that MRAs may be a valuable therapeutic option for patients with HFpEF, but clinical implementation should be carefully individualized and monitored.