Abstract
We investigated whether spironolactone-induced regression of myocardial fibrosis is associated with improvement of left ventricular (LV) diastolic function in dilated cardiomyopathy (DCM). Methods and Results: Tissue Doppler echocardiography, LV catheterization and biopsies were performed in 10 DCM patients before and after 12 months of treatment with spironolactone. The biochemical index of coupling between the synthesis (PIP) and degradation (CITP) of collagen type-I revealed the presence of 2 subgroups: 5 with PIP/CITP < 40 (GroupA) and 5 with PIP/CITP > 40 (GroupB). After the treatment, collagen volume fraction (CVF), LV chamber stiffness, and diastolic strain-rate were significantly improved in GroupB accompanied with a reduction of PIP/CITP, but not in GroupA (Table). CVF correlated with PIP/CITP (r = 0.70). Conclusions: Spironolactone improves LV diastolic function and chamber stiffness accompanied with regression of fibrosis in patients with higher PIP/CITP. [Display omitted]
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