A retrospective study on the short-term effect of high-dose spironolactone (80 mg/d) on chronic congestive heart failure

Abstract To explore the short-term effect of high-dose spironolactone (80 mg/d) on chronic congestive heart failure (CHF). The general clinical data of 211 patients with CHF from February 2016 to August 2019 were collected and analyzed. Patients were divided into Low-dose group (taking 40 mg/d spironolactone) and High-dose group (taking 80 mg/d spironolactone) according to the patient's previous dose of spironolactone. The changes of B-type brain natriuretic peptide (BNP), NT-pro BNP (N terminal pro B type natriuretic peptide), echocardiography, 6-minute walking test (6MWT), and comprehensive cardiac function assessment data were collected for analysis. Compared with before treatment, the blood potassium of the two groups increased significantly (P < .05), but the blood potassium did not exceed the normal range. Compared with before treatment, BNP, NT-pro BNP, LVEDD, LVEDV and NYHA grading were significantly decreased (P < .05), LVEF and 6-MWT were significantly increased (P < .05). Compared with the Low-dose group, the high-dose group BNP (117.49 ± 50.32 vs 195.76 ± 64.62, P < .05), NT-pro BNP (312.47 ± 86.28 vs 578.47 ± 76.73, P < .05), LVEDD (45.57 ± 5.69 vs 51.96 ± 5.41, P <.05), LVEDV (141.63 ± 51.14 vs 189.85 ± 62.49, P < .05) and NYHA grading (1.29 ± 0.41 vs 1.57 ± 0.49, P < .05) were significantly reduced, but, 6-MWT (386.57 ± 69.72 vs 341.73 ± 78.62, P < .05), LVEF (41.62 ± 2.76 vs 36.02 ± 2.18, P < .05) and total effective rate (92.68% vs 81.39%, P < .05) increased significantly. Compared with 40 mg spironolactone, 80 mg spironolactone can rapidly reduce BNP and NT-pro BNP concentration, enhance exercise tolerance, improve clinical signs and cardiac function classification, and has better efficacy.