[The AREA IN-CHF trial (antiremodeling effect of aldosterone receptors blockade with canrenone in mild chronic heart failure): rationale and design].

Abstract	The RALES study has shown that spironolactone reduces the risk of morbidity and mortality both from progressive heart failure and sudden death in patients with NYHA class III or IV heart failure. This favorable effect was clearly independent of a diuretic effect. EPHESUS extended these results to eplerenone in patients with acute myocardial infarction complicated by left ventricular dysfunction and signs of heart failure. Antialdosterone drugs may be effective because they oppose the effects of aldosterone to sodium retention, loss of magnesium and potassium, sympathetic activation, baroreceptor function and vascular compliance. Antialdosterone treatment may also antagonize the effect of aldosterone in promoting cardiac fibrosis. In a RALES substudy baseline serum PIIINP, a marker of extracellular matrix turnover, showed an independent negative correlation with survival and chronic heart failure hospitalizations in the placebo group. Therefore it seems interesting to evaluate the effect of canrenone, an aldosterone receptor blocker, on the progression of left ventricular dysfunction in patients with mild heart failure assuming standard therapy.
Authors	Giuseppe Cacciatore, Alessandro Boccanelli, Gian Francesco Mureddu, Aldo Pietro Maggioni, Roberto Latini, Serge Masson, Giovanni de Simone, Investigatori dell' Area In-CHF
Journal	Italian heart journal : official journal of the Italian Federation of Cardiology (Ital Heart J) Vol. 6 Suppl 1 Pg. 66S-74S (May 2005) ISSN: 1129-471X [Print] Italy
Vernacular Title	Lo studio AREA IN-CHF (antiremodeling effect of aldosterone receptors blockade with canrenone in mild chronic heart failure): razionale e disegno.
PMID	15945301 (Publication Type: English Abstract, Journal Article, Review)
Chemical References	Mineralocorticoid Receptor Antagonists
Topics	Adolescent Adult Aged Aged, 80 and over Clinical Trials as Topic (methods) Heart Failure (complications, drug therapy) Humans Middle Aged Mineralocorticoid Receptor Antagonists Ventricular Remodeling (drug effects)

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