Evidence map›Paper›PMID 26459931›Full record

SynthesisJournal of the American Heart Association2015

Effect of Mineralocorticoid Receptor Antagonists on Cardiac Structure and Function in Patients With Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction: A Meta-Analysis and Systematic Review.

Ambarish Pandey, Sushil Garg, Susan A Matulevicius, Amil M Shah, Jalaj Garg, Mark H Drazner, Alpesh Amin, Jarett D Berry, Thomas H Marwick, Steven P Marso and 2 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 6 pooled it
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 6 syntheses or guidelines pooled it, 73 citations in OpenAlex.

  1. Pooled it
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  11. Article
  12. Review
  13. Rewiring the scar: translational advances in cardiac fibrosis.The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2025
    Review
  14. Review
  15. Observational
  16. Review
  17. Adverse Effects of Aldosterone: Beyond Blood Pressure.Journal of the American Heart Association · 2024
    Review
  18. Review
  19. Bioactive Compounds and Cardiac Fibrosis: Current Insight and Future Prospect.Journal of cardiovascular development and disease · 2023
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Ambarish PandeyUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Sushil GargUniversity of Minnesota Medical Center, Minneapolis, MN, Australia (S.G.).
Susan A MatuleviciusUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Amil M ShahBrigham and Women's Hospital, Boston, MA, Australia (A.M.S.).
Jalaj GargNew York Medical Center, Valhalla, NY, Australia (J.G.).
Mark H DraznerUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Alpesh AminUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Jarett D BerryUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Thomas H MarwickMenzies Research Institute, University of Tasmania, Australia (T.H.M.).
Steven P MarsoUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
James A de LemosUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Dharam J KumbhaniUT Southwestern Medical Center, Dallas, TX, Australia (A.P., S.A.M., M.H.D., A.A., J.D.B., S.P.M., J.A.L., D.J.K.).
Southwestern Medical CenterThe University of Texas Southwestern Medical Center · USBrigham and Women's Hospital · USNew York Medical College · USSouthwestern Medical Center · USUniversity of Minnesota Medical Center · USUniversity of Tasmania · AU

Funding

Systolic & diastolic dysfunction in heart failure and preserved ejection fractionK08HL116792 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SHAH, AMIL M · 2013 to 2017
$735k
NHLBI NIH HHS K08 HL116792
6 · The paper itself

Abstract

backgroundThere has been an increasing interest in use of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure with preserved ejection fraction (HFPEF). However, a comprehensive evaluation of MRA effects on left ventricular (LV) structure and function in these patients is lacking. In this meta-analysis, we evaluated the effects of MRAs on LV structure and function among patients with diastolic dysfunction or HFPEF. METHODS &

resultsRandomized, controlled clinical trials evaluating the efficacy of MRAs in patients with diastolic dysfunction or HFPEF were included. The primary outcome was change in E/e', a specific measure of diastolic function. Secondary outcomes included changes in other measures of diastolic function, LV structure, surrogate markers for myocardial fibrosis (carboxy-terminal peptide of procollagen type I [PICP] and amino-terminal peptide of pro-collagen type-II [PIIINP]), blood pressure, and exercise tolerance. In the pooled analysis, MRA use was associated with significant reduction in E/e' (weighted mean difference [WMD] [95% confidence interval {CI}]: -1.68 [-2.03 to -1.33]; P<0.0001) and deceleration time (WMD [95% CI]: -12.0 ms [-23.3 to -0.7]; P=0.04) as compared with control, suggesting and improvement in diastolic function. Furthermore, blood pressure and levels of PIIINP and PICP were also significantly reduced with MRA therapy with no significant change in LV mass or dimensions.

conclusionMRA therapy in patients with asymptomatic diastolic dysfunction or HFPEF is associated with significant improvement in diastolic function and markers of cardiac fibrosis without a significant change in LV mass or dimensions.

Indexed as

Stroke VolumeChi-Square DistributionDiastoleFibrosisHeart FailureHumansMineralocorticoid Receptor AntagonistsRandomized Controlled Trials as TopicRecovery of FunctionTreatment OutcomeVentricular Dysfunction, LeftVentricular Function, LeftVentricular RemodelingMineralocorticoid Receptor Antagonistsdiastolic dysfunctionheart failure with preserved ejection fractionmineralocorticoid receptor antagonist

Identifiers

PMID26459931
PMCPMC4845109
OpenAlexW1818378016

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.