Evidence map›Paper›PMID 26475142›Full record

Trial reportCirculation. Heart failure2015

Prognostic Importance of Changes in Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction and the Impact of Spironolactone.

Amil M Shah, Brian Claggett, Nancy K Sweitzer, Sanjiv J Shah, Anita Deswal, Inder S Anand, Jerome L Fleg, Bertram Pitt, Marc A Pfeffer, Scott D Solomon

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Heart failure, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00094302 (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist), which is not on this map. Cited by 36 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 8 pooled it
6.4field-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.

NCT00094302 phase3completednot on this map

Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT)

TypeinterventionalSponsorCarelon ResearchRan2006 to 2013Enrolled3,445ConditionsCardiovascular Diseases, Heart Diseases, Heart Failure, CongestiveArmsSpironolactone, Placebo
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 8 syntheses or guidelines pooled it, 86 citations in OpenAlex.

  1. Pooled it
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  8. Guideline
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  19. Left Atrial Hemodynamics and Clinical Utility in Heart Failure.Reviews in cardiovascular medicine · 2024
    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

10 authors at 6 institutions in 1 country.

Amil M ShahFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.). ashah11@partners.org.
Brian ClaggettFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Nancy K SweitzerFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Sanjiv J ShahFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Anita DeswalFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Inder S AnandFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Jerome L FlegFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Bertram PittFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Marc A PfefferFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Scott D SolomonFrom the Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (A.M.S., B.C., M.A.P., S.D.S.); Division of Cardiology, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ (N.K.S.); Cardiology Division, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.); Cardiology Division, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Houston, TX (A.D.); Cardiovascular Division, VA Medical Center, Minneapolis, MN (I.S.A.); National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F.); and Cardiology Division, University of Michigan School of Medicine, Ann Arbor, MI (B.P.).
Michael E. DeBakey VA Medical Center · USNational Heart Lung and Blood Institute · USBaylor College of Medicine · USMinneapolis VA Medical Center · USNorthwestern University · USUniversity of Arizona · US

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 1K08HL116792NHLBI NIH HHS HHSN268200425207CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS K08 HL116792PHS HHS HHSN268200425207C
6 · The paper itself

Abstract

backgroundLimited data exist regarding the impact of aldosterone antagonist therapy on cardiac structure and function in heart failure with preserved ejection fraction and on the prognostic relevance of changes in cardiac structure and function in heart failure with preserved ejection fraction. METHODS AND

resultsCardiac structure and function were assessed by quantitative echocardiography at baseline and at 12- to 18-month follow-up in 239 patients with heart failure with preserved ejection fraction (left ventricular [LV] ejection fraction [LVEF] ≥45%) enrolled in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. The impact of spironolactone therapy on measures of cardiac structure and function was assessed in the study population overall, and change in echocardiographic measures was associated with the subsequent occurrence of the primary composite outcome of cardiovascular death, heart failure hospitalization, or aborted cardiac arrest. Spironolactone was not associated with alterations in cardiac structure and function compared with placebo. Decrease in left atrial volume at follow-up was associated with a lower risk of subsequent occurrence of the primary outcome.

conclusionsTwelve to 18 months of spironolactone therapy was not associated with alterations in cardiac structure or function in patients with heart failure with preserved ejection fraction. Reduction in left atrial volume at follow-up was associated with a lower risk of subsequent occurrence of the primary composite outcome. CLINICAL

trial registrationURL: http:///www.clinicaltrials.gov. Unique identifier: NCT00094302.

Indexed as

AgedDouble-Blind MethodFemaleHeart FailureHumansMaleMiddle AgedMineralocorticoid Receptor AntagonistsPrognosisSpironolactoneStroke VolumeTreatment OutcomeMineralocorticoid Receptor AntagonistsSpironolactoneclinical trialechocardiographyheart failure with preserved ejection fractionspironolactone

Identifiers

PMID26475142
PMCPMC4936912
OpenAlexW1883738259

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Registered trials

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.