Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya31414Editorial articleПередовая статьяReview ArticleMineralocorticoid receptor antagonists in the treatment of patients with heart failure after myocardial infarction and those with chronic heart failureАнтагонисты минералокортикоидных рецепторов в лечении больных с сердечной недостаточностью после инфаркта миокарда и с хронической сердечной недостаточностьюTereshchenkoS NТерещенкоС НZhirovI VЖировИ ВOsmolovskaiaIu FОсмоловскаяЮ Фyuliaosm@mail.ruФГБУ РКНПК Минздрава России, Москва151220138512VOL 85, NO12 (2013)ТОМ 85, №12 (2013)13714310042020Copyright ©; 2013, Consilium MedicumCopyright ©; 2013, ООО "Консилиум Медикум"2013Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/31414

The mineralocorticoid receptor antagonists spironolactone and eplerenone have become part of standard medical therapy for heart failure (HF). Randomized clinical trials have shown the clinical efficacy of spironolactone and eplerenone, which lead to lower death rates in patients with systolic HF. Whether these two drugs are equivalent and able to exert a positive effect in patients with clinical HF, including chronic HF with retained left ventricular systolic function remains to be answered.

Аннотация. Антагонисты минералокортикоидных рецепторов спиронолактон и эплеренон стали частью стандартной медикаментозной терапии у больных с сердечной недостаточностью (СН). В рандомизированных клинических исследованиях показана клиническая эффективность спиронолактона и эплеренона, приводящих к снижению смертности больных с систолической СН. Остаются открытыми вопросы об эквивалентности этих двух препаратов и их способности оказывать положительное влияние у больных с клинически проявляющейся СН, включая хроническую СН с сохраненной систолической функцией левого желудочка.

aldosteronemineralocorticoid receptor antagonistschronic heart failureальдостеронантагонисты минералокортикоидных рецепторовхроническая сердечная недостаточностьESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2012; 33: 1787-1847.McMachon E. Recent studies with eplerenone, a novel selective aldosterone receptor antagonist. Cur Opini Pharmacol 2001; 1: 190-196.Weber K.T., Villarreal D. Aldosterone, and antialdosterone therapy in congestive heart failure. Am J Cardiol 1993; 71 (Suppl A): 3A-11A.Yasky J., Ledesma G.A., Tutera A., Collia L.F. A fixed-dose combination of furosemide and spironolactone in digitalized congestive heart failure patients. Pharmatherapeutica 1986; 4 (8): 480-485.Smith A.G. Spironolactone in the long-term management of patients with congestive heart failure. Curr Med Res Opin 1980; 7 (2): 131-136.Muller J. Spironolactone in the management of congestive heart failure: a rewiew. Clin Ther 1986; 9 (1): 63-76.Arriza J.L., Weinberger C., Cerelli G. et al. Cloning of human mineralocorticoid receptor complementory DNA: structural and functional kinship with the glucocorticoid receptor. Science 1987; 237 (4812): 268-275.Корочкин И.М., Матвеева И.В. Гормональные нарушения и лечение больных с рефрактерными формами застойной сердечной недостаточности. Кардиология 1977; 8: 36-43.Pierpont G.L., Francis G.S., Cohn J.N. Effect of captopril on renal function in patients with congestive heart failure. Br Heart J 1981; 46 (5): 522-527.Sharpe D.N., Coxon R.J. Clinical and haemodynamic effects of low dose captopril in severe chronic heart failure. Br J Clin Phatmacol 1982; 14 (Suppl 2): 161S-167S.Nicholls M.G., Espiner E.A., Ikram H. et al. Angiotensin II is more potent than potassium in regulating aldosterone in cardiac failure: evidence during captopril therapy. J Clin Endocrinol Metab 1981; 52 (6):1253-12536.Swedberg K., Eneroth P., Kjekshus J., Wilhelmsen L. Hormones regulating cardiovascular function in patients with severe congestive heart failure and their relation to mortality. CONSENSUS Trial Study Group. Circulation 1990; 82 (5): 1730-1736.The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987; 316 (23): 1429-1435.Staessen J., Lijnen P., Fagard R. et al. Rise in plasma concentration of aldosterone during long-term angiotensin II suppression. J Endocrinol 1981; 91 (3): 457-465.Borghi C., Boschi S., Ambrosioni E. et al. Evidence of a partial escape of reninangiotensine-aldosterone blocade in patients with acute myocardial infarctiontreated with ACE inhibitors. J Clin Pharmacol 1993; 33 (1): 40-45.Lee A.F., MacFadyen R.J., Struthers A.D. Neurohormonal reactivationin heart failure patients on chronic ACE inhibitor therapy: a longitudinal study. Eur J Heart Fail 1999; 1 (4): 401-406.Мареев В.Ю., Скворцов А.А., Челмакина С.М. и др. Способны ли ингибиторы АПФ эффективно контролировать активность ренин-ангиотензин-альдостероновой системы при длительном лечении хронической сердечной недостаточности? Кардиология 1999; 2: 27-34.Urata H., Healy B.H., Stewart R. et al. Angiotensin II forming pathways in normal and failing human hearts. Circ Res 1990; 66 (4): 883-390.Muller J. Regulation of aldosterone biosynthesis: physiological and clinical aspects. Monographs on Endocrinology. 2nd ed. N.Y.: Springer-Verlag 1988.MacFadyen R.J., Lee A.F., Morton J.J. et al. How often are angiotensin II and aldosterone concentrations raised during chronic ACE inhibitor treatment in cardiac failure? Heart 1999; 82 (1): 57-61.Sato A., Saruta T. Aldosterone escape during angiotensin-converting enzyme inhibitor therapy in essential hypertensive patients with left ventricular hypertrophy. J Int Med Res 2001; 29 (1): 13-21.Мареев В.Ю., Скворцов А.А. Блокада эффектов альдостерона у больных сердечной недостаточностью: современный взгляд на проблему - эплеренон (часть II). Сердеч недостат 2011; 4: 222-227.Pitt B., Zannand F., Remme W. et al. The effect of spirinilactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999; 341: 709-717.Delyani J., Myles K., Funder J. et al. Eplerenone (SC 66110), a highly selective aldosteron antagonist. Am J Hypertens 1998; 11: 94A.Cook C.S., Berry L.M., Kim D.H. et al. Involvement of CYP3A in the metabolism of eplerenone in humans and dogs: differential metabolism by CYP3A4 and CYP3A5. Drug Metab Dispos 2002; 30 (12): 1344-1351.Weinberger M.H., Roniker B., Krause S.L., Weiss R.J. Eplerenone, a selective aldosterone blocker, in mild-to-moderate hypertension. Am J Hypertens 2002; 15 (8): 709-716.Sadee W., Dagcioglu M., Schroder R. Pharmacokinetics of spironolactone, canrenone and canrenoate-K in humans. J Pharmacol Exp Ther 1973; 185 (3): 686-695.Pitt B., Roniker B. Eplerenone, a novel selective aldosteron receptor antagonist (SARA): dose-finding study in patients with heart failure. J Am Coll Cardiol 1999; 33: 188A-189A.Degasparo M., Joss U., Ramjoue А. et al. Three new epoxy-spironolactone derivates: characterization in vivo and in vitro. J Pharmacol Exp Ther 1987; 240: 650-656.Zannad F., McMurray J.J.V., Drexler H. et al. Rationale and design of the Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure (EMPHASIS-HF). Eur J Heart Fail 2010; 12 (6): 617-622.Zannad F., McMurray J.J.V., Krum H. et al. Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms N Engl J Med 2011; 364: 11-21.Swedberg K., Zannad F., McMurray J.J. et al. Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure) study. J Am Coll Cardiol 2012; 59 (18): 1598-1603.Pitt B., Remme W., Zannad F. et al. Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction. N Engl J Med 2003; 348: 1309-1321.Mottram P.M., Haluska B., Leano R. et al. Effect of aldosterone antagonism on myocardial dysfunction in hypertensive patients with diastolic heart failure. Circulation 2004; 110 (5): 558-565.Mak G.J., Ledwidge M.T., Watson C.J. et al. Natural history of markers of collagen turnover in patients with early diastolic dysfunction and impact of eplerenone. J Am Coll Cardiol 2009; 54 (18): 1674-1682.Edwards N.C., Ferro C.J., Kirkwood H. et al. Effect of spironolactone on left ventricular systolic and diastolic function in patients with early stage chronic kidney disease. Am J Cardiol 2010; 106 (10): 1505-1511.Deswal A., Richardson P., Bozkurt B., Mann D.L. Results of the Random­ized Aldosterone Antagonism in Heart Failure with Preserved Ejection Fraction trial (RAAM-PEF). J Card Fail 2011; 17 (8): 634-642.Edelmann F.W.R., Schmidt A.G. Effect of spironolactone on dia­stolic function and exercise capacity in patients with heart failure with preserved ejection fraction: The Aldo-DHF randomized controlled trial. JAMA 2013; 309 (8): 781-791.Desai A.S., Lewis E.F., Li R. et al. Rationale and design of the treatment of preserved cardiac function heart failure with an aldosterone antagonist trial: a randomized, controlled study of spironolactone in patients with symptomatic heart failure and preserved ejection fraction. Am Heart J 2011; 162 (6): 966-972.Guichard J., Clark D. II, Calhoun D.A. et al. Aldosterone receptor antagonists: current perspectives and therapies. Vascular Health and Risk Management 2013; 9: 321-331.http://www.clinicaltrials.gov/ct2/show/NCT01176968?term=aldosterone+and+reminder&rank=1http://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_458235.pdf