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Finerenone: a breakthrough mineralocorticoid receptor antagonist for heart failure, diabetes and chronic kidney disease.
Egypt Heart J
December 2024
Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Background: Aldosterone is categorized as a mineralocorticoid hormone produced in the zona glomerulosa of the adrenal cortex. Aldosterone has considerable action in sodium and water retention along with cardiac remodeling, promoting fibrosis and these detrimental effects have been counteracted by mineralocorticoid receptors antagonists over time. Spironolactone, a non-selective steroidal MRA used extensively is potent but has serious adverse effects like gynecomastia and hyperkalemia.
View Article and Find Full Text PDFAldosterone synthase inhibitors: a potential revival for treatment of renal and cardiovascular diseases.
J Clin Endocrinol Metab
December 2024
Université Paris Cité, INSERM CIC1418, 75015 Paris, France; Hypertension Department, AP-HP, Hôpital, Georges-Pompidou, 75015 Paris, France.
Inappropriate aldosterone excess plays a key role in the pathophysiology of various cardiovascular, endocrine and renal diseases. Mineralocorticoid receptor (MR) antagonists (MRAs) such as spironolactone block of the harmful effects of aldosterone and are recommended treatment in these various conditions. However, the sexual adverse effects of spironolactone due to its lack of specificity for the MR and the risk of hyperkalemia in patients with decreased renal function, limit its use.
View Article and Find Full Text PDFMineralocorticoid Receptor Antagonists in Heart Failure: An Update.
Circ Heart Fail
December 2024
Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, Nancy, France (J.P.F., F.Z.).
Spironolactone, a steroidal mineralocorticoid receptor antagonist (MRA), has been used to treat patients with heart failure (HF) for more than half a century. Spironolactone improved outcomes in patients with severely symptomatic HF with reduced ejection fraction, and later, eplerenone expanded the benefits to patients with mildly symptomatic HF with reduced ejection fraction and myocardial infarction complicated by HF. Spironolactone reduced HF events in some patients with HF with preserved ejection fraction, but the results were not generalizable to all patients with HF with preserved ejection fraction.
View Article and Find Full Text PDFFinerenone, Serum Potassium, and Clinical Outcomes in Heart Failure With Mildly Reduced or Preserved Ejection Fraction.
JAMA Cardiol
November 2024
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Article Synopsis
- Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, improved outcomes for heart failure patients in the FINEARTS-HF trial but led to elevated serum potassium levels.
- The study aimed to analyze the frequency of abnormal serum potassium levels (<3.5 mmol/L and >5.5 mmol/L) and the impact of finerenone treatment compared to placebo on patient outcomes.
- Results showed that participants taking finerenone experienced significantly higher potassium levels over time, with increased risk of levels >5.5 mmol/L and reduced risk of levels <3.5 mmol/L, indicating a notable effect of the drug on potassium regulation.
Cardiac involvement in a female patient with Beçhet's disease: newer diagnostic and therapeutic approaches-a case report.
Eur Heart J Case Rep
November 2024
Department of Cardiology, University of Athens Medical School, Hippokration General Hospital, 114 Vasilissis Sofias Avenue, Athens 11527, Greece.
Background: Behçet's disease (BD) is a multisystemic chronic inflammatory disorder. Cardiac manifestations in BD are extremely rare. There have been no reports of cardiac involvement of BD and especially endomyocardial fibrosis in the left ventricle (LV).
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