The use of spironolactone reduces left ventricular mass and improves arterial stiffness in early-stage CKD. These effects suggest that aldosterone exerts adverse cardiovascular effects in CKD and that spironolactone is worthy of further study as a treatment that could reduce adverse cardiovascular events. (Is Spironolactone Safe and Effective in the Treatment of Cardiovascular Disease in Mild Chronic Renal Failure; NCT00291720).

changes within the RV that are associated with adverse surgical outcomes and poorer prognosis following mitral valve surgery. Future studies are needed to confirm whether LGE is a new imaging biomarker that can be used to risk stratify severe asymptomatic MR patients for surgery. Abstract 110 Table 1 Features of patients with and without gadolinium enhancement Late gadolinium enhancement Number of patients MR fraction (%) Systolic RV volume (ml/ m 2) RV ejection fraction (%) Peak VO 2 (ml/ kg/min) VE/ VCO 2 None 43 32±12 28.5±7.7 61±8 24.6±6.9 31.1 ±5.0 RV insertion gadolinium 8 46±17* 31.4±7.6* 55±6* 23.1±8.7 33.2 ±3.2* LV myocardial gadolinium 10 42±19* 35.1±11.1* 55±8* 23.0±5.9 36.7 ±6.9* *denotes statistical significance of P0.05 compared to non-gadolinium cohort on Independent samples 2 tailed T-Test Abstract 110 Figure 1 Late gadolinium enhancement of the basal inferolateral LV

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