Aldosterone Antagonism in Diastolic Heart Failure

Exclusion Criteria

• •1. Patients requiring eplerenone or spironolactone for treatment of other comorbid illnesses, e.g. ascites due to cirrhosis. Also, patients with severe hepatic impairment will not be included.
• •2. Contraindication to eplerenone therapy with creatinine \> 2.5 mg/dl or serum potassium \> 5.0 mEq/L or creatinine clearance \< 30 ml/min/1.73 m2 or intolerance to eplerenone or spironolactone in the past
• •3. Significant valvular heart disease, pericardial disease or severe chronic lung disease with cor pulmonale, as the cause of symptoms and signs of CHF
• •4. Patients with technically inadequate echocardiographic windows or patients with severe mitral annular calcification
• •5. Unstable angina or MI within 4 weeks prior to enrollment
• •6. Patient with severe peripheral vascular disease and claudication or other physical conditions that will limit the distance walked by them
• •7. Pregnant or lactating females
• •8. History of alcohol or substance abuse or history of repeated non-compliance with medications
• •9. History of cancer within 3 years (other than resected cutaneous basal or squamous cell carcinoma)
• •10. Participation in any other drug trial within 30 days prior to enrollment
• •11. Inability to provide informed consent
• •12. On drugs that are strong inhibitors of CYP3A4 such as ketoconazole, itraconazole, nefazodone, trolandeomycin, clarithromycin, ritonavir, nelfinavir etc.