Heart failure & cardiomyopathies
The Antifibrotic Effects of Eplerenone in Hypertrophic Cardiomyopathy: A Randomized Clinical Trial
Authors' conclusion
In patients with nonobstructive HCM, there was a reduction in myocardial T1 time with eplerenone, consistent with a reduction in diffuse myocardial fibrosis.
Study context
- Population
- Patients with nonobstructive hypertrophic cardiomyopathy (HCM) (resting LV outflow tract gradient <30 mm Hg)
- Participants
- 61 patients
- Comparison
- Eplerenone vs placebo
- Eplerenonen = 30
- Placebon = 31reference
- Primary endpoint
- Native T1 time on CMR as an index of diffuse fibrosis
- Follow-up
- 12 months
Methodological detailsdouble-blind, placebo-controlled
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Native T1 time
| Group | Value | Baseline | Change from baseline | Within-group P |
|---|---|---|---|---|
| Eplerenone | mean 1,259 (SD 92) ms | 1,315 ± 134 ms | 3.7% ± 9% reduction | P = 0.041 |
| Placebo | mean 1,238 (SD 70) ms | 1,234 ± 28 ms | 1.1% ± 9% increase | P = 0.854 |
Value
Eplerenonemean 1,259 (SD 92) ms
Placebomean 1,238 (SD 70) ms
Baseline
Eplerenone1,315 ± 134 ms
Placebo1,234 ± 28 ms
Change from baseline
Eplerenone3.7% ± 9% reduction
Placebo1.1% ± 9% increase
Within-group P
EplerenoneP = 0.041
PlaceboP = 0.854
- Eplerenone vs Placebo: P = 0.07 — 3.7% reduction vs 1.1% increase
Secondary outcomes
Functional status and diastolic function (E/e' ratio, mitral E/A ratio)
- No significant change in functional status or markers of diastolic function
Original publication
The Antifibrotic Effects of Eplerenone in Hypertrophic Cardiomyopathy: A Randomized Clinical Trial. JACC Heart Fail. Published 16 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it