Aldosterone inhibition in patients with heart failure with preserved ejection fraction.

The study by Dr Edelmann and colleagues1 investigated the effects of spironolactone on diastolic function in patients with symptomatic diastolic HF. Under the broad definition of improvement of diastolic function, the authors included echocardiographic variables indicative of both relaxation (first phase of diastole, active) and compliance (second phase, passive) of the left ventricle. For precision, reduced left ventricular compliance (ie, determining the increase in ventricular filling pressures) is always associated with but not equivalent to a deficit of relaxation