To the Editor 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.
Milan A, Abram S, Veglio F. Aldosterone Inhibition in Patients With Heart Failure With Preserved Ejection
Fraction. JAMA. 2013;310(2):204-205. doi:10.1001/jama.2013.7973