Discussion
This study was designed to determine whether increased potassium levels influence systolic and diastolic myocardial performance. It is the first randomized intervention study to indicate that targeting high-normal p-K levels using dietary guidance, oral potassium supplements and MRAs improves echocardiographic indices of myocardial systolic and diastolic function. No difference in changes was found in contractile heterogeneity measured by MD between groups.The findings of the present study are in line with previous experimental and observational studies investigating myocardial mechanical function in relation to potassium depletion. Induced potassium depletion in a canine-model (n = 27) has been associated with impaired systolic and diastolic responses to stress tests with epinephrine and increased preload [In exploratory analysis of a subset of 131 patients from the TOPCAT trial, there was a trend towards improvement of Longitudinal Strain in patients treated with spironolactone (1.1% [-0.2;-2.4], P = 0.09) [