However at the time of TOPCAT, the benefit of medical therapies for heart failure was limited to those with a reduced LVEF. Such patients share similar signs and symptoms as patients who have heart failure and a reduced LVEF, as well as an impaired quality of life and a poor prognosis. Many patients with heart failure have a normal or near-normal left ventricular ejection fraction (LVEF). The TOPCAT trial evaluated the effectiveness of aldosterone antagonist therapy in reducing cardiovascular mortality, aborted cardiac arrest, and heart failure hospitalization in patients who have heart failure with preserved systolic function.
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