Within the cardiac muscle, aldosterone binding to mineralocorticoid receptors promotes extracellular matrix and collagen deposition that stimulates myocardial fibrosis.[28–31] Spironolactone, a nonselective mineralocorticoid receptor antagonists, can prevent myocardial fibrosis.[28,32,33] Since spironolactone prevents cardiac fibrosis, it may be beneficial in HFpEF. This evidence concerns the gene NR3C2 and Myocardial fibrosis.