Local cardiac renin-angiotensin system: hypertension and cardiac failure

Area of Science:

• Cardiovascular Physiology
• Endocrinology
• Molecular Cardiology

Background:

• The renin-angiotensin system (RAS) is traditionally viewed as a systemic endocrine regulator.
• Angiotensin II, the primary effector peptide of the RAS, influences arterial pressure.
• Emerging evidence highlights the presence and function of RAS components within various organs and tissues.

Purpose of the Study:

• To review the evidence supporting the role of the cardiac renin-angiotensin system (RAS) in hypertensive heart disease (HHD).
• To discuss the mitogenic and growth-promoting effects of angiotensin II on cardiac cells.
• To integrate the understanding of local cardiac RAS activity with systemic RAS function in the context of HHD.

Main Methods:

• Literature review of studies investigating the renin-angiotensin system (RAS) and hypertensive heart disease (HHD).
• Analysis of research on the effects of angiotensin II on cardiac myocytes and non-myocytic cells.
• Synthesis of evidence regarding the local expression and activity of RAS components within the heart.

Main Results:

• Angiotensin II exerts direct mitogenic and growth-promoting effects on cardiac myocytes and non-myocytic elements.
• These cellular effects significantly contribute to the development and progression of hypertensive heart disease (HHD).
• The identification of RAS components within the heart supports the concept of a functional cardiac RAS.

Conclusions:

• The cardiac renin-angiotensin system (RAS) is a critical local system involved in hypertensive heart disease (HHD).
• Angiotensin II's direct effects on cardiac cells are key mechanisms driving HHD.
• Understanding the cardiac RAS is essential for comprehending and potentially treating HHD.