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Left ventricular remodeling after myocardial infarction: does the cardiac renin-angiotensin system play a role?
K Lindpaintner1, N Niedermaier, H Drexler
1Department of Cardiology, Children's Hospital, Boston, Massachusetts 02115.
Abstract:
Possible cardioprotective effects are one of the most intriguing aspects of the expanding spectrum of clinical indications for the use of converting-enzyme inhibitors. Among them, the prevention of postinfarction ventricular remodeling--a deleterious process leading to eccentric cardiac hypertrophy and, eventually, to congestive heart failure--has attracted particular interest and attention. This communication examines the possible role of the endogenous cardiac renin-angiotensin system in the pathophysiology of ventricular remodeling. Although much of the evidence is indirect, there are several lines of investigation that strongly support the causative participation of the cardiac renin-angiotensin system in ventricular remodeling.
Insights
Converting-enzyme inhibitors may protect the heart. This study explores how the cardiac renin-angiotensin system contributes to post-heart attack ventricular remodeling, a key factor in heart failure development.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Converting-enzyme inhibitors (CEIs) show potential cardioprotective effects.
- Postinfarction ventricular remodeling is a detrimental process leading to heart failure.
Purpose of the Study:
- To investigate the role of the endogenous cardiac renin-angiotensin system (cRAS) in ventricular remodeling after myocardial infarction.
- To examine the potential of CEIs in preventing this remodeling process.
Main Methods:
- Review of existing literature and indirect evidence.
- Analysis of studies investigating the cRAS in cardiac pathophysiology.
Main Results:
- Indirect evidence suggests the cRAS plays a causative role in ventricular remodeling.
- CEIs may offer a strategy to mitigate this remodeling.
Conclusions:
- The endogenous cardiac renin-angiotensin system is implicated in the pathophysiology of postinfarction ventricular remodeling.
- Further research into CEIs' role in preventing heart failure is warranted.