[Angiotensin-converting-enzyme inhibitor and heart hypertrophy]

There is evidence from experiments in animals, biological and molecularbiological investigations, that extra-renal renin-angiotensin systems may have important implications in the pathogenesis of various diseases, in particular in regard to the development of hypertrophy in smooth muscle cells of blood vessels and in the myocardium. Thus, it is getting more likely, that angiotensin II is an endogenous growth factor. We have recently shown, in an animal model of left ventricular hypertrophy (aortic stenosis due to a silver clip on the aorta ascendens), that chronic application of an ACE-inhibitor results in a nearly complete regression of left ventricular hypertrophy even under the conditions of an unaltered afterload. The extent of the regression of left ventricular hypertrophy was not statistically different from animals in which the regression of hypertrophy was achieved by removal of the clip. According to these results, we demonstrated for the first time, that the renin-angiotensin system plays a major role in the maintenance of left ventricular hypertrophy and that after the inhibition of the system, a considerable regression of left ventricular mass can be achieved which is independent from hemodynamic factors.