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Aldosterone and the heart: from basic research to clinical evidence
C Catena1, G Colussi, L Marzano
1Internal Medicine, Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy.
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|November 19, 2011
Summary
Elevated aldosterone may harm organs independently of blood pressure. Aldosterone antagonists show promise for treating heart conditions beyond systolic heart failure.
Area of Science:
- Cardiovascular Endocrinology
- Renal Physiology
- Metabolic Diseases
Background:
- Long-term elevated aldosterone is linked to cardiac, vascular, renal, and metabolic issues.
- Mineralocorticoid receptor antagonists demonstrate benefits in systolic heart failure, suggesting aldosterone's direct cardiac impact.
Purpose of the Study:
- To review recent findings on aldosterone's cardiac effects independent of blood pressure.
- To explore the role of aldosterone in various cardiovascular and metabolic conditions.
Main Methods:
- Narrative overview synthesizing data from experimental animal models.
- Analysis of clinical findings in conditions including primary aldosteronism, hypertension, and heart failure.
Main Results:
- Aldosterone directly impacts cardiac cells (cardiomyocytes, fibroblasts) via mineralocorticoid receptors, causing hypertrophy, remodeling, and fibrosis.
- These cardiac effects occur independently of aldosterone's renal actions.
- Aldosterone antagonists show potential benefits across multiple conditions.
Conclusions:
- Aldosterone exerts direct detrimental effects on the heart, mediated by mineralocorticoid receptors.
- Understanding these non-renal effects is crucial for managing heart failure, hypertension, and other aldosterone-related diseases.
- Aldosterone antagonists represent a promising therapeutic strategy.
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