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The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
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Aldosterone and Myocardial Pathology.

Alessandro Cannavo1, Andrea Elia2, Daniela Liccardo2

  • 1Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States; Department of Translational Medical Science, Federico II University of Naples, Naples, Italy.

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Summary

Aldosterone (Aldo) impacts cardiovascular health by affecting heart cells via the mineralocorticoid receptor (MR). Blocking this pathway may treat heart failure (HF).

Keywords:
AldosteroneAngiotensinCardiovascularEplerenoneHeart failureMineralocorticoid receptorSpirinolactone

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Area of Science:

  • Endocrinology
  • Cardiovascular Physiology
  • Molecular Biology

Background:

  • Aldosterone (Aldo) is a hormone historically linked to kidney function.
  • Emerging evidence highlights significant extra-renal effects of Aldo, particularly on the cardiovascular system.
  • The mineralocorticoid receptor (MR) mediates Aldo's actions in various cardiovascular cells.

Purpose of the Study:

  • To review the current understanding of Aldo's role in cardiovascular homeostasis.
  • To explore the cellular mechanisms of Aldo action in the heart.
  • To discuss therapeutic strategies targeting the Aldo/MR pathway in cardiovascular diseases.

Main Methods:

  • Review of pre-clinical (in vitro, in vivo) studies.
  • Analysis of human clinical trial data.
  • Examination of genomic and non-genomic signaling pathways activated by Aldo.

Main Results:

  • Aldo influences cardiomyocytes, fibroblasts, and vascular cells (smooth muscle and endothelial cells).
  • High Aldo levels are associated with cardiovascular disorders, including heart failure (HF).
  • Aldo-MR signaling activates intracellular pathways regulating cardiovascular function and growth.

Conclusions:

  • Aldosterone plays a crucial role in cardiovascular homeostasis through MR activation.
  • Targeting the detrimental Aldo/MR signaling pathway offers a potential therapeutic approach for heart failure.
  • Further research into Aldo's cardiovascular effects is warranted to develop effective treatments.