Related Experiment Video

Updated: Jul 20, 2025

Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model
10:18

Ascending Aortic Constriction in Rats for Creation of Pressure Overload Cardiac Hypertrophy Model

Published on: June 29, 2014

17.2K

Angiotensin-Converting Enzyme and Heart Failure

Sara Álvarez-Zaballos1, Manuel Martínez-Sellés1,2,3

  • 1Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBERCV, 28007 Madrid, Spain.

Frontiers in Bioscience (Landmark Edition)
|August 1, 2023
PubMed

Insights

This review covers how drugs targeting the renin-angiotensin-aldosterone system (RAAS) treat heart failure (HF). It details RAAS pathophysiology, neurohormonal changes, and the evidence for ACE inhibitors, ARBs, and ARNI in HF management.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biomedical Science

Background:

  • Heart failure (HF) management relies heavily on pharmacotherapy.
  • The renin-angiotensin-aldosterone system (RAAS) plays a critical role in HF pathophysiology.
  • Neurohormonal dysregulation is a hallmark of heart failure.

Purpose of the Study:

  • To review the pathophysiology of the RAAS in heart failure.
  • To discuss the mechanisms of action for RAAS-targeting drugs.
  • To summarize the clinical evidence for these agents in HF patients.

Main Methods:

  • Literature review of RAAS pathophysiology and HF.
  • Analysis of drug classes: ACE inhibitors, ARBs, and ARNI (sacubitril/valsartan).
  • Assessment of evidence for drug efficacy in heart failure.

Main Results:

  • RAAS activation contributes to cardiac remodeling and dysfunction in HF.
  • ACE inhibitors, ARBs, and ARNI modulate the RAAS to improve HF outcomes.
  • Evidence supports the use of these agents in reducing HF morbidity and mortality.

Conclusions:

  • Pharmacotherapy targeting the RAAS is essential for heart failure treatment.
  • Understanding RAAS pathophysiology guides the selection of effective HF medications.
  • ACE-related drugs, including ARNI, are vital in managing patients with heart failure.

Keywords:
angiotensin-converting enzymeheart failuremortality

More Related Videos

A Model of Cardiac Remodeling Through Constriction of the Abdominal Aorta in Rats07:31

A Model of Cardiac Remodeling Through Constriction of the Abdominal Aorta in Rats

Published on: December 2, 2016

10.1K
A Modified Technique for Transverse Aortic Constriction in Mice04:52

A Modified Technique for Transverse Aortic Constriction in Mice

Published on: August 18, 2022

4.6K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
463
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
15
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
692
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
16
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
13