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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
Summary
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.
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