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Pharmacology of cardiac and vascular remodeling
H A Struijker-Boudier1, J F Smits, J G De Mey
1Department of Pharmacology, Cardiovascular Research Institute Maastricht, University of Limburg, The Netherlands.
Insights
Cardiovascular diseases disrupt the heart and blood vessels
Area of Science:
- Cardiovascular medicine
- Cellular biology
- Pharmacology
Background:
- Cardiovascular diseases are characterized by structural changes in the heart and blood vessels.
- Normal cardiovascular structure relies on intricate mechanical and cellular regulatory mechanisms.
- Disturbances in these mechanisms trigger a remodeling process involving cellular changes and extracellular matrix alterations.
Purpose of the Study:
- To outline the structural abnormalities in cardiovascular diseases.
- To discuss pharmacotherapy strategies targeting cardiovascular remodeling.
- To highlight existing and novel drug classes influencing cardiovascular structure.
Main Methods:
- Review of the pathophysiology of cardiovascular remodeling.
- Analysis of the mechanisms of action for various cardiovascular drug classes.
- Exploration of emerging therapeutic targets in cardiovascular disease.
Main Results:
- Cardiovascular remodeling involves phenotypic modulation, cellular hyperplasia/hypertrophy, and extracellular matrix dynamics.
- Pharmacotherapy can correct structural abnormalities by modulating mechanical stresses or chemical mediators.
- Existing drugs (ACE inhibitors, calcium antagonists, etc.) and novel agents targeting peptidergic mediators impact remodeling.
Conclusions:
- Optimal treatment of cardiovascular diseases requires addressing structural remodeling.
- Pharmacological interventions targeting mechanical and chemical pathways are crucial.
- Developing drugs that interfere with peptidergic mediators represents a promising therapeutic avenue.
Abstract:
Cardiovascular diseases involve changes in the structure of the heart and blood vessels. Normal structure is maintained by a sophisticated set of mechanical and cellular "checks and balances." A disturbance of these checks and balances induces a remodeling process. The most distinguished features of this process are phenotypic modulation of various cell types in the cardiovascular system; cellular hyperplasia and hypertrophy; and extracellular matrix production, deposition, and degradation. Optimal pharmacotherapy of cardiovascular diseases should be aimed at correcting structural abnormalities in the heart and blood vessels. This goal can be achieved by influencing mechanical stresses on the cardiovascular system or by interfering with the chemical mediators of the remodeling process. Many existing groups of cardiovascular drugs, such as angiotensin-converting enzyme inhibitors, calcium-antagonists, alpha- and beta-adrenoceptor antagonists, and antithrombotic drugs, influence cardiovascular remodeling. New approaches involve the development of drugs acting on peptidergic mediators of cardiovascular remodeling.