Aldosterone and the Heart: From Basic Research to Clinical Evidence

作者：Catena C; Colussi G; Marzano L; Sechi L A^*

来源：Hormone and Metabolic Research, 2012, 44(3): 181-187.

DOI：10.1055/s-0031-1291318

• arrhythmia
• atrial fibrillation
• essential hypertension
• heart failure
• mineralocorticoid receptor antagonists
• primary aldosteronism
• spironolactone

Recent views suggest that long-term exposure to elevated aldosterone concentrations might result in cardiac, vascular, renal, and metabolic sequelae that occur independent of the blood pressure level. Indirect evidence of the untoward eff ects of aldosterone on the heart has been clearly established in clinical studies that have tested the eff ects of mineralocorticoid receptor antagonists in the treatment of systolic heart failure. As it has become clear in recent years, the interaction between aldosterone and the heart has to deal with additional actions of the hormone on specifi c cell types, cellular mechanisms, and molecules that are involved in regulation of tissue responses, leading to hypertrophy, remodeling, and fi brosis. The majority of these eff ects are mediated by activation of the mineralocorticoid receptors that are expressed in cardiomyocytes and cardiac fi broblasts, and mediate the genomic eff ects of the hormone. Evidence of interactions between aldosterone and the heart that occur independent of the renal eff ects of aldosterone, however, is not limited to the context of systolic heart failure and observations obtained in other disease states have led, together with fi ndings of animal studies, to a better understanding of the potential benefi ts of aldosterone antagonists. In this narrative overview, we highlight the most recent fi ndings that have been obtained in experimental animal models and in clinical conditions that include, in addition to systolic heart failure, primary aldosteronism, essential hypertension, diastolic heart failure, and arrhythmia.

• 出版日期2012-3