Remodeling and reparation of the cardiovascular system.
Growth or altered metabolism of nonmyocyte cells (cardiac fibroblasts, vascular smooth muscle and endothelial cells) alters myocardial and vascular structure (remodeling) and function. However, the precise roles of circulating and locally generated factors such as angiotensin II, aldosterone and endothelin that regulate growth and metabolism of nonmyocyte cells have yet to be fully elucidated. Trials of pharmacologic therapy aimed at preventing structural remodeling and repairing altered myocardial structure to or toward normal in the setting of hypertension, heart failure and diabetes are reviewed. It is proposed that these are therapeutic goals that may reduce cardiovascular morbidity and mortality. Although this hypothesis remains unproved the primary goal of therapy should be to preserve or restore tissue structure and function.
Weber
K T
KT
Department of Medicine, School of Medicine, University of Missouri-Columbia 65212.
Anversa
P
P
Armstrong
P W
PW
Brilla
C G
CG
Burnett
J C
JC
Cruickshank
J M
JM
Devereux
R B
RB
Giles
T D
TD
Korsgaard
N
N
Leier
C V
CV
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000627:therapeutic use; D006332:Cardiomegaly / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003094:Collagen / Q000378:metabolism; D003326:Coronary Circulation; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D016232:Endothelins / Q000037:antagonists & inhibitors / Q000502:physiology; D004730:Endothelium, Vascular / Q000378:metabolism; D005355:Fibrosis; D006321:Heart / Q000254:growth & development; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D006978:Hypertension, Renovascular / Q000188:drug therapy; D009131:Muscle, Smooth, Vascular / Q000473:pathology / Q000502:physiology; D009206:Myocardium / Q000737:chemistry / Q000473:pathology; D007703:Peptidyl-Dipeptidase A / Q000032:analysis / Q000502:physiology; D051381:Rats; D014655:Vascular Resistance
D016232:Endothelins; D003094:Collagen; D002216:Captopril; D007703:Peptidyl-Dipeptidase A