[Myocardial fibrosis--the theoretical bases, clinical aspects and therapeutic implications].
A review on the present knowledges of the myocardial structure, with particular emphasis on the collagen network and its degradation/synthesis process was performed. Myocardial fibrosis and cardiac remodeling concepts are analysed, explaining them in the context of ventricular hypertrophy, arterial hypertension, myocardial remodeling in ischemic heart disease and cardiac remodeling in the aged. We also review the role of the renin-angiotensin-aldosterone system in myocardial fibrosis, as well as the results of preventing action of angiotensin converting enzyme inhibitors and aldosterone antagonists in myocardial fibrosis and consequent cardiac remodeling in the animal experimentation. Clinical and therapeutic implications of this knowledge are discussed as well as therapeutic implication in man, in view of recent studies.
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Serviço de Cardiologia, UTIC-Arsénio Cordeiro, Hospital de Santa Maria, Lisboa.
D000818:Animals; D003094:Collagen / Q000378:metabolism; D004719:Endomyocardial Fibrosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D006321:Heart / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D012084:Renin-Angiotensin System
D000451:Mineralocorticoid Receptor Antagonists; D003094:Collagen
Fibrose miocárdica--fundamentos teóricos, aspectos clínicos e implicações terapêuticas.