Aldosteronism in heart failure: a proinflammatory/fibrogenic cardiac phenotype. Search for biomarkers and potential drug targets.
Heart failure is a major health problem of epidemic proportions. Irrespective of its etiologic origins, a dysfunction of this normally efficient muscular pump is associated with systemic consequences, a progressive downhill clinical course and poor prognosis. Ventricular dysfunction is ultimately accompanied by neurohormonal system activation that accounts for: the congestive heart failure syndrome; an induction of oxi/nitrosative stress; adverse vascular remodeling; and activation of the immune system that contributes to a wasting syndrome known as cardiac cachexia. Circulating effector hormones of the renin-angiotensin-aldosterone system are an integral feature of this neurohormonal activation; they have systemic consequences. Insights into the pathophysiology of heart failure will identify improved methods of prevention, including biomarkers to aid in its detection and identification of risk, and to the development of specific drug targets. Herein we address one aspect of the neurohormonal profile of heart failure, namely that related to aldosteronism. Our focus is directed at the link between aldosteronism and its adverse influence on coronary vasculature structure, a proinflammatory/fibrogenic cardiac phenotype, which is based on an immunostimulatory state that includes activated peripheral blood mononuclear cells.
Weber
Karl T
KT
Division of Cardiovascular Diseases, Department of Medicine, School of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA. KTWeber@utmem.edu
Gerling
Ivan C
IC
Kiani
Mohammad F
MF
Guntaka
Ramareddy V
RV
Sun
Yao
Y
Ahokas
Robert A
RA
Postlethwaite
Arnold E
AE
Warrington
Kenneth J
KJ
D000450:Aldosterone / Q000097:blood; D000818:Animals; D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D005355:Fibrosis / Q000097:blood; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000503:physiopathology; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000150:complications; D007249:Inflammation / Q000097:blood; D020257:Ventricular Remodeling / Q000187:drug effects* / Q000502:physiology
D015415:Biomarkers; D000450:Aldosterone