Hypertensive heart disease and fibrosis.
OBJECTIVE
The clinical importance of fibrosis in hypertensive heart disease is now well recognized. However, the precise mechanisms involved in the pathophysiology and therefore the potential cardioreparative strategies are still not fully understood. These areas continue to be the focus of extensive research. This review summarizes the work conducted in this field over the past 12 months.


RESULTS
This article further confirms the involvement of the renin-angiotensin system in cardiac fibrosis and illustrates the supportive roles of mineralocorticoids, endothelin, and novel signaling pathways. It also summarizes the most recent data examining the genetic aspects of myocardial fibrosis and further clarifies potential cardioreparative strategies.


CONCLUSIONS
Myocardial fibrosis in hypertensive heart disease remains an area of intensive research. Whereas recent work has expanded our knowledge of the underlying processes in the development of this fibrosis, additional scientific and clinical research is required to assist clinical risk assessment and to provide evidence that therapeutic intervention confers improved clinical outcome in hypertensive heart disease.
Moncrieff
Joanne
J
Department of Cardiology, Stobhill Hospital, Balornock Road, Glasgow G21 3UW, Scotland, UK.
Lindsay
M Mitchell
MM
Dunn
Francis G
FG
D002318:Cardiovascular Diseases / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D016232:Endothelins / Q000502:physiology; D005355:Fibrosis; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008264:Macrophages / Q000502:physiology; D009206:Myocardium / Q000473:pathology*; D017923:Sodium-Hydrogen Exchangers / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D016232:Endothelins; D017923:Sodium-Hydrogen Exchangers