Targeting the renin-angiotensin-aldosterone-system in atrial fibrillation: a shift from electrical to structural therapy?
Despite its increasing incidence and prevalence, treatment options in atrial fibrillation (AF) are far from ideal and often limited. After decades of focus on the electrical aspects of AF with unsatisfactory results, recent research is focusing increasingly on the atrial structural remodelling that underlies the development of AF in different pathological conditions, such as hypertension, heart failure, diabetes mellitus and coronary artery disease. The aim of this review is to provide a comprehensive overview of the role of the renin-angiotensin-aldosterone-system in AF and to highlight the clinical evidence on renin-angiotensin-aldosterone-system blockade as a therapeutic option in AF.
Choudhury
Anirban
A
University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
Varughese
George I
GI
Lip
Gregory Y H
GY
D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D048909:Diabetes Complications / Q000188:drug therapy; D016503:Drug Delivery Systems; D004554:Electric Countershock; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects*; D055502:Secondary Prevention; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors