title: Role of angiotensin II in the evolution of diastolic heart failure.
abstract: More than half of all persons with heart failure (HF) have diastolic HF. The prevalence of diastolic HF increases from 46% in persons younger than 45 years to 59% in those 85 years and older. The annual mortality rate associated with diastolic HF is >10%. Diagnosis is based on signs and symptoms of HF, elevated plasma B-type natriuretic peptide, preserved left ventricular systolic function, and evidence of diastolic dysfunction by Doppler examination on two-dimensional echocardiography. Approximately 80% of patients with diastolic HF have increased left ventricular mass and a history of hypertension. Neurohormonal activation is a key aspect of this condition. Studies suggest that activation of the renin-angiotensin-aldosterone system, specifically direct cardiac effects of angiotensin II and aldosterone, contributes to the pathogenesis and progression of diastolic dysfunction. Hence, there is a rationale for use of agents that antagonize the renin-angiotensin-aldosterone system, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone antagonists, in patients with heart failure.
authors.affiliation: Division of Cardiology and Nutrition, William Beaumont Hospital, Royal Oak, MI 48073, USA.
authors.forename: Kavitha M
authors.initials: KM
authors.lastname: Chinnaiyan
authors.forename: Daniel
authors.initials: D
authors.lastname: Alexander
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
mesh_terms: D000804:Angiotensin II / Q000502:physiology*; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D000804:Angiotensin II