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Role of aldosterone in ventricular remodeling

Role of aldosterone in ventricular remodeling. By Group Ⅱ. Introduction : ventricular remodeling. synthesis of aldosterone changes in CHF. role of aldosterone in ventricular remodeling. conclusion. Introduction. Ventricular remodeling :

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Role of aldosterone in ventricular remodeling

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  1. Role of aldosterone in ventricular remodeling By Group Ⅱ

  2. Introduction : ventricular remodeling synthesis of aldosterone changes in CHF role of aldosterone in ventricular remodeling conclusion

  3. Introduction • Ventricular remodeling: Any structural change of the left ( or right ) in response to a change in loading conditions , including alterations in ventricular mass ,chamber size and shape. crawford MH, cardiology.2004;325-326

  4. Mariell Jessup, M.D., and Susan Brozena, M.D. Heart Failure, N Engl J Med 2003;348:2007-18.

  5. ventricular remodeling Activite of neuroendocrine Activite of cytokine Abnormal gene expression ……

  6. The Renin–Angiotensin–Aldosterone System Karl T. ,Weber. Aldosterone in congestive heart failure, New Engl J Med, 2001; 345:1689-1697

  7. Heart AS mRNA

  8. Improve aldosterone Role of aldosterone in ventricular remodeling ? Experimental evidence Inhibitor aldosterone

  9. inhibitor 10 days later placebo Sham-operated 10 weeks later placebo Left coronary artery ligation (CHF) 10 days later eplerenone

  10. fibrosis

  11. Result & Discussion

  12. fibrosis hypertropy ACE AT1 receptor aldostenone Ang Ⅱ

  13. ATPase

  14. Serca2 ATPase

  15. Result & discussion

  16. Role of aldosterone in ventricular remodeling fibrosis hypertropy ATPase Serca2 ATPase function

  17. System possible explanation for role of aldosterone in CHF Myocardial reduce interstitial fibrosis and interstital remodeling reduce left ventricular hypertrophy Vascular more tendency for thrombosis decrease endothelial function decrease baroreceptor function Renal increase urinary potassium and magnesium loss worse volume status with enhanced sodium loss

  18. Conclusion • Local synthesis of aldosterone improved after myocardial infarction or heart failure. • Aldosterone induced a significant cardiac fibrosis and hypertrophy ,impaired the cardiac pump and decreased the activity of ATPase of heart. Therefore , it plays a important role in ventricular remodeling. • To fully understand the mechanism of ventricular remodeling ,we will need to investigate the molecular networks of aldosterone.

  19. Reference • Daniela F,Palol G,et al . Additive amelioration of left ventricular remodeling and molecular alterations by combined aldosterone and angiotensin receptor blockade after myocardial infarction. Cardiovascular Research, 2005: 67 : 97– 105. • Karl T. ,Weber. Aldosterone in congestive heart failure,N Engl J Med, 2001; 345:1689-97 • Mariell Jessup, M.D., and Susan Brozena, M.D. Heart Failure, N Engl J Med 2003;348:2007-18. • Micheline Monteiro de Resende , Katalin Kauser , José Geraldo Mill . Regulation of cardiac and renal mineralocorticoid receptor expression by captopril following myocardial infarction in rats. Life Sciences 2006 :78 :3066–3073 • KIRKWOOD F. ADAMS, JR. Pathophysiologic role of the renin-angiotensin-aldosterone and sympathetic nervous systems in heart failure. Am J Health-Syst Pharm.Vol 2004 :61:4-13 • C.Heymes,A.Garnier. et cl. Aldosterone-synthase overexpression in heart: a tool to explore aldosterone’s effects. 2004:217:213-219 • Tony Karram, Anan Abbasi, Shlomo Keidar,et al. Effects of spironolactone and eprosartan on cardiac remodeling and angiotensin-converting enzyme isoforms in rats with experimental heart failure.2005:289:1351-1358

  20. Title: Role of aldosterone in ventricular remodeling By: 吴翔、卓敏、李嘉华 et al Date: 21 NOV. 2006 Thank you !

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