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Beneficial Effects of Angiotensin Blockade in Heart Failure Due to Myocardial Infarction

  • Chapter
The Hypertrophied Heart

Part of the book series: Progress in Experimental Cardiology ((PREC,volume 3))

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Summary

Although congestive heart failure is commonly associated with cardiac hypertrophy and/or cardiac dilation, the exact mechanisms for this complex syndrome are not clear. Furthermore, very little is known about the factors associated with the transition of cardiac hypertrophy to heart failure. Since the activation of both peripheral and tissue rennin-angiotensin systems (RAS) is considered to be involved in the genesis of cardiac hypertrophy, we believe that the increased activity of RAS for a prolonged period constitutes one of the important factors in the development of congestive heart failure. Thus angiotensin blockade in animals or patients with congestive heart failure has been shown to exert beneficial effects in terms of preventing clinical signs, improving heart function, and reducing mortality. In this regard, it is pointed out that the blockade of RAS can be achieved either by using different types of angiotensin-converting enzyme (ACE) inhibitors or by angiotensin receptor blockers. Because of the role of the sarcoplasmic reticulum (SR) in the regulation of intracellular Ca2+ and the evidence that the occurrence of Ca2+-handling abnormalities in cardiornyocytes plays a critical role in heart dysfunction, it is becoming dear that remodeling of the SR membrane with respect to changes in some of the Ca2+-regulation proteins such as Ca-pump ATPase, Ca2+-release channels, and phospholamban is intimately associated with congestive heart failure. Some studies have now shown that the SR functional defects in congestive heart failure can be partially prevented by treatment with ACE inhibitors or inhibitors of the angiotensin receptors. Further, investigations with respect to the cardiac SR gene expression and protein contents in the failing hearts with or without RAS blockade are required to show whether ACE inhibitors and angiotensin receptor blockers prevent SR defects by affecting the cardiac gene expression in congestive heart failure.

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Authors and Affiliations

  1. Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, 351 Tache Avenue, Canada

    Naranjan S. Dhalla & Xiaobing Guo

  2. Department of Physiology, Faculty of Medicine, University of Manitoba, Winnipeg, R2H 2A6, Canada

    Naranjan S. Dhalla & Xiaobing Guo

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  1. Naranjan S. Dhalla
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Editors and Affiliations

  1. Department of Internal Medicine, Aoto Hospital, Jikei University School of Medicine, Tokyo, Japan

    Nobuakira Takeda M.D., Ph.D. (Associate Professor) (Associate Professor)

  2. Jikei University School of Medicine, Tokyo, Japan

    Makoto Nagano M.D., Ph.D. (Professor Emeritus) (Professor Emeritus)

  3. Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Faculty of Medicine, University of Manitoba, Winnipeg, Canada

    Naranjan S. Dhalla Ph.D., M.D. (Hon.), D.Sc. (Hon) (Distinguished Professor and Director) (Distinguished Professor and Director)

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Dhalla, N.S., Guo, X. (2000). Beneficial Effects of Angiotensin Blockade in Heart Failure Due to Myocardial Infarction. In: Takeda, N., Nagano, M., Dhalla, N.S. (eds) The Hypertrophied Heart. Progress in Experimental Cardiology, vol 3. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4423-4_23

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