Key result
Circulating angiotensin II is implicated in promoting reactive perivascular and interstitial fibrosis in the myocardium, suggesting potential cardioprotective effects of ACE inhibitors.
Why the study?
Do angiotensin converting enzyme inhibitors prevent myocardial fibrosis and adverse remodelling in left ventricular pressure overload?
Do angiotensin converting enzyme inhibitors prevent myocardial fibrosis and adverse remodelling in left ventricular pressure overload?
The review highlights the pathophysiological role of angiotensin II in myocardial fibrosis and adverse remodelling, providing a rationale for the cardioprotective use of ACE inhibitors.
Answers are grounded in this paper and cite their sources.
Offers mechanistic rationale for ACE inhibitors in pressure overload; leaves open clinical effects on fibrosis and remodelling.
From a morphologic standpoint, the myocardium has three compartments: cardiac myocytes; intramyocardial coronary arteries with a microcirculation; and an interstitium composed largely of fibrillar collagen. As long as intercompartmental equilibrium exists, myocardial mechanics and energetics and myocyte viability will each be preserved. 2. The hypertrophic process seen with left ventricular pressure overload secondary to renovascular hypertension alters this equilibrium because of the adverse remodelling of intramural coronary arteries and fibrillar collagen. The pathogenetic mechanism(s) responsible for the observed myocardial fibrosis, having reactive and reparative components, remains to be elucidated. 3. Attractive circumstantial evidence, however, has been obtained to incriminate circulating angiotensin II in this process. Five lines of evidence favouring the role of angiotensin II in promoting the reactive perivascular and interstitial fibrosis and the reparative fibrosis are presented, including the potential cardioprotective effects of angiotensin converting enzyme inhibitors.
No takes yet. Share an insight, caveat, or question.
Weber et al. (1989) conducted a review in Myocardial remodeling and renovascular hypertension. Angiotensin II / ACE inhibitors was evaluated. Circulating angiotensin II is implicated in promoting reactive perivascular and interstitial fibrosis in the myocardium, suggesting potential cardioprotective effects of ACE inhibitors.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: