Article

Potential role of the tissue renin-angiotensin system in the pathophysiology of congestive heart failure.

Cardiovascular Division, University of Minnesota Hospitals, Minneapolis 55455.
The American Journal of Cardiology (impact factor: 3.37). 11/1990; 66(11):22D-30D; discussion 30D-32D. pp.22D-30D; discussion 30D-32D
Source: PubMed

ABSTRACT The circulating renin-angiotensin system (RAS) plays an important role in the maintenance of cardiovascular homeostasis. It has recently been demonstrated that endogenous RAS exist in target tissues that are important in cardiovascular regulation. This article reviews the multiple effects of angiotensin II in target tissues, the evidence for the presence of functional tissue RAS and the data that suggest a role for these tissue RAS in the pathophysiology of heart failure. Activation of circulating neurohormones is predictive of worsened survival in heart failure; however, cardiac and renal tissue RAS activities are also increased in the compensated stage of heart failure, when plasma renin-angiotensin activity is normal. It is hypothesized that the plasma RAS maintains circulatory homeostasis during acute cardiac decompensation, while changes in tissue RAS contribute to homeostatic responses during chronic sustained cardiac impairment. This concept of different functions of circulating and tissue RAS in the pathophysiology of heart failure may have important pharmacologic implications.

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Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

Activation
 
acute cardiac decompensation
 
angiotensin II
 
article reviews
 
cardiac impairment
 
cardiovascular homeostasis
 
cardiovascular regulation
 
circulating renin-angiotensin system
 
circulatory homeostasis
 
compensated stage
 
endogenous RAS
 
functional tissue RAS
 
heart failure
 
homeostatic responses
 
pharmacologic implications
 
plasma RAS
 
plasma renin-angiotensin activity
 
renal tissue RAS activities
 
target tissues
 
tissue RAS
 

A T Hirsch