Article

Inappropriate left ventricular mass and angiotensin converting enzyme gene polymorphism

Department of Clinical and Experimental Medicine, Federico II University Hospital, School of Medicine, Naples, Italy.
Journal of Human Hypertension (Impact Factor: 2.7). 12/2001; 15(11):811-3. DOI: 10.1038/sj.jhh.1001264
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Available from: Giovanni de Simone, Mar 24, 2014
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    • "Among the complex pathophysiological factors contributing to the development of LVD, the renin–angiotensin–aldosterone system (RAAS) has been recognized to play a pivotal role. Hyperactivation of RAAS promotes structural and functional changes leading to myocardial fibrosis, stiffness and left ventricular hypertrophy [1] [2] [3] [4]. A large proportion of patients with altered RAAS homeostasis presents with isolated increase in plasma renin activity (PRA) or aldosterone concentrations (PAC). "
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    ABSTRACT: Background Right ventricular dysfunction (RVD) is associated with poor cardiovascular outcome. The renin- angiotensin-aldosterone system is involved in alterations of the left ventricular geometry and function. Detrimental effects of the renin-angiotensin-aldosterone system on the right ventricular function are being postulated, but data supporting this assumption are still lacking. The aim of the study was to assess the impact of hyperreninemia, hyperaldosteronism or their combination on right ventricular function in hypertensive individuals. Methods Plasma renin activity (PRA) and plasma aldosterone concentrations (PACs) were measured in 116 hypertensive patients, divided as follows: normal PRA and PAC (n=38); high PRA and normal PAC (hypereninemia) (n=26); normal PRA and high PAC (hyperaldosternism) (n=27); high PRA and PAC (HRA) (n=25). Echocardiographic evaluation of the left and right ventricles (RV), including tissue Doppler imaging, was performed. RVD was identified by tissue Doppler Imaging-derived Myocardial Performance Index, calculated with a multisegmental approach. Results Indices of the right ventricular structure and function, as well as the prevalence of RVD, were higher in hyperreninemia and hyperaldosternism groups as compared with the normal group, and a further increase was observed in the HRA patients. Regression models showed a similar risk of RVD in the hyperreninemia and hyperaldosternism patients, regardless of systemic and pulmonary pressure, as well as left ventricular dysfunction. Notably, patients with both hyperreninemia and hyperaldosternism exhibited the strongest association with RVD as compared with patients with only hyperreninemia or hyperaldosternism. Conclusions Isolated hyperreninemia or hyperaldosternism determines a similar impairment of the right ventricular function, whereas their combination is further detrimental. Renin and aldosterone may represent early biomarkers of right ventricular dysfunction in hypertension.
    Full-text · Article · Sep 2014 · Journal of Cardiovascular Medicine
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    • "Among the complex pathophysiological factors contributing to the development of LVD, the renin–angiotensin–aldosterone system (RAAS) has been recognized to play a pivotal role. Hyperactivation of RAAS promotes structural and functional changes leading to myocardial fibrosis, stiffness and left ventricular hypertrophy [1] [2] [3] [4]. A large proportion of patients with altered RAAS homeostasis presents with isolated increase in plasma renin activity (PRA) or aldosterone concentrations (PAC). "

    Full-text · Article · Jul 2013 · International journal of cardiology
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