[The role of aldosterone in the development of postinfarction fibrosis].

Abstract

Aldosterone was discovered in 1953, and until the beginning of the 1960s, when spironolactone was developed, it was the focus of considerable interest among the scientific community. The following 30 years represented a sort of Dark Age, interrupted by the Weber's classic studies. He first demonstrated the pivotal role of aldosterone in the promotion of cardiac hypertrophy and fibrosis and such an observation represented a solid background for the implementation of large survival trials, the RALES and the EPHESUS. These landmark studies showed that aldosterone receptor blockade prolongs survival in advanced and postinfarction heart failure, respectively. After a myocardial infarction, there is a significant upregulation of the local steroidogenic system in the area remote from the scar, that leads to a remarkable fibroblast activation, collagen deposition, and reactive fibrosis. Fibrosis in turn further impairs systolic and diastolic function, and induces electrical heterogeneity with attendant ominous arrhythmias. The following review will dwell upon the importance of fibrosis in postinfarction heart failure, the role of aldosterone, and the novel therapeutic approach based on mineralocorticoid receptor blockade.

• Authors: Antonio Cittadini, Raffaella Serpico, Maria Gaia Monti, Luigi Saccà
• Journal: Italian heart journal : official journal of the Italian Federation of Cardiology (Ital Heart J) Vol. 6 Suppl 1 Pg. 43S-50S (May 2005) ISSN: 1129-471X [Print] Italy
• Vernacular Title: II ruolo dell'aldosterone nello sviluppo della fibrosi postinfartuale.
• PMID: 15945299 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Aldosterone

Topics

• Aldosterone (physiology)
• Animals
• Fibrosis (etiology, prevention & control)
• Forecasting
• Humans
• Myocardium (pathology)