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Mineralocorticoid receptor activation in myocardial infarction and failure: recent advances.

Abstract
The classical view of aldosterone actions via the mineralocorticoid receptor (MR) limited to control of fluid balance and blood pressure homoeostasis has been progressively overcome by clinical and experimental evidence emphasizing the pleiotropic role of MR activation in the pathogenesis of cardiovascular disease. Clinical studies have shown the benefit of MR blockade in patients with left ventricular dysfunction and heart failure after myocardial infarction (MI), hypertension or diabetic nephropathy. Deleterious effects of MR activation include cardiac structural and electrical remodelling, cardiovascular fibrosis, inflammation and oxidative stress. Complexity of pathophysiological role of MR derives from the presence of circulating glucocorticoids at higher concentrations than aldosterone and the equal affinity of the MR for aldosterone, cortisol and corticosterone. Recent experimental studies using different animal models and genetic tools have deeply explored the cell-specific functional role of MR in cardiovascular pathology. This review addresses emerging preclinical studies as well as ongoing clinical trials regarding MR activation in MI and failure.
AuthorsPaolo Galuppo, Johann Bauersachs
JournalEuropean journal of clinical investigation (Eur J Clin Invest) Vol. 42 Issue 10 Pg. 1112-20 (Oct 2012) ISSN: 1365-2362 [Electronic] England
PMID22536780 (Publication Type: Journal Article, Review)
Copyright© 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation.
Chemical References
  • Mineralocorticoid Receptor Antagonists
  • Receptors, Mineralocorticoid
  • Aldosterone
Topics
  • Aldosterone (physiology)
  • Genetic Techniques
  • Heart Failure (etiology)
  • Humans
  • Hyperkalemia (chemically induced)
  • Mineralocorticoid Receptor Antagonists (pharmacology, therapeutic use)
  • Myocardial Infarction (etiology)
  • Randomized Controlled Trials as Topic
  • Receptors, Mineralocorticoid (genetics, metabolism)
  • Ventricular Dysfunction, Left (etiology)

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