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K T Weber

Publications and source records attributed to K T Weber.

At least 163 records · Page 9Linked to original sources
PubMed1993

Angiotensin-converting enzyme and myocardial fibrosis in the rat receiving angiotensin II or aldosterone.

Angiotensin-converting enzyme (ACE) is present in tissues composed largely of fibrillar collagen such as heart valves, the adventitia of great vessels and intramyocardial coronary arteries, and the scar that follows myocardial infarction. We tested the hypothesis that such tissue ACE is related to fibrous tissue formation and that its appearance is independent of circulating renin and angiotensin peptides. For this purpose we selected experimental models that simulate primary and secondary hyperaldosteronism, each of which are associated with the appearance of myocardial fibrosis. ACE in the excised heart and aorta was localized by in vitro autoradiography with [125I]351A, while fibrosis was identified by light microscopy in sections stained with collagen specific picrosirius red. Tissue was obtained at 2, 4, and 6 weeks from various experimental groups: unoperated, untreated, age- and sex-matched controls; age- and sex-matched uninephrectomized control rats on a high sodium diet; and rats that had received either aldosterone (ALDO) or angiotensin II (AII). Compared with controls, we found ACE binding (1) unchanged after 2 weeks of ALDO, but increased in the adventitia of intramural coronary arteries after 4 weeks, in keeping with the perivascular fibrosis that appeared in each ventricle; (2) markedly increased after 6 weeks of ALDO, where it not only involved coronary vessels but also microscopic scars that appeared in atria and ventricles; (3) increased in the coronary adventitia and sites of scarring, each of which were present 2 weeks after AII; and (4) markedly increased after 4 and 6 weeks of AII as fibrosis became more extensive.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1993

Angiotensin II and aldosterone receptor binding in rat heart and kidney: response to chronic angiotensin II or aldosterone administration.

Angiotensin II (AII) and mineralocorticoid receptors (MRs) have been identified in the mammalian heart and kidney. Their response to chronic elevations in circulating AII or aldosterone (ALDO) (or both) is unknown in either primary or secondary hyperaldosteronism. Nonendothelial angiotensin-converting enzyme (ACE) activity has been found in the fibrous tissue response that involves intramyocardial coronary arteries and microscopic scarring. Whether this tissue ACE could affect AII receptors and MRs in the area of myocardial fibrosis is likewise unknown. To address these questions, we monitored AII and MR binding in the rat heart and kidney after chronic AII or ALDO infusion. All receptor and MR binding were localized by in vitro autoradiography with 125I-[Sar1, Ile8]-labeled AII and [1,2,6,7 3H]-labeled ALDO, respectively. To characterize AII receptor subtypes, a type I antagonist (DuP753) or type II antagonist (PD 123177) was used. Four experimental groups were examined: unoperated, untreated, age- and sex-matched controls; age- and sex-matched uninephrectomized control rats receiving a high sodium diet; animals that received AII (9 micrograms/hr sc) for 2, 4, 6, or 8 weeks; and uninephrectomized rats on a high sodium diet that received ALDO (0.75 microgram/hr sc) for similar periods of time.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1993

Renin-angiotensin system and myocardial fibrosis in hypertension: regulation of the myocardial collagen matrix.

The cardiac interstitium is composed of non-myocyte cells embedded in a highly organized extracellular matrix containing a three-dimensional collagen network which serves to maintain the architecture of the myocardium and determines myocardial stiffness. In hypertensive heart disease, a heterogeneity in myocardial structure, created by the altered behaviour of cardiac fibroblasts responsible for collagen synthesis and degradation, can explain the appearance of diastolic and ultimately systolic dysfunction of the left ventricle. In vivo, circulating and myocardial renin-angiotensin systems (RAS) were found to be involved in the regulation of the structural remodelling of the cardiac interstitium. In vitro, in cultured adult rat cardiac fibroblasts, angiotensin II was shown to stimulate collagen synthesis and to inhibit collagenase activity, which is the key enzyme for collagen degradation. In the SHR-model of primary hypertension, left ventricular hypertrophy could be regressed and abnormal myocardial diastolic stiffness, due to interstitial fibrosis, could be restored to normal by inhibition of the myocardial RAS. These antifibrotic or cardioreparative effects of ACE inhibition that occurred irrespective of blood pressure normalization may be valuable in reversing left ventricular diastolic dysfunction in hypertensive heart disease.

Animals↗
PubMed1993

Glucocorticoid metabolism in the cardiac interstitium: 11 beta-hydroxysteroid dehydrogenase activity in cardiac fibroblasts.

The interstitial fibrosis seen in the heart and systemic organs in states of primary or secondary mineralocorticoid excess suggests that fibroblasts are responsive to mineralocorticoid. In vitro studies demonstrating increased fibroblast collagen synthesis in response to MC are consonant with this view. The nicotinamide-adenine dinucleotide phosphate(+)-dependent enzyme 11 beta-hydroxysteroid dehydrogenase converts the glucocorticoids corticosterone and cortisol to the inactive metabolites 11-dehydrocorticosterone and cortisone, respectively, conferring mineralocorticoid specificity to the cells within which it is active. We investigated the presence of 11 beta-hydroxysteroid dehydrogenase in sonicates of cultured vascular endothelial cells and cardiac fibroblasts by incubating sonicates for 1 hour in the presence of 5 x 10(-9) mol/L tritiated corticosterone or tritiated cortisol (1 microCi) and using reverse-phase high-performance liquid chromatography coupled to an on-line radioisotope detector for steroid separation and quantitation. Extracts of bovine endothelial cells showed no enzymatic activity with either substrate, whereas extracts of rat cardiac fibroblasts readily converted corticosterone to 11-dehydrocorticosterone, even in the absence of exogenous nicotinamide-adenine dinucleotide phosphate+ (10% conversion). When 5 x 10(-4) mol/L nicotinamide-adenine dinucleotide phosphate+ was added to sonicated fibroblasts, conversion increased to 50%, corresponding to 12 pmol 11-dehydrocorticosterone formed/mg protein. Conversion of cortisol to cortisone was not observed in fibroblast or endothelial cell extracts. Significant levels of corticosterone to 11-dehydrocorticosterone conversion (0.14 pmol/10(6) cells/hour) were detected in intact fibroblasts, but no 11-dehydrogenation of corticosterone was observed in intact endothelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

11-Hydroxycorticosteroids↗
PubMed1993

Coronary microvascular fluid flux and permeability: influence of angiotensin II, aldosterone, and acute arterial hypertension.

Vascular permeability of the coronary and mesenteric circulation is increased in association with the arterial hypertension that accompanies either endogenous activation of the renin-angiotensin-aldosterone system (RAAS) or exogenous administration of angiotensin II (AII). Whether this occurs as a result of increased intravascular pressure or of elevations in plasma concentrations of AII or aldosterone (ALDO) (or both) is unclear. This acute study of filtration-independent coronary fluid exchange and macromolecular permeability was undertaken to address these issues in open-chest, anesthetized dogs. The influence of arterial hypertension, with or without associated elevations in plasma AII or ALDO (or both), on coronary permeability was examined by monitoring the response in cardiac lymph flow, protein concentration, and capillary and intramural coronary artery structure. Experimental groups received a 90-minute intravenous infusion of either AII (n = 8), methoxamine (MX; n = 7), or ALDO plus MX (n = 5) in equipotent doses that raised arterial pressure to comparable levels. When we compared these animals with normotensive, instrumented controls (n = 5), we found that (1) lymph flow was a function of arterial and microvascular pressures in each group; (2) increased protein permeability, myocardial edema, extravasated red cells, and infused colloidal carbon were found in both ventricles with AII, together with endothelial discontinuities and enhanced abluminal capillary endothelial vesicle formation, when plasma ALDO had risen significantly in response to AII; and (3) macromolecular permeability was no different from that in controls after MX or ALDO plus MX. Based on this short-term study of acute arterial hypertension, we would conclude that acute elevations in microvascular pressure increase fluid flux, whereas increased circulating effector hormones of the RAAS, not plasma ALDO or hypertension alone, alter coronary microvascular structure and permeability to macromolecules Responsible mechanisms remain to be defined.

Aldosterone↗
PubMed1992

Factors associated with reactive and reparative fibrosis of the myocardium.

Myocardial fibrosis can be defined as an abnormal increase in collagen concentration of either ventricle. This accumulation of collagen, represented predominantly by fibrillar type I collagen, can occur a) on a reactive basis in the interstitial space and adventitia of intramyocardial coronary arteries and does not require myocyte necrosis, or b) as a replacement for necrotic myocytes, where it is considered a scar. Both forms can be found in the same ventricle. Various factors have been found to contribute to the reactive and reparative fibrosis that appears in both ventricles in acquired hypertension. In the case of microscopic scarring, myocyte necrosis is related to catecholamine or angiotensin II- mediated toxicity, reduced potassium stores that accompany chronic mineralocorticoid excess, and coronary vascular remodeling. Reactive fibrosis is associated with elevations in plasma aldosterone concentrations that are inappropriate relative to dietary sodium intake. These findings set the stage for additional in vivo and in vitro studies that may shed more light on our understanding of the factors that regulate the accumulation of fibrous tissue in the myocardium--a major determinant of pathologic structural remodeling which enhances its susceptibility to reentrant arrhythmias and ventricular dysfunction.

Aldosterone↗
PubMed1992

Remodeling and reparation of the cardiovascular system.

Growth or altered metabolism of nonmyocyte cells (cardiac fibroblasts, vascular smooth muscle and endothelial cells) alters myocardial and vascular structure (remodeling) and function. However, the precise roles of circulating and locally generated factors such as angiotensin II, aldosterone and endothelin that regulate growth and metabolism of nonmyocyte cells have yet to be fully elucidated. Trials of pharmacologic therapy aimed at preventing structural remodeling and repairing altered myocardial structure to or toward normal in the setting of hypertension, heart failure and diabetes are reviewed. It is proposed that these are therapeutic goals that may reduce cardiovascular morbidity and mortality. Although this hypothesis remains unproved the primary goal of therapy should be to preserve or restore tissue structure and function.

Animals↗
PubMed1992

Reactive and reparative myocardial fibrosis in arterial hypertension in the rat.

OBJECTIVE: Myocardial fibrosis is an important determinant of pathological hypertrophy. In two experimental models of arterial hypertension the purpose of the study was (a) to determine total collagen volume fraction and relative contribution of scarring and perivascular/interstitial fibrosis; and (b) to assess the effects of the aldosterone receptor antagonist spironolactone on these patterns of fibrosis. METHODS: 76 eight week old Sprague-Dawley rats weighing 180 to 200 g were used for the studies. Using videodensitometry total collagen volume fraction was separated into the various components for the left and right ventricles in the following experimental models: renovascular hypertension occurring following unilateral renal ischaemia; continuous aldosterone administration via osmotic minipumps with either high (AL) or low (ALLO) sodium diet; renovascular hypertension and AL after pretreatment and continuous treatment with either 20 or 200 mg.kg-1.d-1 subcutaneously of the competitive aldosterone receptor antagonist spironolactone. All groups were compared to age and sex matched controls. RESULTS: After eight weeks, systolic pressure was comparably increased in renovascular hypertension and AL and it remained raised with low dose spironolactone treatment in either model, but was normal with high dose spironolactone or low sodium diet. Left ventricular hypertrophy, expressed as a significant increase in left to right ventricular weight and left ventricle to body weight ratios, was present in renovascular hypertension, AL, and AL + low dose spironolactone compared to control (p < 0.005). In either ventricle: (1) the amount of interstitial/perivascular fibrosis and myocardial scarring was increased (p < 0.005) in renovascular hypertension and AL compared to control; (2) each was reduced (p < 0.005) with either dose of spironolactone; and (3) only scars were seen in ALLO. CONCLUSIONS: Myocardial fibrosis of either ventricle was comparable in renovascular hypertension and AL. Spironolactone was able largely to prevent the perivascular/interstitial fibrosis and scarring in either model irrespective of the development of left ventricular hypertrophy and arterial hypertension. Low sodium diet in hyperaldosteronism prevented hypertension and left ventricular hypertrophy, but not scarring. These findings suggest that a rise in plasma aldosterone, relative to sodium intake, may play a role in mediating collagen accumulation in the heart during the development of experimental arterial hypertension.

Aldosterone↗
PubMed1992

Myocardial collagen matrix remodelling in arterial hypertension.

The cardiac interstitium is composed of non-myocyte cells and a structural fibrillar protein network which plays a dominant role in governing the structure, architecture, and mechanical behaviour of the myocardium. Herein we review the fibrillar collagen network, its various components, and the functions they serve in the normal and structurally remodelled myocardium in arterial hypertension. The heterogeneity in myocardial structure, created by the altered behaviour of non-myocyte cells, particularly cardiac fibroblasts, which are responsible for collagen synthesis or degradation and thereby fibrous tissue accumulation, is a major determinant for the appearance of diastolic dysfunction and ultimately systolic myocardial failure. Regulatory mechanisms related to this fibrous tissue response are reviewed to draw attention to the hitherto neglected role of cardiac fibroblasts in mediating adverse structural remodelling of the myocardium and showing how this can be prevented through the use of pharmacological agents that interfere with the regulation of the myocardial collagen matrix. Several lines of evidence suggest that circulating and tissue renin-angiotensin-aldosterone systems (RAAS) are involved in the structural remodelling of the non-myocyte compartment. These include the cardioprotective effects of angiotensin converting enzyme (ACE) inhibition and aldosterone receptor antagonism that were found to prevent myocardial fibrosis in the rat with renovascular hypertension. In the rat with genetic hypertension, established left ventricular hypertrophy and abnormal myocardial diastolic stiffness due to interstitial fibrosis, RAAS inhibition resulted in restoration of myocardial structure and function to normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Prevention of structural changes in the heart in hypertension by angiotensin converting enzyme inhibition.

BACKGROUND: The long-term effects of hypertension on the heart culminate in congestive heart failure. The underlying causes are contractile impairment due to myocyte loss and reduced compliance due to myocardial fibrosis. Newer strategies in antihypertensive therapy must, therefore, focus on prevention of myocardial damage ('cardioprotection') or, if an abnormality has occurred, on reversal towards normal myocardial structure and function ('cardioreparation'). OBJECTIVE: To investigate the question of whether angiotensin converting enzyme (ACE) inhibition can influence myocardial remodelling in hypertension to produce cardioprotective and cardioreparative effects. METHODS AND RESULTS: Infusion of pathophysiological levels of circulating angiotensin II in rats causes cardiac myocyte necrosis, followed by fibroblast proliferation. This necrosis is not secondary to adrenergic activation or raised blood pressure. Similarly, renovascular hypertension results in cardiac myocyte necrosis, which can be prevented by pretreatment with the ACE inhibitor captopril. In established genetic hypertension in rats, sustained treatment with high-dose lisinopril normalizes the blood pressure, reverses left ventricular hypertrophy, reverses excessive interstitial and perivascular fibrosis (and consequently the impaired compliance), and reverses excessive coronary artery medial thickening (thereby normalizing coronary vascular reserve). With a low dose of lisinopril that does not reduce blood pressure significantly, only the excessive fibrosis is reversed. CONCLUSION: ACE inhibition has demonstrated promising myocardial remodelling effects in experimental models of hypertensive heart disease.

Angiotensin II↗
PubMed1992

Regulatory mechanisms of myocardial hypertrophy and fibrosis: results of in vivo studies.

Left ventricular hypertrophy is a major risk factor associated with the appearance of adverse cardiovascular events. A distortion in myocardial structure, mediated by an abnormal accumulation of fibrillar collagen within the adventitia of intramyocardial coronary arteries and neighbouring interstitial spaces, alters the electrical and mechanical behaviour of the myocardium. The mechanisms responsible for the regulation of cardiac myocyte growth and collagen accumulation are therefore of considerable interest. Herein we review results of in vivo studies conducted in the authors' laboratory that addressed these issues in various experimental models. The findings indicate that in arterial hypertension myocardial hypertrophy is related to ventricular systolic pressure work. Myocardial fibrosis, on the other hand, is not related to haemodynamic workload, but rather the presence of mineralocorticoid excess relative to sodium intake and excretion. Accordingly, fibrosis can appear in both the hypertensive left and non-hypertensive right ventricles. Pharmacological probes, administered in variable doses, were used to further test and support this hypothesis. In both primary and secondary hyperaldosteronism, it was possible to prevent the pathological structural remodelling of the myocardium with an aldosterone receptor antagonist, while in unilateral renal ischaemia ACE inhibition was similarly cardioprotective. Other studies demonstrated that it was feasible to regress the fibrous tissue response and normalise diastolic stiffness. This concept of cardioreparation suggests that heart failure due to this type of structural remodelling may be reversible.

Animals↗
PubMed1992

Pathologic hypertrophy with fibrosis: the structural basis for myocardial failure.

The major risk factor associated with the appearance of adverse cardiovascular events and outcome attributable to cardiovascular disease is left ventricular hypertrophy (LVH). Why this should be so resides not in the increase in myocardial mass per se, but in the disruption of myocardial structure. An abnormal accumulation of fibrillar collagen within the adventitia of intramyocardial coronary arteries and neighboring interstitial spaces represents such a distortion in structure. Furthermore, this fibrosis disrupts the electrical and mechanical behavior of the hypertrophied myocardium. Mechanisms responsible for fibrillar collagen accumulation have been examined in intact animals and cultured cardiac fibroblasts. In vivo studies indicate that myocardial fibrosis is associated with the presence of chronic mineralocorticoid excess, relative to sodium intake and excretion, not hemodynamic workload. Accordingly, fibrosis can appear in both the hypertensive, hypertrophied and nonhypertensive, nonhypertrophied ventricles. In both primary and secondary hyperaldosteronism it was possible to prevent myocardial fibrosis with an aldosterone receptor antagonist, while in unilateral renal ischemia angiotensin converting enzyme (ACE) inhibition was similarly cardioprotective. A regression in fibrous tissue and normalization of diastolic stiffness has also been possible using ACE inhibition, bringing forward the concept of cardioreparation and the notion that heart failure due to fibrosis may be reversible. In vitro studies indicate that effector hormones of the renin-angiotensin-aldosterone system stimulate fibroblast collagen synthesis. Aldosterone, in pathophysiologic concentrations, and angiotensin II, in much larger concentrations, each enhance collagen synthesis without altering the mitogenic potential of these cells. Thus, elevations in circulating aldosterone and angiotensin II, relative to sodium intake, have the potential to not only alter sodium homeostasis and vascular tonicity, but also the structure of cardiovascular tissue. Thus, myocardial fibrosis represents a structural basis for pathologic hypertrophy and ultimately accounts for the appearance of adverse cardiovascular events and outcomes.

Animals↗
PubMed1992

Fibrosis of the human heart and systemic organs in adrenal adenoma.

In experimental animals, chronic mineralocorticoid (MC) excess is associated with fibrosis of the myocardium and systemic organs, where both a reactive, i.e. interstitial and perivascular, and reparative, i.e. microscopic scarring following cardiac myocyte necrosis, fibrosis are found. We sought to determine if a similar fibrous tissue response was present in human myocardium and systemic organs in association with adrenal adenoma. Postmortem specimens of heart, adrenals, pancreas, lungs, kidney and liver were obtained from 5 patients (age 67 +/- 5 years) with autopsy-proven adrenal adenoma. Documented histologically normal tissue from age-matched patients was used for comparison. Tissue sections were stained with the collagen specific stain Sirius Red F3BA and analyzed using normal and polarized light. Reactive and/or reparative fibrosis was found in the heart, pancreas, adrenal glands and lungs, but not in the kidney or liver. These observations support a link between chronic MC excess and fibrosis of the heart and systemic organs in humans with adrenal adenoma.

Adenoma↗
PubMed1992

Myocardial fibrosis and the renin-angiotensin-aldosterone system.

In both men and women left ventricular hypertrophy (LVH) is the major risk factor associated with the appearance of diastolic and/or systolic myocardial failure. It is not the growth of cardiac myocytes, however, that is responsible for an abnormal structural remodeling of the hypertrophied myocardium in pathologic LVH, but instead, nonmyocyte cells whose behavior and growth are altered by chronic elevations in circulating hormones. Hormone-mediated cardiac fibroblast proliferation and/or enhanced collagen synthesis, for example, account for myocardial fibrosis. The signals mediating nonmyocyte cell involvement in LVH may also involve locally generated hormones having paracrine properties. Herein we review experimental findings pertaining to the reparative and reactive fibrosis of the myocardium seen in various forms of acquired and genetic arterial hypertension, where circulating or tissue renin-angiotensin-aldosterone systems are respectively activated. These hormonal systems determine whether myocardial structure will be altered in arterial hypertension and, accordingly, if myocardial failure ensues. The mechanisms by which these hormones lead to myocardial fibrosis remain to be elucidated and correspondingly will determine if fibrosis can be effectively prevented. At the same time, experimental strategies that regress excess collagen in LVH have been identified, but need to be developed further to determine if myocardial failure, caused by fibrosis, is indeed reversible in humans.

Aldosterone↗
PubMed1992

Myocardial fibrosis and the concepts of cardioprotection and cardioreparation.

PURPOSE: To examine the inter-relationship between effector hormones of the renin-angiotensin-aldosterone system and fibrosis, a determinant of abnormal myocardial stiffness, and to determine whether pharmacological interference with these hormones can prevent or regress this pathological structural remodeling. EFFECTS OF ANGIOTENSIN II AND ALDOSTERONE: Two morphological expressions of myocardial fibrosis are evident, a perivascular and interstitial fibrosis, not related to cardiac myocyte necrosis, and microscopic scarring that replaces lost myocytes. The former, a reactive fibrosis, is related to elevations in circulating mineralocorticoids (aldosterone or deoxycorticosterone) with increased dietary sodium, and not to arterial hypertension or ventricular loading. Scarring follows the cytotoxicity associated with elevated plasma angiotensin II levels and the increased K+ excretion that accompanies chronic mineralocorticoid excess. EFFECTS OF PHARMACOLOGICAL INTERFERENCE: Given the association of these hormones with fibrosis, the concept of cardioprotection was evaluated in various prevention trials. Reactive fibrosis was prevented in unilateral renal ischaemia by angiotensin converting enzyme (ACE) inhibition with captopril and in either primary or secondary hyperaldosteronism by antagonism of the aldosterone receptor with spironolactone. Scarring (and cell loss) was prevented in renal ischemia by captopril and by K(+)-sparing diuretics (spironolactone, amiloride) in primary hyperaldosteronism. In treatment trials, where reactive fibrosis was established, lisinopril promoted regression of the fibrosis and therefore was cardioprotective. CONCLUSIONS: Myocardial fibrosis is related to chronic mineralocorticoid excess (with increased dietary sodium), angiotensin II and increased K+ excretion. Cardioprotective and cardioreparative strategies that respectively prevent or regress the development of fibrous tissue have been demonstrated in experimental models and now merit clinical evaluation.

Angiotensin II↗
PubMed1992

Mineralocorticoid excess, dietary sodium, and myocardial fibrosis.

Unlike the non-renin-dependent hypertension associated with infrarenal aorta banding, an abnormal accumulation of fibrillar collagen occurs within the adventitia of intramural coronary arteries and neighboring interstitial space of the left and right ventricles in arterial hypertension associated with primary or secondary hyperaldosteronism. Based on these findings it was suggested that this interstitial and perivascular fibrosis was mediated by mineralocorticoid excess (i.e., elevated plasma aldosterone relative to dietary sodium) and not ventricular loading. To further address the importance of mineralocorticoid excess, we examined the fibrous tissue response after 8 weeks in the following uninephrectomized rat groups receiving a high-sodium diet: D-aldosterone (ALDO) infusion (0.75 micrograms/hr sc, n = 16); deoxycorticosterone acetate (DOCA) administration (100 mg/kg/wk sc, n = 8); and administration of a mineralocorticoid-like substance, glycyrrhizic acid (GA; 1 gm kg/wk sc, n = 8). Compared with ALDO infusion and sodium deprivation (n = 9), untreated controls (n = 14), and uninephrectomized rats with high dietary sodium and no mineralocorticoid administration (n = 15), we found (1) hypertension and left ventricular hypertrophy with all forms of mineralocorticoid excess; (2) a rise in collagen volume fraction with ALDO, and an increase in perivascular collagen with DOCA; and (3) no observance of myocardial fibrosis with GA or experimental controls, including ALDO infusion and sodium deprivation. Thus, in the presence of enhanced sodium intake, chronic administration of ALDO or DOCA are associated with collagen accumulation in the myocardium, whereas with the mineralocorticoid-like compound GA, myocardial fibrosis was not seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1991

Myocardial remodeling and pathologic hypertrophy.

The hallmark of myocardial hypertrophy associated with congestive failure is interstitial fibrosis. How does the fibrosis develop, and what can be done about it? Hormonal and hemodynamic factors are examined. Experimental studies with ACE inhibitors or aldosterone receptor antagonists suggest that the fibrosis may be prevented or reversed.

Animals↗