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Role of Angiotensin II Receptor Blockade During Remodeling After Myocardial Infarction

  • Chapter
Angiotensin II Receptor Blockade Physiological and Clinical Implications

Part of the book series: Progress in Experimental Cardiology ((PREC,volume 2))

Summary

Increased levels of angiotensin (Ang) II in myocardial infarction (MI), left ventricular (LV) volume overload, and heart failure promote vasoconstriction, increased LV impedance, ischemic injury, ischemia-reperfusion (IR) injury, and LV remodeling with hypertrophy and fibrosis. One strategy for achieving cardioprotection is to decrease Ang II receptor stimulation using angiotensin-converting enzyme (ACE) inhibitors. Another strategy for achieving cardioprotection is by selective blockade of Ang II type 1 (AT1) receptors or type 2 (AT2) receptors using selective antagonists. Functionality has been associated mainly with AT1 receptors, and AT1 receptor blockade is emerging as a new class of agents for therapy of hypertension, LV hypertrophy, and congestive heart failure. The role of AT1 blockade in limiting remodeling after MI has been controversial. Our recent results using the isolated rat working heart model suggest functional roles for both AT1 and AT2 receptor blockade in recovery from IR injury. Furthermore, chronic treatment with AT1 blockade in dogs limited early LV remodeling. Thus, Ang II receptor antagonists are emerging as new cardioprotective agents, alone or in combination with ACE inhibitors.

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  1. Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada

    Bodh I. Jugdutt

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Editors and Affiliations

  1. Institute of Cardiovascular Sciences St. Boniface General Hospital Research Centre Faculty of Medicine, University of Manitoba, Winnipeg, Canada

    Naranjan S. Dhalla Ph.D., M.D. (Hon.) (Distinguished Professor and Director MRC Group in Experimental Cardiology), Peter Zahradka Ph.D. (Associate Professor), Ian M. C. Dixon Ph.D. (Assistant Professor) & Robert E. Beamish M.D. (Professor Emeritus) (Distinguished Professor and Director MRC Group in Experimental Cardiology),  (Associate Professor),  (Assistant Professor) &  (Professor Emeritus)

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Jugdutt, B.I. (1998). Role of Angiotensin II Receptor Blockade During Remodeling After Myocardial Infarction. In: Dhalla, N.S., Zahradka, P., Dixon, I.M.C., Beamish, R.E. (eds) Angiotensin II Receptor Blockade Physiological and Clinical Implications. Progress in Experimental Cardiology, vol 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5743-2_33

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  • DOI: https://doi.org/10.1007/978-1-4615-5743-2_33

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