Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 168, Issue 6, Pages 5135-5142Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2013.08.022
Keywords
Aldosterone; Aldosterone antagonist; Atrial fibrillation; Oxidative stress
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Funding
- NHLBI NIH HHS [R01 HL111314] Funding Source: Medline
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Atrial fibrillation (AF), the most common cardiac arrhythmia, is an electrocardiographic description of a condition with multiple and complex underlying mechanisms. Oxidative stress is an important driver of structural remodeling that creates a substrate for AF. Oxidant radicals may promote increase of atrial oxidative damage, electrical and structural remodeling, and atrial inflammation. AF and other cardiovascular morbidities activate angiotensin (Ang-II)-dependent and independent cascades. A key component of the renin-angiotensin-aldosterone system (RAAS) is the mineralocorticoid aldosterone. Recent studies provide evidence of myocardial aldosterone synthesis. Aldosterone promotes cardiac oxidative stress, inflammation and structural/electrical remodeling via multiple mechanisms. In HF patients, aldosterone production is enhanced. In patients and in experimental HF and AF models, aldosterone receptor antagonists have favorable influences on cardiac remodeling and oxidative stress. Therapeutic approaches that seek to reduce AF burden by modulating the aldosterone system are likely beneficial but underutilized. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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