Cargando…
Renin Activity in Heart Failure with Reduced Systolic Function—New Insights
Regardless of the cause, symptomatic heart failure (HF) with reduced ejection fraction (rEF) is characterized by pathological activation of the renin–angiotensin–aldosterone system (RAAS) with sodium retention and extracellular fluid expansion (edema). Here, we review the role of active renin, a cru...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651297/ https://www.ncbi.nlm.nih.gov/pubmed/31261774 http://dx.doi.org/10.3390/ijms20133182 |
_version_ | 1783438313801121792 |
---|---|
author | Sullivan, Ryan D. Mehta, Radhika M. Tripathi, Ranjana Reed, Guy L. Gladysheva, Inna P. |
author_facet | Sullivan, Ryan D. Mehta, Radhika M. Tripathi, Ranjana Reed, Guy L. Gladysheva, Inna P. |
author_sort | Sullivan, Ryan D. |
collection | PubMed |
description | Regardless of the cause, symptomatic heart failure (HF) with reduced ejection fraction (rEF) is characterized by pathological activation of the renin–angiotensin–aldosterone system (RAAS) with sodium retention and extracellular fluid expansion (edema). Here, we review the role of active renin, a crucial, upstream enzymatic regulator of the RAAS, as a prognostic and diagnostic plasma biomarker of heart failure with reduced ejection fraction (HFrEF) progression; we also discuss its potential as a pharmacological bio-target in HF therapy. Clinical and experimental studies indicate that plasma renin activity is elevated with symptomatic HFrEF with edema in patients, as well as in companion animals and experimental models of HF. Plasma renin activity levels are also reported to be elevated in patients and animals with rEF before the development of symptomatic HF. Modulation of renin activity in experimental HF significantly reduces edema formation and the progression of systolic dysfunction and improves survival. Thus, specific assessment and targeting of elevated renin activity may enhance diagnostic and therapeutic precision to improve outcomes in appropriate patients with HFrEF. |
format | Online Article Text |
id | pubmed-6651297 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-66512972019-08-08 Renin Activity in Heart Failure with Reduced Systolic Function—New Insights Sullivan, Ryan D. Mehta, Radhika M. Tripathi, Ranjana Reed, Guy L. Gladysheva, Inna P. Int J Mol Sci Review Regardless of the cause, symptomatic heart failure (HF) with reduced ejection fraction (rEF) is characterized by pathological activation of the renin–angiotensin–aldosterone system (RAAS) with sodium retention and extracellular fluid expansion (edema). Here, we review the role of active renin, a crucial, upstream enzymatic regulator of the RAAS, as a prognostic and diagnostic plasma biomarker of heart failure with reduced ejection fraction (HFrEF) progression; we also discuss its potential as a pharmacological bio-target in HF therapy. Clinical and experimental studies indicate that plasma renin activity is elevated with symptomatic HFrEF with edema in patients, as well as in companion animals and experimental models of HF. Plasma renin activity levels are also reported to be elevated in patients and animals with rEF before the development of symptomatic HF. Modulation of renin activity in experimental HF significantly reduces edema formation and the progression of systolic dysfunction and improves survival. Thus, specific assessment and targeting of elevated renin activity may enhance diagnostic and therapeutic precision to improve outcomes in appropriate patients with HFrEF. MDPI 2019-06-28 /pmc/articles/PMC6651297/ /pubmed/31261774 http://dx.doi.org/10.3390/ijms20133182 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Sullivan, Ryan D. Mehta, Radhika M. Tripathi, Ranjana Reed, Guy L. Gladysheva, Inna P. Renin Activity in Heart Failure with Reduced Systolic Function—New Insights |
title | Renin Activity in Heart Failure with Reduced Systolic Function—New Insights |
title_full | Renin Activity in Heart Failure with Reduced Systolic Function—New Insights |
title_fullStr | Renin Activity in Heart Failure with Reduced Systolic Function—New Insights |
title_full_unstemmed | Renin Activity in Heart Failure with Reduced Systolic Function—New Insights |
title_short | Renin Activity in Heart Failure with Reduced Systolic Function—New Insights |
title_sort | renin activity in heart failure with reduced systolic function—new insights |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651297/ https://www.ncbi.nlm.nih.gov/pubmed/31261774 http://dx.doi.org/10.3390/ijms20133182 |
work_keys_str_mv | AT sullivanryand reninactivityinheartfailurewithreducedsystolicfunctionnewinsights AT mehtaradhikam reninactivityinheartfailurewithreducedsystolicfunctionnewinsights AT tripathiranjana reninactivityinheartfailurewithreducedsystolicfunctionnewinsights AT reedguyl reninactivityinheartfailurewithreducedsystolicfunctionnewinsights AT gladyshevainnap reninactivityinheartfailurewithreducedsystolicfunctionnewinsights |