Cardiac RAAS

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The renin-angiotensin system (RAS), also known as renin-angiotensin-aldosterone system (RAAS) is well-known for its role in regulating blood pressure, fluid volume, and capillary perfusion. It is one of the most important systems studied by those interested in the cardiovascular system and those involved in the pathogenesis of heart and renal diseases. The renin-angiotensin system exists in two frameworks: a circulating system and multiple local, tissue-specific systems. Local RAS have been found in the pancreas, heart, brain, vessels, adrenal glands, and reproductive tracts (1). In the classical RAS pathway, the crucial hormone angiotensin (Ang) II is formed by cleavage of angiotensin I. The effects of Ang II are mainly carried out by two receptors: angiotensin II receptor type 1 (AT1R) and angiotensin receptor type two (AT2R). The physiological attributes and regulations by Ang II vary based on tissues. For example, the brain RAS regulates thirst, salt appetite, sympathetic activation, and vasopressin release while kidney RAS regulates fibrosis and sodium retention.

In this paper, an overview of the components of the circulatory renin-angiotensin system and their productions will be given, along with evidence in support of a cardiac RAS. The local RAS of the heart deviate from the classical pathway in two ways, one being other sources of productions such as myocytes and fibroblasts that differ from renal or neural RAS, and the other being its functions and roles that distinguish it from other tissue RAS. Based on conducted research, the renin-angiotensin system is a critical component that contributes to the progression of heart failure (2). This has spurred further research on suppression of RAS in order to control the rate o...

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... (December 6, 1999) The renin-angiotensin-aldosterone system: a specific target for hypertension management. Am. J. Hypertens. 10.1016/S0895 7061(99)00103-X
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8. Kumar, R., Singh, V.P., and Baker, K.M. (April 2009) The intracellular renin-angiotensin system in the heart. Curr. Hypertens. Rep. 10.1007/s11906-009-0020-y
9. Shearer, F., Lang, C.C., and Struthers, A.D. (September 11, 2013) Renin–angiotensin–aldosterone system inhibitors in heart failure. Clin. Pharmacol. Ther. 10.1038/clpt.2013.135
10. Abadir, P.M., Walston, J.D., and Carey, R.M. (September 29, 2012) Subcellular characteristics of functional intracellular renin–angiotensin systems. Peptides. 10.1016/j.peptides.2012.09.016

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