THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION
Atrial fibrillation (AF) is one of the most common cardiac rhythm disorders. Its prevalence is about 1 % in the general population and exceeds 7 % in individuals older than 60 years of age. It is known that hyperactivation of the renin-angiotensin-aldosterone system plays a key role in structural an...
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2019-07-01
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| Series: | Архивъ внутренней медицины |
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| Online Access: | https://www.medarhive.ru/jour/article/view/946 |
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| author | N. T. Vatutin A. N. Shevelok G. G. Taradin I. N. Kravchenko |
| author_facet | N. T. Vatutin A. N. Shevelok G. G. Taradin I. N. Kravchenko |
| author_sort | N. T. Vatutin |
| collection | DOAJ |
| description | Atrial fibrillation (AF) is one of the most common cardiac rhythm disorders. Its prevalence is about 1 % in the general population and exceeds 7 % in individuals older than 60 years of age. It is known that hyperactivation of the renin-angiotensin-aldosterone system plays a key role in structural and electrical myocardial remodeling in AF. Increased activity of the renin-angiotensin-aldosterone system causes inflammation, fibrosis and oxidative stress in cardiomyocytes. Last studies suggest that most of negative effects previously explained by angiotensin-2 may be particularly caused by excessive aldosterone activity. More data about extra-adrenal hormone production (in the myocardium, the vascular wall and even the brain) have appeared, and its receptors were found far beyond the kidneys — in cardiomyocytes, endothelial cells, fibroblasts, monocytes, and macrophages. It was also shown that aldosterone has a wide profile of pathogenic effects, one of which is the stimulation of atrial myocardial fibrosis as the structural basis for AF. The discovery of new features of aldosterone suggests that blockade of mineralocorticoid receptors may prevent or slow down atrial remodeling and thereby reduce the incidence of AF. The article presents data of the world literature and the results of own studies devoted to the use of mineralocorticoid receptor antagonists in patients with AF. Modern concepts of the role of aldosterone in the arrhythmia development and the main approaches of upstream-therapy are described. The possibilities of using eplerenone and spironolactone in primary and secondary prevention of AF are discussed. |
| format | Article |
| id | doaj-art-ed10706ed1e54ce5ac1d3556095fecbf |
| institution | Kabale University |
| issn | 2226-6704 2411-6564 |
| language | Russian |
| publishDate | 2019-07-01 |
| publisher | SINAPS LLC |
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| series | Архивъ внутренней медицины |
| spelling | doaj-art-ed10706ed1e54ce5ac1d3556095fecbf2025-08-20T03:37:08ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642019-07-019426026810.20514/2226-6704-2019-9-4-260-268744THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATIONN. T. Vatutin0A. N. Shevelok1G. G. Taradin2I. N. Kravchenko3State Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»; State Institution «V.K. Gusak Institute of Urgent and Recovery Surgery»State Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»State Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»State Institution «V.K. Gusak Institute of Urgent and Recovery Surgery»Atrial fibrillation (AF) is one of the most common cardiac rhythm disorders. Its prevalence is about 1 % in the general population and exceeds 7 % in individuals older than 60 years of age. It is known that hyperactivation of the renin-angiotensin-aldosterone system plays a key role in structural and electrical myocardial remodeling in AF. Increased activity of the renin-angiotensin-aldosterone system causes inflammation, fibrosis and oxidative stress in cardiomyocytes. Last studies suggest that most of negative effects previously explained by angiotensin-2 may be particularly caused by excessive aldosterone activity. More data about extra-adrenal hormone production (in the myocardium, the vascular wall and even the brain) have appeared, and its receptors were found far beyond the kidneys — in cardiomyocytes, endothelial cells, fibroblasts, monocytes, and macrophages. It was also shown that aldosterone has a wide profile of pathogenic effects, one of which is the stimulation of atrial myocardial fibrosis as the structural basis for AF. The discovery of new features of aldosterone suggests that blockade of mineralocorticoid receptors may prevent or slow down atrial remodeling and thereby reduce the incidence of AF. The article presents data of the world literature and the results of own studies devoted to the use of mineralocorticoid receptor antagonists in patients with AF. Modern concepts of the role of aldosterone in the arrhythmia development and the main approaches of upstream-therapy are described. The possibilities of using eplerenone and spironolactone in primary and secondary prevention of AF are discussed.https://www.medarhive.ru/jour/article/view/946aldosteronerenin-angiotensin-aldosterone systematrial fibrillationrelapseseplerenonespironolactone |
| spellingShingle | N. T. Vatutin A. N. Shevelok G. G. Taradin I. N. Kravchenko THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION Архивъ внутренней медицины aldosterone renin-angiotensin-aldosterone system atrial fibrillation relapses eplerenone spironolactone |
| title | THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION |
| title_full | THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION |
| title_fullStr | THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION |
| title_full_unstemmed | THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION |
| title_short | THE USE OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN THE PRE VENTION OF ATRIAL FIBRILLATION |
| title_sort | use of mineralocorticoid receptor antagonists in the pre vention of atrial fibrillation |
| topic | aldosterone renin-angiotensin-aldosterone system atrial fibrillation relapses eplerenone spironolactone |
| url | https://www.medarhive.ru/jour/article/view/946 |
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