Title:Aldosterone Effect on Cardiac Structure and Function
Volume: 20
Issue: 4
Author(s): Ekhlas Mahmoud Al-Hashedi*Fuad A. Abdu
Affiliation:
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
- Department of Cardiology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
Keywords:
Aldosterone, cardiac remodelling, primary aldosteronism, essential hypertension, heart failure, atrial fibrillation.
Abstract:
Background: Cardiac remodelling could be a key mechanism in aldosteronemediated
cardiovascular morbidity and mortality. Experimental and clinical evidence has
demonstrated that aldosterone causes cardiac structural remodelling and dysfunction by its profibrotic
and pro-hypertrophic effects, which result mainly from the direct effects on myocardial
collagen deposition, inflammation, and oxidative stress. Clinical studies have investigated the
aldosterone effects on the heart in different clinical conditions, including general population, essential
hypertension, primary aldosteronism, heart failure, and atrial fibrillation. Robust findings
indicate that aldosterone or the activation of the cardiac mineralocorticoid receptor can cause
damage to myocardial tissue by mechanisms independent of the blood pressure, leading to tissue
hypertrophy, fibrosis, and dysfunction.
Conclusion: Aldosterone-mediated cardiovascular morbidity and mortality mainly result from
cardiac structural and functional alterations. In different clinical settings, aldosterone can induce
cardiac structural remodelling and dysfunction via several pathological mechanisms, including
cardiac fibrosis, inflammation, and oxidative stress. Aldosterone antagonists could effectively
decrease or reverse the detrimental aldosterone-mediated changes in the heart.
