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首页> 外文期刊>Circulation research: a journal of the American Heart Association >Role of Mineralocorticoid Receptor Antagonists in Cardiovascular Disease
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Role of Mineralocorticoid Receptor Antagonists in Cardiovascular Disease

机译:盐皮质激素受体拮抗剂在心血管疾病中的作用

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Aldosterone exerts its best known sodium homeostasis actions by controlling sodium excretion at the level of the distal tubules via activation of the apical epithelial sodium channel and the basolateral Na+/K+ ATPase pump. Recently, this mineralocorticoid hormone has been demonstrated to act on the heart and blood vessels. Excess release of aldosterone in relation to the salt status induces both genomic and nongenomic effects that by promoting endothelial dysfunction, and vascular and cardiorenal adverse remodeling, contribute to the target organ damage found in hypertension, heart failure, myocardial infarction, and chronic renal failure. Mineralocorticoid receptor blockers have been shown to be highly effective in resistant hypertension and to slow down heart failure progression, and in experimental animals, the development of atherosclerosis. Blockade of the action of aldosterone and potentially other mineralocorticoid steroids has been increasingly demonstrated to be an extremely beneficial therapy in different forms of cardiovascular disease. This review provides a summary of the knowledge that exists on aldosterone actions in the cardiovascular system and, in providing the translational impact of this knowledge to the clinical arena, illustrates how much more needs to be achieved in exploring the use of mineralocorticoid receptor blockers in less advanced stages of heart, renal, and vascular disease.
机译:醛固酮通过激活顶端上皮钠通道和基底外侧Na + / K + ATPase泵来控制远端小管水平的钠排泄,从而发挥其最著名的钠稳态作用。最近,已证明这种盐皮质激素可作用于心脏和血管。与盐状态相关的醛固酮的过量释放会诱导基因组和非基因组效应,它们通过促进内皮功能障碍以及血管和心肾不良重塑而导致对目标器官的损害,这些损害是在高血压,心力衰竭,心肌梗塞和慢性肾衰竭中发现的。盐皮质激素受体阻滞剂已显示出在抵抗性高血压和减慢心衰进展以及实验动物动脉粥样硬化发展中非常有效。越来越多地证明,醛固酮和可能的其他盐皮质激素类固醇的阻断作用是在不同形式的心血管疾病中极为有益的疗法。这篇综述总结了有关心血管系统中醛固酮作用的知识,并在将其转化为临床领域的意义上,说明了探索用更少的盐皮质激素受体阻滞剂需要更多的知识。心脏,肾脏和血管疾病的晚期。

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