Local Cardiac Renin-Angiotensin Aldosterone System (eBook)

Until recently, the renin-angiotensin-aldosterone system has been considered a systemic endocrine hormonal system exclusively. It is now known that each component of the renin-angiotensin system is produced, synthesized and indeed, present in many organisms including the heart and vessels. This volume presents the most recent clinical and laboratory experiences of the leading physicians and investigators in the field of the local cardiac renin-angiotensin aldosterone system.

Cardiovascular, renal and hypertension oriented physicians, investigators and scientists would find this book of interest.

Edward D. Frohlich, M.D., M.A.C.P, F.A.C.C., is the Alton Ochsner Distinguished Scientist at the Ochsner Clinic Foundation in New Orleans, Louisiana. He is also Professor of Medicine and of Physiology at Louisiana State University School of Medicine, New Orleans, and Clinical Professor of Medicine and Adjunct Professor of Pharmacology at Tulane University School of Medicine, New Orleans. He is past Editor-in-Chief of the American Heart Association journal HYPERTENSION.

Richard N. Re, M.D., is the Section Head, Hypertension at the Ochsner Clinic Foundation in New Orleans, Louisiana. He is also Ochsner's Scientific Director of Research.

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How exciting it is to see a field so well established as the ren- angiotensin system continue to grow and mature. Originally, following the original identification of renin by Tigerstedt and Bergman over 100 years ago, workers in this area spent years attempting to establish its role in experimental and renal hypertension. The early work by Goldblatt, in 1934, demonstrated that the placement of a clip around a renal artery was clearly related to the subsequent development of hypertension. However, it wasn't until the simultaneous finding by two different geographically separated teams, Page, et al, in the United States and Braun-Menendez, et al, in Argentina that the peptide angiotensin was identified. Thus, the rate-limiting enzyme renin was released from the kidney and catalyzed a biochemical cascade which was eventually shown to produce the elevated arterial pressure. Subsequently, many workers contributed to the elucidation of the concept and sequence of angiotensin I1 generation. Thus, the enzyme renin acted upon its protein substrate, produced in the liver, to liberate the decapeptide angiotensin I which, upon circulating through the pulmonary circulation, finally produced the potent octapeptide angiotensin. Several important subsequent findings demonstrated that angiotensin I1 promoted the release of the adrenal corticosteroid from that gland, thereby resulting in a larger system, the renin-angiotensin-aldosterone system. Further, this system demonstrated a classical biofeedback and the circulating octapeptide was shown to have additional biological activities in organs other than heart, vessels, kidney, adrenals, and even brain.