Abstract

The pathophysiologic cycle that links myocardial failure with the appearance of congestive heart failure is not fully understood. It is clear, however, that an activation of several neurohormonal systems and the interplay between kidneys, adrenal glands, and heart contribute to abnormal sodium and water homeostasis. Aldosterone, the body's most potent mineralocorticoid hormone, contributes to intravascular and extravascular volume expansion, and thus to the appearance of symptomatic failure. Antialdosterone therapy in patients with secondary hyperaldosteronism due to heart failure must achieve one or more of the following goals: reduce or, preferably, normalize plasma aldosterone levels by limiting synthesis; antagonize the renal and systemic effects of aldosterone at its receptor sites; and eliminate or minimize the multiple stimuli to aldosterone secretion.

Keywords

AldosteroneHeart failureInternal medicineMedicineHyperaldosteronismCardiologyMineralocorticoid receptorEndocrinologyHomeostasisMineralocorticoidHormoneSpironolactoneEplerenone

MeSH Terms

AldosteroneAngiotensin-Converting Enzyme InhibitorsAnimalsDiureticsHeart FailureHumansMineralocorticoid Receptor AntagonistsReceptorsMineralocorticoidRenin-Angiotensin SystemSpironolactone

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Publication Info

Year
1993
Type
review
Volume
71
Issue
3
Pages
A3-A11
Citations
107
Access
Closed

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Citation Metrics

107
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0
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81
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Cite This

Karl T. Weber, Daniel Villarreal (1993). Aldosterone and antialdosterone therapy in congestive heart failure. The American Journal of Cardiology , 71 (3) , A3-A11. https://doi.org/10.1016/0002-9149(93)90238-8

Identifiers

DOI
10.1016/0002-9149(93)90238-8
PMID
8422002

Data Quality

Data completeness: 81%