© 1999 by European Society of Cardiology
Copyright © 1999, European Society of Cardiology
Aldosterone and the heart: towards a physiological function?
INSERM U127, Hôpital Lariboisière, IFR Circulation, Université Denis Diderot, Paris, France
* Corresponding author. Tel.: +33-144-631-727; fax: +33-148-742-315 delcayre@infobiogen.fr
Received 28 July 1998; accepted 3 March 1999
KEYWORDS Aldosterone; Mineralo-receptor; Fibrosis; Heart; Hypertension
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1 Introduction |
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Aldosterone (Aldo) plays an essential role in regulation of body sodium and potassium homeostasis by acting on epithelial tissues such as kidney and colon. Since about ten years the two dogmas which classically characterize Aldo, i.e., a synthesis in adrenal glands only and an action exclusively in epithelial tissues, have been challenged. Namely, Aldo receptors are present in the heart and specific actions of Aldo can be demonstrated in this organ. This suggests that cardiac tissue may be a genuine target for Aldo. Moreover, there are indications that an increase of plasma Aldo may be a risk factor in cardiovascular pathologies. For example, the CONSENSUS multicentric study has shown a relationship between plasma Aldo concentration and mortality in patients with congestive heart failure [1] The very recent discovery of Aldo synthesis in rat heart [2] brings a new step to the evolution of our ideas concerning the physiology of this
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2 Aldosterone receptors in heart |
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2.1 The intracellular mineralo-receptor
2.2 MR specificity for Aldo
2.3 MR mechanism of action
2.4 Membrane receptors
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3 Aldosterone synthesis |
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3.1 Control of aldosterone synthesis in adrenals
3.2 Aldosterone synthesis in heart
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4 Effects of aldosterone in heart |
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4.1 Cardiac fibrosis
4.2 Ionic transports
4.3 Rapid (non-genomic) effects
4.4 Polymorphisms of aldo-synthase
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5 Function(s) of cardiac aldosterone |
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5.1 Characterization of the cardiac steroidogenic system
6.1 Physiological significance
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7 Conclusion |
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