The renin–angiotensin system is thought to have a key role in the structural remodeling of the left ventricle that accompanies healing after acute myocardial infarction and is an important determinant of long-term prognosis. Does a direct renin inhibitor provide additive benefit to patients already treated with β-blockers and either angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers?
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
McDonald, K. M. et al. Early ventricular remodeling after myocardial damage and its attenuation by converting enzyme inhibition. Trans. Assoc. Am. Physicians 103, 229–235 (1990).
St John Sutton, M. et al. Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril. Circulation 89, 68–75 (1994).
Pfeffer, M. A. et al. on behalf of the SAVE Investigators. The effect of captopril on mortality and morbidity in patients with left ventricular dysfunction following myocardial infarction: results of the survival and ventricular enlargement trial. N. Engl. J. Med. 327, 669–677 (1992).
Gradman, A. H. et al. Aliskiren, a novel orally effective renin inhibitor, provides dose-dependent antihypertensive efficacy and placebo-like tolerability in hypertensive patients. Circulation 111, 1012–1018 (2005).
Solomon, S. D. et al. for the Aliskiren Study in Post-MI Patients to Reduce Remodeling (ASPIRE) investigators. Effect of the direct renin inhibitor aliskiren on left ventricular remodeling following myocardial infarction with systolic dysfunction. Eur. Heart J. doi:10.1093/eurheartj/ehq522.
Cohn, J. N., Ferrari, R. & Sharpe, N. on Behalf of an International Forum on Cardiac Remodeling. Cardiac remodeling–concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. J. Am. Coll. Cardiol. 35, 569–582 (2000).
Sharpe, N. et al. Early prevention of left ventricular dysfunction following myocardial infarction with angiotensin converting enzyme inhibition. Lancet 337, 872–876 (1991).
Hayashi, M. et al. Immediate administration of mineralocorticoid receptor antagonist spironolactone prevents post-infarct left ventricular remodeling associated with suppression of a marker of myocardial collagen synthesis in patients with first anterior acute myocardial infarction. Circulation 107, 2559–2565 (2003).
Krum, H. et al. Effect of valsartan added to background ACE inhibitor therapy in patients with heart failure: results from Val-HeFT. Eur. J. Heart Fail. 6, 937–945 (2004).
Taylor, A. L. et al. for the African-American Heart Failure Trial Investigators. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N. Engl. J. Med. 351, 2049–2057 (2004).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Cohn, J. Inhibiting LV remodeling—the need for a targeted approach. Nat Rev Cardiol 8, 248–249 (2011). https://doi.org/10.1038/nrcardio.2011.48
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrcardio.2011.48
This article is cited by
-
Reverse remodeling in heart failure—mechanisms and therapeutic opportunities
Nature Reviews Cardiology (2012)
-
Cardiac remodeling at the population level—risk factors, screening, and outcomes
Nature Reviews Cardiology (2011)
