Neurohumoral Impact of Hypertension and Chronic Kidney Disease on the Acute Myocardial Infarction: Pathogenic Interactions of Cardiac Remodeling Using Aldosterone Antagonists

V.K. Tashchuk, O.S. Polianska, O.I. Hulaha, O.M. Hinhuliak

Abstract


The course of acute Q-myocardial infarction with existing hypertension is associated with excessive activation of renin-angiotensin-aldosterone system, loss of contractility in smooth muscle cells, atrial enlargement, and reduced level of neuropeptide vasopressin, when using aldosterone antagonists, provides functional protection against heart failure. Eplerenone compared to spironolactone contributes to a significant reduction in aldosterone concentration, especially in patients with chronic kidney disease stage II. The levels of atrial natriuretic peptide, angiotensin-converting enzyme and von Willebrand factor in these patients, when using spironolactone, had a statistically significant upward trend, and when using eplerenone, there was a statistically significant decrease in their concentration. Neurohormonal parameters are not only diagnostic markers of the disease course, some of them are independent predictors of cardiovascular accidents progression.


Keywords


myocardial infarction; hypertension; chronic kidney disease; heart failure; aldosterone antagonists

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DOI: https://doi.org/10.22141/2224-1485.3.41.2015.80660

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