Angiotensin and the Heart

In the last decade, ACE inhibitors have become a cornerstone of cardiovascular drug therapy. Beneficial effects in patients with hypertension, heart failure, and post myocardial infarction have been established in large clinical trials. In parallel, ex­ perimental research has shifted the interest from the immediate homeostatic function of the circulating renin-angiotensin-system to the multiple paracrine functions of local tissue renin-angiotensin-systems, including hypertrophy, hyperplasia, athe- oenesis, and vasomotion. . It was the aim or a symposium held in Hamburg, October 22-24, 1992, to bring together an international panel of experimental and clinical scientists and to discuss the most recent findings on the role of angiotensin and associated mediators in car­ diovascular adaptation and disease, with a particular emphasis on the treatment of such disease by ACE inhibitors. The meeting and this publication were generously supported by Astra Chemicals. H. Grobecker G. Heusch B. E. Strauer Contents Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V Introduction Local expression and pathophysiological role of renin-angiotensin in the blood vessels and heart Dzau, V. J. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Myocardial Perfusion Angiotensin, ACE-inhibitors and endothelial control of vasomotor tone Luscher, T. F. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Local and neurohumoral control of coronary blood flow Krajcar, M. , G. Heusch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 ACE-inhibitors in coronary artery disease? Vogt, M. , W. Matz, B. E. Strauer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Myocardial Hypertrophy Molecular mechanisms of cardiac gene expression Nadal-Ginard, B. , V. Mahdavi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Myocardial perfusion dependent and independent mechanisms of regional myocardial dysfunction in hypertrophy Vatner, S. F. , L. Hittinger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .