Angiotensin II and angiotensin 1-7: which is their role in atrial fibrillation?

Heart Failure Reviews
Annamaria MascoloFrancesco Rossi

Abstract

Atrial fibrillation (AF) is a significant cause of morbidity and mortality as well as a public health burden considering the high costs of AF-related hospitalizations. Pre-clinical and clinical evidence showed a potential role of the renin angiotensin system (RAS) in the etiopathogenesis of AF. Among RAS mediators, angiotensin II (AII) and angiotensin 1-7 (A1-7) have been mostly investigated in AF. Specifically, the stimulation of the pathway mediated by AII or the inhibition of the pathway mediated by A1-7 may participate in inducing and sustaining AF. In this review, we summarize the evidence showing that both RAS pathways may balance the onset of AF through different biological mechanisms involving inflammation, epicardial adipose tissue (EAT) accumulation, and electrical cardiac remodeling. EAT is a predictor for AF as it may induce its onset through direct (infiltration of epicardial adipocytes into the underlying atrial myocardium) and indirect (release of inflammatory adipokines, the stimulation of oxidative stress, macrophage phenotype switching, and AF triggers) mechanisms. Classic RAS blockers such as angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARB) may prevent AF by affecting t...Continue Reading

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Citations

Aug 28, 2020·Frontiers in Cardiovascular Medicine·Annamaria MascoloAnnalisa Capuano
Oct 8, 2020·Journal of Arrhythmia·Yueying WangTong Liu
Jan 9, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Leonid TyanAlexey V Glukhov
May 8, 2021·Frontiers in Pharmacology·Annamaria MascoloAnnalisa Capuano
Aug 8, 2021·International Journal of Molecular Sciences·Samantha L CooperJeanette Woolard
Aug 21, 2021·Clinical and Experimental Hypertension : CHE·Shakhi Shylesh C MUma Devi P

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