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As heart failure sets in, there is activation of RAS (Fig 2.1). Adrenergic stimulation of beta-1 receptors in juxtaglomerular apparatus of the kidneys results in release of renin. Another mechanism i.e. responsible for renin release is baroreceptor stimulation in renal vascular bed by reduction of renal blood flow.
Angiotensin II that is released is a powerful vasoconstrictor and stimulates the release of aldosterone. It also causes remodeling of cardiac myocytes. Aldosterone retains sodium and has direct effects on myocardium. The result is increased systemic vascular resistance and development of edema. Hence the interruption of this renin-angiotensin-aldosterone axis by angiotensin-converting enzyme inhibitors (ACE-Inhibitors) or angiotensin receptor blockers (ARBs) has salutary effects as there is reduction in systemic vascular resistance, afterload reduction, mild diuresis and improvement in the cardiac output.
Angiotensin II also has direct role in modifying the structure and function of myocardium.
Q. 2-Dimensional Echocardiography constrictive pericarditis? Thickened pericardium can be detected. In about a third of patients there will be associated some degree of perica
Explain Diagnostic Approach to Congenital Heart Disease ? It is often easy to recognise the presence of CHD in older children and adults. As in any other form of heart disease
In the above sections we discussed in detail the fossil record of primates in general and more particularly those of apes and the humans. Despite the fact that in recent years a nu
Determine the solubility of micronutrient cations The solubility of micronutrient cations is at a maximum at low pH values. As the pH increases the ions of these elements first
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