%0 Journal Article
%T A Systematic Review to Investigate Whether Angiotensin-(1-7) Is a Promising Therapeutic Target in Human Heart Failure
%A Vincent C. H. Lee
%A Elizabeth N. Lloyd
%A Helena C. Dearden
%A Kenneth Wong
%J International Journal of Peptides
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/260346
%X Context. Heart failure (HF) is a common condition causing much morbidity and mortality despite major advances in pharmacological and device therapies. Preclinical data suggest a cardioprotective role of Angiotensin-(1-7) in animal models of HF. Objective. Perform a systematic review on the effects of Angiotensin-(1-7) on humans, focusing on HF. Results. 39 studies were included in the review (4 in human HF and (35) in non-HF patients). There is only one intervention study on 8 patients with human HF, using Angiotensin-(1-7), with forearm blood flow (FBF) as the endpoint. Angiotensin-(1-7) caused no significant effect on FBF in this HF study but caused vasodilation in 3 out of 4 non-HF studies. In one other non-HF study, Angiotensin-(1-7) infusion led to a significant increase in blood pressure in normal men; however, effects were <0.03% that of angiotensin II. Cardioprotective effects seen in non-HF studies include for instance beneficial actions against atherosclerosis and myocardial fibrosis. Conclusions. The main finding of our systematic review is that Angiotensin-(1-7) plays an important cardioprotective role in HF in animals and in patients without heart failure. More research is required to test the hypothesis that Angiotensin-(1-7) benefits patients with heart failure. 1. Introduction Heart failure (HF) is a major health problem for many developed world populations and has a relatively poor prognosis. Within the US population, the incidence approaches 1%, with a lifetime risk of 1 in 5 for both men and women at the age of 40 years [1]. In 2005, there was an estimated near 1.1 million admissions to American hospitals associated with HF, which was up from approximately 400,000 in 1979 [2]. This substantial increase in prevalence and hospitalisation meant an epidemic was declared [3, 4]. Over the coming years, the prevalence is likely to increase due to changing lifestyles and diets of the developing world, advances in heart failure therapeutics, an increase in prevalence of conditions which have cardiovascular consequences such as obesity and diabetes, and better survival from other heart conditions where HF is the end stage especially with the increased use of primary angioplasty for myocardial infarction. Figures from the United States show an estimated bill totalling $39.2 billion in 2010, to cover the direct and indirect cost of HF [5]. One in 8 death certificates in America mentioned HF, and in 20% of cases, it was the primary cause. In 2006, the number of any-mention deaths from HF was 283,000 [1]. Five-year mortality is 45¨C60% [6], and
%U http://www.hindawi.com/journals/ijpep/2013/260346/