A Systematic Review to Investigate Whether Angiotensin-(1-7)‎ Is a Promising Therapeutic Target in Human Heart Failure

الملخص EN

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.