Diabetes, heart damage, and angiotensin II. What is the relationship link between them? A minireview

Abstract

Cardiovascular complications are the main cause of mortality and morbidity in the diabetic patients, in whom changes in myocardial structure and function have been described. Numerous molecular mechanisms have been proposed that could contribute to the development of a cardiac damage. In this regard, angiotensin II (Ang II), a proinflammatory peptide that constitutes the main effector of the renin-angiotensin system (RAS) has taken a relevant role. The aim of this review was to analyze the role of Ang II in the different biochemical pathways that could be involved in the development of cardiovascular damage during diabetes. We performed an exhaustive review in the main databases, using the following terms: angiotensin II, cardiovascular damage, renin angiotensin system, inflammation, and diabetes mellitus. Classically, the RAS has been defined as a complex system of enzymes, receptors, and peptides that help control the blood pressure and the fluid homeostasis. However, in recent years, this concept has undergone substantial changes. Although this system has been known for decades, recent discoveries in cellular and molecular biology, as well as cardiovascular physiology, have introduced a better understanding of its function and relationship to the development of the diabetic cardiomyopathy.

Fasting increases circulating angiotensin levels and brain Agtr1a expression in male rats

“…57 Increased inflammatory activity in adipose tissue, including by AT 1 R activation, may lead to dysregulated metabolic control, such as occurs in diabetes mellitus. 58 Despite the potential peripheral effects of AT 1 R blockade, we also observed an impaired response of PVN Trh mRNA and ARC Cartpt mRNA downregulation in response to fasting in losartantreated rats. Both the thyroid hormone axis and CART have been demonstrated to regulate glucose metabolism.…”

“…Nevertheless, regarding AT 1 R in metabolism, adipose tissue has been shown to have an important role in RAS, 54 expressing angiotensinogen, 55 ACE and AT 1 R, 56 acting both locally, inducing adipocyte growth and inflammation, and systemically, contributing to higher levels of ANG II 57 . Increased inflammatory activity in adipose tissue, including by AT 1 R activation, may lead to dysregulated metabolic control, such as occurs in diabetes mellitus 58 . Despite the potential peripheral effects of AT 1 R blockade, we also observed an impaired response of PVN Trh mRNA and ARC Cartpt mRNA downregulation in response to fasting in losartan‐treated rats.…”

The Effect of Nephrectomy on Some Hormones in Adult White Rabbit’s Male (New Zealand Strain)

“…Renin is actively released from stored granules, whereas prorenin is released constitutively (6). Renin is a protease that initiates the rate-limiting step of the system known as renin-angiotensin (RAS), a system of hormones, enzymes, and active and inactive peptides that work in concert with the heart, blood vessels, and kidneys to regulate blood pressure and the balance of electrolytes and fluids [7]. Renin converts angiotensinogen produced by the liver into angiotensin-I, which activated the RAS [8].…”

“…Renin converts angiotensinogen produced by the liver into angiotensin-I, which activated the RAS [8]. The hormone angiotensin-converting enzyme (ACE), which is primarily located in the lungs, can convert the decapeptide angiotensin-I into the octapeptide angiotensin-II [7]. Angiotensin II also urges the adrenal cortex to secrete the hormone aldosterone Hence, it also called renin-angiotensin-aldosterone system (RAAS).…”

Role of Strain in the Early Diagnosis of Diabetic Cardiomyopathy

“…1 As complicações cardiovasculares são a principal causa de morte nos indivíduos com diabetes. 2,3 Dentre elas, encontra-se a cardiomiopatia diabética, que se caracteriza por alterações estruturais e funcionais cardíacas, na ausência de outros fatores conhecidos para o desenvolvimento de disfunção miocárdica, como doença coronariana, hipertensão arterial ou doenças valvares significativas. 4 O remodelamento cardíaco no diabetes resulta de mecanismos como neuropatia autonômica cardiovascular, ativação do sistema reninaangiotensina-aldosterona, fibrose miocárdica intersticial, microangiopatia, citocinas inflamatórias e alterações metabólicas, como a hiperglicemia, 5,6 e a detecção do remodelamento neste contexto requer métodos sensíveis de diagnóstico.…”