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Nephrol Dial Transplant (2001) 16: 1532-1535
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Vasopeptidase inhibitors—concepts and evidence

Frank Ruschitzka, Roberto Corti, Thomas Quaschning, Matthias Hermann and Thomas F. Lüscher

CardioVascular Center, Cardiology, University Hospital Zurich, Switzerland

Keywords: angiotensin-converting enzyme; heart failure; hypertension; renal; treatment; vasopeptidase inhibitor

Introduction

Structural, humoral and neuronal factors are involved in cardiovascular regulation. The renin–angiotensin–aldosterone system (RAAS) plays a central role in cardiovascular regulation as both a circulating hormone and a paracrine mediator. The endothelium is a source of paracrine mediators such as nitric oxide (NO), endothelial-derived hyperpolarizing factor (EDHF) and endothelin (Figure 1Go). These circulating and local regulatory systems exhibit complex synergisms and interactions; the sympathetic nervous system stimulates secretion of rennin and angiotensin II which, centrally and at the presynaptic level, increase sympathetic nerve activity and enhance endothelin and vasopressin production. Atrial natriuretic peptides on the other hand counteract the RAAS and endothelin. Endothelial substances act primarily locally and exhibit vasoconstrictor, vasodilating, and mitogenic effects. All these regulatory systems are responsible for proper circulatory homeostasis and for structural vascular and myocardial regulation.


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  		Fig. 1. The synergistic effects resulting from combined ACE and . . . [Full Text of this Article]

 
Natriuretic peptides

Neutral endopeptidases

Combined ACE and NEP inhibitors

Vasopeptidase inhibitors and hypertension

Vasopeptidase inhibitors and renal function

Vasopeptidase inhibitors and congestive heart failure

Vasopeptidase inhibitors and angioedema

Conclusion

Acknowledgments

Notes

References


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