Novel aspects of angiotensin II action in the heart. Implications to myocardial ischemia and heart failure.

The influence of angiotensin II (Ang II) on cardiac structural and electrophysiological remodeling was discussed including the novel concept that the renin angiotensin aldosterone is involved in the regulation heart cell volume. Particular attention was given to the role of Ang II AT1 receptors as mechanosensors which are activated by mechanic stretch independently of Ang II. These findings highly suggest that RAS inhibitors or AT1 receptor blockers have additional beneficial therapeutics effects by changing mechanical transduction. The influence of cell swelling on cell communication as well as the effect of Ang II on cell volume and the consequent activation of ionic channels and the generation of cardiac arrhythmias was reviewed. The discovery of ACE2 and its relevance to heart pathology was also discussed.