RAAS System in Heart Failure

Angiotensinogen

Angiotensin 1

Angiotensin 2

Increase in Sympathetic activity (increase in heart rate to try and compensate for reduced oxygen delivery )

Na+ retention, H2O reabsorption (at kidney tubules)

Vasoconstriction

Angiotensin Converting Enzyme (ACE)

Aldosterone

RAAS system is a hormone system that regulates blood pressure and fluid balance.

Renin Released

Liver

Increased Blood Pressure

Increased blood volume

Increased cardiac hypertrophy - increased heart muscle mass - remodelling

Reduced cardiac output (reduced volume of blood pumped out of the heart per minute)

Kidney detects reduced blood volume at the glomerulus

Reduced left ventricular ejection fraction

Fluid overload

Backup of blood back into the lungs and the body

Inactivates Bradykinin - increased bradykinin levels

ACE inhibitors - Ramipril, Perindopril

Aldosterone Antagonists - Spironolactone

Beta blockers - Metoprolol SR, Bisoprolol, Carvedilol, Nebivolol

Angiotensin 2 receptor blockers (ARBs/ATll antagonists/sartans) - Irbesartan, Candesartan, Telmisartan

Vasodilation

Heart Failure