Circulation Research. 2003;93:69-76
Published online before print June 5, 2003, doi: 10.1161/01.RES.0000080521.15238.E5
Published online before print June 5, 2003, doi: 10.1161/01.RES.0000080521.15238.E5
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© 2003 American Heart Association, Inc.
Integrative Physiology |
Transgenic Model of Aldosterone-Driven Cardiac Hypertrophy and Heart Failure
From the Departments of Genomics Sciences (W.Q., J.J.G.), Cardiovascular & Metabolic Diseases (E.G.M., B.R.B., A.E.R.), Global Medical Affairs (R.R.), and Global Toxicology (E.A.G.B.), Pfizer, Inc, St Louis, Mo, and Prince Henry’s Institute of Medical Research (J.W.F.), Clayton, Victoria, Australia.
Correspondence to Ellen G. McMahon, PhD, Pfizer, Inc, 800 N Lindbergh Blvd, Mail Zone T1G, St Louis, MO 63167. E-mail ellen.g.mcmahon{at}pfizer.com
Aldosterone classically promotes unidirectional transepithelial sodium transport, thereby regulating blood volume and blood pressure. Recently, both clinical and experimental studies have suggested additional, direct roles for aldosterone in the cardiovascular system. To evaluate aldosterone activation of cardiomyocyte mineralocorticoid receptors, transgenic mice overexpressing 11ß-hydroxysteroid dehydrogenase type 2 in cardiomyocytes were generated using the mouse 
-myosin heavy chain promoter. This enzyme converts glucocorticoids to receptor-inactive metabolites, allowing aldosterone occupancy of cardiomyocyte mineralocorticoid receptors. Transgenic mice were normotensive but spontaneously developed cardiac hypertrophy, fibrosis, and heart failure and died prematurely on a normal salt diet. Eplerenone, a selective aldosterone blocker, ameliorated this phenotype. These studies confirm the deleterious consequences of inappropriate activation of cardiomyocyte mineralocorticoid receptors by aldosterone and reveal a tonic inhibitory role of glucocorticoids in preventing such outcomes under physiological conditions. In addition, these data support the hypothesis that aldosterone blockade may provide additional therapeutic benefit in the treatment of heart failure.
Key Words: 11ß-hydroxysteroid dehydrogenase type 2 • mineralocorticoid • eplerenone • mineralocorticoid receptor • heart failure
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