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Relation of the renin–angiotensin–aldosterone system with potential cardiac injury and remodelling: the SABPA study

Lebo F. Gafane-Matemane, Nametsegang L. Mokae, Yolandi Breet & Leone Malan

Blood Press. 2020 Feb;29(1):31-38.

1) Summarize your work in one sentence.

This study examined the associations of markers of cardiac injury and remodelling with the renin-angiotensin-aldosterone system (RAAS) and copeptin, a surrogate marker of vasopressin in a bi-ethnic South African cohort.

2) Summarize your findings in one sentence.

We found an adverse association between a marker of cardiac injury and renin as well as copeptin in the black population, while the white group seemed to present with a negative feedback loop between markers of cardiac injury and remodelling, the RAAS and copeptin.

3) Which were the more important methods you used in this work? If it is not a traditional method you can briefly explain the concept of that methodology.

We determined active plasma renin concentration and plasma aldosterone, from which aldosterone-to-renin ratio was calculated. Cardiac Troponin T was measured in serum as a marker of cardiomyocyte injury, while ECG-left ventricular hypertrophy and N-terminal pro-brain natriuretic peptide were used as indicators of cardiac remodelling. Plasma copeptin was used as a surrogate marker of vasopressin and has also been linked to myocardial infarction in previous studies.

4) What did you learn from this paper, what was your take-home message?

A pre-existing vulnerable cardiovascular state in black participants of this study may have predisposed the group to cardiomyocyte injury due to RAAS dysregulation. Interactions with other blood pressure-regulating pathways as seen with copeptin in the current study may influence treatment in clinical practice.

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