The 2° Human and Veterinary Crosstalk Symposium on Aldosterone was held in Bordeaux the 1st and 2nd October 2011. More than 70 specialists in human and veterinary cardiology and nephrology attended the meeting, the logical follow-up of the first one held in 2009. The symposium focused on the topic of aldosterone breakthrough, a phenomenon observed in the most part of human and canine patients chronically treated with ACE-inhibitors or angiotensin receptor blockers. The aldosterone breakthrough is clinically relevant as chronic exposure to high concentrations of aldosterone results in expansion of extracellular volume, favours potassium and magnesium wasting, contributes to endothelial dysfunction and vascular inflammation with renal, vascular and cardiac remodelling, reduction of glomerular filtration rate, increasing proteinuria, cardiac fibrosis, hypertrophy and progression of heart failure. The efficacy of mineralcorticoid receptor blockers (MRBs) (spironolactone among these) is validated in patients with heart failure and systolic dysfunction as well as in dogs affected by moderate to severe heart failure due to mitral valve disease. MRBs appears as promising molecules in the treatment of human and canine patients at earlier stages of heart failure or suffering from chronic kidney disease and/or proteinuria, even in the context of cardiorenal syndromes, whereby dysfunction in one organ may induce dysfunction of the other. One session addressed the practical use of biomarkers in the diagnosis and prognosis of heart disease, with particular reference to multi-marker strategies for patient risk stratification.
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