The heart is capable of responding to stressful situations by increasing muscle mass, which is broadly defined as cardiac hypertrophy. This phenomenon minimizes ventricular wall stress for the heart undergoing a greater than normal workload. At initial stages, cardiac hypertrophy is associated with normal or enhanced cardiac function and is considered to be adaptive or physiological; however, at later stages, if the stimulus is not removed, it is associated with contractile dysfunction and is termed as pathological cardiac hypertrophy. It is during physiological cardiac hypertrophy where the function of subcellular organelles, including the sarcolemma, sarcoplasmic reticulum, mitochondria, and myofibrils, may be upregulated, while pathological cardiac hypertrophy is associated with downregulation of these subcellular activities. The transition of physiological cardiac hypertrophy to pathological cardiac hypertrophy may be due to the reduction in blood supply to hypertrophied myocardium as a consequence of reduced capillary density. Oxidative stress, inflammatory processes, Ca2+-handling abnormalities, and apoptosis in cardiomyocytes are suggested to play a critical role in the depression of contractile function during the development of pathological hypertrophy.
机构:
Univ Utah, Sch Med, Div Endocrinol Metab & Diabet, Salt Lake City, UT 84112 USA
Univ Utah, Sch Med, Program Mol Med, Salt Lake City, UT 84112 USAUniv Utah, Sch Med, Div Endocrinol Metab & Diabet, Salt Lake City, UT 84112 USA
Abel, E. Dale
Doenst, Torsten
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机构:
Univ Jena, Dept Cardiothorac Surg, D-07747 Jena, GermanyUniv Utah, Sch Med, Div Endocrinol Metab & Diabet, Salt Lake City, UT 84112 USA