Cardiac Hypertrophy: From Pathophysiological Mechanisms to Heart Failure Development

Reviews in Cardiovascular Medicine

Ferdinando Carlo Sasso¹  Raffaella Epifani¹  Maria Alfano¹  Alfredo Caturano¹  Erica Vetrano¹  Raffaele Marfella¹  Raffaele Galiero¹  Giovanni Docimo¹  Luca Rinaldi¹  Celestino Sardu¹  Teresa Salvatore² 

[1] Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, I-80138 Naples, Italy;Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, I-80138 Naples, Italy;

关键词: cardiac hypertrophy;    heart failure;    pathophysiology;    diabetic cardiomyopathy;    metabolism;   

DOI  :  10.31083/j.rcm2305165

来源: DOAJ

【 摘 要 】

Cardiac hypertrophy develops in response to increased workload to reduce ventricular wall stress and maintain function and efficiency. Pathological hypertrophy can be adaptive at the beginning. However, if the stimulus persists, it may progress to ventricular chamber dilatation, contractile dysfunction, and heart failure, resulting in poorer outcome and increased social burden. The main pathophysiological mechanisms of pathological hypertrophy are cell death, fibrosis, mitochondrial dysfunction, dysregulation of Ca2+-handling proteins, metabolic changes, fetal gene expression reactivation, impaired protein and mitochondrial quality control, altered sarcomere structure, and inadequate angiogenesis. Diabetic cardiomyopathy is a condition in which cardiac pathological hypertrophy mainly develop due to insulin resistance and subsequent hyperglycaemia, associated with altered fatty acid metabolism, altered calcium homeostasis and inflammation. In this review, we summarize the underlying molecular mechanisms of pathological hypertrophy development and progression, which can be applied in the development of future novel therapeutic strategies in both reversal and prevention.

【 授权许可】

Unknown