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[Molecular aspects of cardiac hypertrophy and their implications in cardiomyopathies]
Insights
Cardiac hypertrophy, an adaptive heart response, can lead to heart failure. This review discusses molecular mechanisms in hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM).
Area of Science:
- Cardiology
- Molecular Biology
- Pathophysiology
Context:
- Cardiac hypertrophy is an adaptive response to cardiomyocyte damage from intrinsic (e.g., sarcomere mutations in hypertrophic cardiomyopathy) or extrinsic factors (e.g., ischemia, overload, metabolic diseases, arrhythmias).
- While initially compensatory, sustained cardiac hypertrophy can progress to systolic dysfunction and decompensation.
- A subset of hypertrophic cardiomyopathy patients develop a dilated phase, resembling dilated cardiomyopathy.
Purpose:
- To review the molecular mechanisms underlying cardiac hypertrophy in hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM).
- To elucidate the transition from compensated hypertrophy to decompensated heart failure.
Summary:
- Cardiac hypertrophy involves adaptive changes in cardiomyocytes in response to various stressors.
- Sarcomere mutations are a key intrinsic cause, while ischemia and overload are common extrinsic triggers.
- The review focuses on the molecular pathways driving hypertrophy in HCM and DCM, including the progression to dilated cardiomyopathy.
Impact:
- Provides insights into the molecular basis of cardiac hypertrophy and its progression to heart failure.
- Enhances understanding of the relationship between hypertrophic cardiomyopathy and dilated cardiomyopathy.
- Informs potential therapeutic strategies targeting molecular pathways in cardiomyopathies.
Abstract:
Cardiac hypertrophy or hypertrophy of cardiomyocytes is an adaptive response of the heart against an intrinsic or extrinsic damage in cardiomyocytes. A typical intrinsic defect causing cardiac hypertrophy is the sarcomere mutations found in hypertrophic cardiomyopathy (HCM) and extrinsic defects include cardiac ischemia, pressure- or volume-overload, metabolic diseases and arrhythmias. The hypertrophic response is a compensatory mechanism to augments cardiac output, however, sustained hypertrophy may lead to systolic dysfunction or de-compensation state. It is well known that some patients with HCM develop to dilated-phase or burn-out phase, which resembles dilated cardiomyopathy (DCM). In this review, molecular mechanisms underlying the cardiac hypertrophy in HCM and DCM will be discussed.