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Physiological and pathological cardiac hypertrophy
Ippei Shimizu1, Tohru Minamino2
1Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan; Division of Molecular Aging and Cell Biology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Insights
The heart adapts to increased demand through physiological or pathological hypertrophy. This review details the molecular and cellular mechanisms differentiating these cardiac growth responses.
Area of Science:
- Cardiology
- Molecular Biology
- Cellular Biology
Background:
- The heart requires continuous high energy supply for blood circulation.
- Cardiac homeostasis is maintained by growth (hypertrophy), angiogenesis, and metabolic plasticity.
- Cardiac hypertrophy is classified as physiological (normal function) or pathological (dysfunction).
Purpose of the Study:
- To review key molecules and cellular responses in cardiac hypertrophy.
- To differentiate between physiological and pathological cardiac hypertrophy.
- To understand adaptive and maladaptive cardiac remodeling.
Main Methods:
- Literature review of molecular and cellular mechanisms.
- Analysis of signaling pathways involved in cardiac growth.
- Comparison of cellular responses in different hypertrophy types.
Main Results:
- Physiological hypertrophy occurs during normal growth, pregnancy, and in athletes.
- Pathological hypertrophy results from stress (hypertension, infarction) and involves fibrosis, capillary rarefaction, and inflammation.
- Pathological hypertrophy leads to cellular dysfunction, epigenetic changes, and heart failure.
Conclusions:
- Understanding the molecular basis of cardiac hypertrophy is crucial for differentiating adaptive from maladaptive responses.
- Key differences in cellular responses and molecular signaling distinguish physiological from pathological cardiac hypertrophy.
- This review provides insights into mechanisms driving cardiac remodeling and potential therapeutic targets.
Abstract:
The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy.
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