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Updated: Jun 26, 2025

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Published on: July 14, 2021
Stress and Heart in Remodeling Process: Multiple Stressors at the Same Time Kill
Fatih Yalçin1,2, Maria Roselle Abraham1, Mario J Garcia3
1Department of Cardiology, UCSF HEALTH, School of Medicine, Cardiac Imaging, San Francisco, CA 94143, USA.
Hypertension and stress can cause stressed heart morphology (SHM), including basal septal hypertrophy (BSH). Early management of hypertension and chronic stress is crucial for preventing heart failure.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Pathophysiology
Background:
- Myocardial remodeling results from acute or chronic stress.
- Stressed heart morphology (SHM) describes basal septal hypertrophy (BSH) linked to emotional and chronic stress from hypertension.
- Acute stress cardiomyopathy (ASC) and hypertension often coexist clinically.
Purpose of the Study:
- To explore geometric and functional aspects of the septal base under acute and chronic stress.
- To investigate the pre-existing hypertension-mediated myocardial involvement in ASC cases.
- To discuss the impact of multiple stressors on myocardial remodeling and heart failure prevention.
Main Methods:
- Review of existing research findings on hypertension and ASC.
- Analysis of microimaging studies in small animals with induced pressure overload.
- Examination of tissue aspects in conditions with excessive sympathetic overdrive.
Main Results:
- Hypertension-mediated myocardial involvement may precede ASC.
- A hyperkinetic tissue response at the base is observed in both hypertension and ASC.
- Hypertension is implicated in recurrent ASC and BSH development.
Conclusions:
- Combined hypertension and chronic stress contribute to myocardial remodeling.
- Early, combined management of hypertension and stress is vital for preventing global remodeling and heart failure.
- Segmental remodeling in patients with multiple stressors warrants attention for timely intervention.
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