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Structural Remodeling of Cardiac Myocytes in Hypertrophy and Progression to Failure

  • Chapter
Cardiac Remodeling and Failure

Part of the book series: Progress in Experimental Cardiology ((PREC,volume 5))

  • 126 Accesses

Abstract

Studies conducted in recent years have underscored the importance of cardiac structural alterations in the progression to failure. For instance, therapies that arrest or reverse structural abnormalities produce the most striking improvements in patient outcome. Cardiac myocytes comprise about 75% of the heart mass and provide mechanical force for contraction. Consequently, structural changes in these cells are likely to play a key role in heart failure. Many myocyte cytoskeletal alterations have been observed in heart failure. Experiments in transgenic mice suggest that such changes can cause heart failure. Importantly, viral infections have been linked to cytoskeletal alterations known to cause heart failure. Perhaps, the most consistent and important myocyte structural alteration in progression to heart failure is a change in the shape of cardiac myocytes. In heart failure of both ischemic and hypertensive etiologies, progressive chamber dilatation is due largely to myocyte lengthening from series addition of new sarcomeres. During this critical transition period, myocyte diameter does not change. It is encouraging to know that this maladaptive change in myocyte shape is potentially reversible. Isolated myocyte data from patients with heart failure on LVAD (left ventricular assist device) support and animals genetically predisposed to heart failure and treated with ACE inhibitors or AT1 receptor antagonists have demonstrated significant reversal of myocyte shape alterations. As we learn more about signaling abnormalities affecting myocyte structure in heart failure, important new therapies will undoubtedly be developed in the near future as a result of this information.

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Authors and Affiliations

  1. The South Dakota Health Research Foundation Cardiovascular Research Institute, University of South Dakota School of Medicine, 1400 West 22nd Street, Sioux Falls, SD, 57105, USA

    A Martin Gerdes PhD & Xuejun Wang

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  2. Xuejun Wang
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Correspondence to A Martin Gerdes PhD .

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Editors and Affiliations

  1. Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Faculty of Medicine, University of Manitoba, Winnipeg, Canada

    Pawan K. Singal PhD, DSc (Professor), Ian M. C. Dixon PhD (Associate Professor), Lorrie A. Kirshenbaum PhD (Associate Professor) & Naranjan S. Dhalla PhD, MD (HON), DSc (HON) (Distinguished Professor and Director) (Professor),  (Associate Professor),  (Associate Professor) &  (Distinguished Professor and Director)

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Gerdes, A.M., Wang, X. (2003). Structural Remodeling of Cardiac Myocytes in Hypertrophy and Progression to Failure. In: Singal, P.K., Dixon, I.M.C., Kirshenbaum, L.A., Dhalla, N.S. (eds) Cardiac Remodeling and Failure. Progress in Experimental Cardiology, vol 5. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-9262-8_12

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  • DOI: https://doi.org/10.1007/978-1-4419-9262-8_12

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-4864-1

  • Online ISBN: 978-1-4419-9262-8

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