Towards a re-definition of 'cardiac hypertrophy' through a rational characterization of left ventricular phenotypes: a position paper of the Working Group 'Myocardial Function' of the ESC.

Authors:
Prof. Guido Iaccarino, MD, PhD
Prof. Guido Iaccarino, MD, PhD
Federico II University of Naples
Full Professor of Applied Medical Science and Technology
Cardiology
Napoli, Campania | Italy
Guido Tarone
Guido Tarone
University of Torino
Italy
Prof. Dr. Johann Bauersachs, MD
Prof. Dr. Johann Bauersachs, MD
Hannover Medical School
Cardiology, Intensive Care
Hannover | Germany
Peter H Sugden
Peter H Sugden
Imperial College London

Eur J Heart Fail 2011 Aug 27;13(8):811-9. Epub 2011 Jun 27.

Myocardial Genetics, British Heart Foundation-Centre for Research Excellence, National Heart & Lung Institute, Imperial College London, Flowers Building, 4th floor, South Kensington Campus, London SW7 2AZ, UK.

Many primary or secondary diseases of the myocardium are accompanied with complex remodelling of the cardiac tissue that results in increased heart mass, often identified as cardiac 'hypertrophy'. Although there have been numerous attempts at defining such 'hypertrophy', the present paper delineates the reasons as to why current definitions of cardiac hypertrophy remain unsatisfying. Based on a brief review of the underlying pathophysiology and tissue and cellular events driving myocardial remodelling with or without changes in heart dimensions, as well as current techniques to detect such changes, we propose to restrict the use of the currently popular term 'hypertrophy' to cardiac myocytes that may or may not accompany the more complex tissue rearrangements leading to changes in shape or size of the ventricles, more broadly referred to as 'remodelling'. We also discuss the great potential of genetically modified (mouse) models as tools to define the molecular pathways leading to the different forms of left ventricle remodelling. Finally, we present an algorithm for the stepwise assessment of myocardial phenotypes applicable to animal models using well-established imaging techniques and propose a list of parameters most suited for a critical evaluation of such pathophysiological phenomena in mouse models. We believe that this effort is the first step towards a much auspicated unification of the terminology between the experimental and the clinical cardiologists.

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http://dx.doi.org/10.1093/eurjhf/hfr071DOI Listing

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August 2011
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11 Citations
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