Subcellular remodelling may induce cardiac dysfunction in congestive heart failure

被引:73
作者
Dhalla, Naranjan S. [1 ]
Saini-Chohan, Harjot K. [1 ]
Rodriguez-Leyva, Delfin [1 ]
Elimban, Vijayan [1 ]
Dent, Melissa R. [1 ]
Tappia, Paramjit S. [1 ]
机构
[1] Univ Manitoba, Fac Med, Dept Physiol, St Boniface Gen Hosp,Res Ctr,Inst Cardiovasc Sci, Winnipeg, MB R2H 2A6, Canada
基金
加拿大健康研究院;
关键词
NA+-K+-ATPASE; GENETICALLY-DETERMINED CARDIOMYOPATHY; CONTRACTILE PROTEIN ABNORMALITIES; ADRENOCEPTOR SIGNAL-TRANSDUCTION; SARCOPLASMIC-RETICULUM FUNCTION; RENIN-ANGIOTENSIN SYSTEM; MYOCARDIAL-INFARCTION; GENE-EXPRESSION; EXTRACELLULAR-MATRIX; CALCIUM-TRANSPORT;
D O I
10.1093/cvr/cvn281
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
It is commonly held that cardiac remodelling, represented by changes in muscle mass, size, and shape of the heart, explains the progression of congestive heart failure (CHF). However, this concept does not provide any clear information regarding the development of cardiac dysfunction in CHF. Extensive research has revealed that various subcellular organelles such as the extracellular matrix, sarcolemma, sarcoplasmic reticulum, myofibrils, mitochondria, and nucleus undergo varying degrees of changes in their biochemical composition and molecular structure in CHF. This subcellular remodelling occurs due to alterations in cardiac gene expression as well as activation of different proteases and phospholipases in the failing hearts. Several mechanisms including increased ventricular wall stress, prolonged activation of the renin-angiotensin and sympathetic systems, and oxidative stress have been suggested to account for subcellular remodelling in CHF. Furthermore, subcellular remodelling is associated with changes in cardiomyocyte structure, cation homeostasis as well as functional activities of cation channels and transporters, receptor-mediated signal transduction, Ca2+-cycling proteins, contractile and regulatory proteins, and energy production during the development of heart failure. The existing evidence supports the view that subcellular remodelling may result in cardiac dysfunction and thus play a critical role in the transition of cardiac hypertrophy to heart failure.
引用
收藏
页码:429 / 438
页数:10
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