收稿日期: 2019-04-26
网络出版日期: 2019-06-24
基金资助
国家自然科学基金资助项目(31430039);国家自然科学基金资助项目(81670228);国家自然科学基金资助项目(81730009);上海市科委实验动物研究专项资助项目(16140901100);上海市卫计委科研课题面上资助项目(201640044);复旦大学附属中山医院人才培养计划资助项目(2017ZSYXQN09)
Recent progress in understanding mechanical stretch induced myocardial remodeling
Received date: 2019-04-26
Online published: 2019-06-24
心肌重构是心力衰竭等心血管主要事件的独立危险因素. 血流动力学病理性改变产生的机械应力异常增加可直接触发心肌重构, 同时伴随神经体液因子表达升高, 产生协同作用,进一步加重心肌重构. 根据机械应力超负荷不同, 心肌重构可分为压力超负荷心肌重构和容量超负荷心肌重构. 两类心肌重构在心脏大体结构、细胞和分子水平上存在明显差异. 虽然容量超负荷在心脏疾病中普遍存在, 但既往研究多集中于压力超负荷心肌重构, 而对容量超负荷心肌重构认识不足. 近期发现钙处理蛋白(如钙/钙调素依赖蛋白激酶Ⅱ)和蛋白激酶B(Akt)可能介导两类超负荷心肌重构的差异. 整合已有报道及本课题组的最新成果, 概述两类机械应力心肌重构的异同, 为心肌肥厚的精准化研究和个性化诊疗提供参考.
吴剑, 邹云增 . 机械应力诱导心肌重构的研究进展[J]. 上海大学学报(自然科学版), 2019 , 25(3) : 375 -380 . DOI: 10.12066/j.issn.1007-2861.2139
Myocardial remodeling is an independent risk factor for major cardiovascular events such as heart failure. An abnormal increase in mechanical stress caused by hemodynamic pathological changes can directly trigger myocardial remodeling, accompanied by increased expression of neurohumoral factors, resulting in a synergistic effect which could further aggravate myocardial remodeling. Myocardial remodeling can be divided into pressure overload myocardial remodeling and volume overload myocardial remodeling, according to the type of mechanical stress overload. There are significant differences in the two types of myocardial remodeling at the gross structural, cellular, and molecular levels of the heart. Although volume overload is prevalent in various heart diseases, previous studies have focused on pressure overload myocardial remodeling, with a lack of sufficient elucidation of volume overload myocardial remodeling. It has been discovered through research that calcium-handling proteins and Akt may be held responsible for the difference between the two types of overload myocardial remodeling. This paper, which combines the previous achievements with our latest research results, outlines the similarities and differences between the two types of mechanical stress myocardial remodeling, attempts to shed some new light on precision research and personalized diagnosis and treatment of cardiac hypertrophy.
Key words： myocardial remodeling; pressure overload; volume overload; concentric; eccentric
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