ECM remodeling in hypertensive heart disease
Bradford C. Berk, … , Keigi Fujiwara, Stephanie Lehoux
Bradford C. Berk, … , Keigi Fujiwara, Stephanie Lehoux
Published March 1, 2007
Citation Information: J Clin Invest. 2007;117(3):568-575. https://doi.org/10.1172/JCI31044.
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ECM remodeling in hypertensive heart disease

Abstract

Hypertensive heart disease (HHD) occurs in patients that clinically have both diastolic and systolic heart failure and will soon become the most common cause of heart failure. Two key aspects of heart failure secondary to HHD are the relatively highly prevalent LV hypertrophy and cardiac fibrosis, caused by changes in the local and systemic neurohormonal environment. The fibrotic state is marked by changes in the balance between MMPs and their inhibitors, which alter the composition of the ECM. Importantly, the fibrotic ECM impairs cardiomyocyte function. Recent research suggests that therapies targeting the expression, synthesis, or activation of the enzymes responsible for ECM homeostasis might represent novel opportunities to modify the natural progression of HHD.

Authors

Bradford C. Berk, Keigi Fujiwara, Stephanie Lehoux

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Figure 1

Schematic representation of changes in the cardiac chambers of an individual with HHD compared with idiopathic or ischemic cardiomyopathy.

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Schematic representation of changes in the cardiac chambers of an indivi...
The main difference between HHD and the other two main causes of heart failure (ischemic heart disease associated with prior myocardial infarction[s] and idiopathic dilated cardiomyopathy) is the nature of the geometric remodeling of the LV chamber. Patients with HHD usually present with LVH but with a normal-sized LV chamber and preserved systolic function. By contrast, patients with heart failure secondary to ischemia or idiopathic cardiomyopathy usually have an enlarged, dilated LV chamber and more frequently also have RV enlargement.