Molecular mechanisms in evolutionary cardiology failure
Autor: | Claude Delcayre, Bernard Swynghedauw, Alain Cohen-Solal, Alexandre Mebazaa, Jane-Lyse Samuel |
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Rok vydání: | 2010 |
Předmět: |
Senescence
Inotrope medicine.medical_specialty General Neuroscience Ischemia Biology medicine.disease General Biochemistry Genetics and Molecular Biology Muscle hypertrophy History and Philosophy of Science Fibrosis Internal medicine Cardiac hypertrophy Heart failure medicine Cardiology Myocardial fibrosis |
Zdroj: | Annals of the New York Academy of Sciences. 1188:58-67 |
ISSN: | 0077-8923 |
DOI: | 10.1111/j.1749-6632.2009.05084.x |
Popis: | Integration of the relevant evolutionary paradigm in cardiology has not yet been fully achieved: In the past, heart failure (HF) was mainly ascribed to infections, and the origins of cardiac hypertrophy (CH) were regarded as mechanical. Recent changes in lifestyle have both reduced the incidence of infections and increased lifespan, and HF is now seen as a complex disease--one that is still caused by mechanical disorder, but also associated with ischemia and senescence. The long-held view that CH serves to restore myocardial economy back to normal is still valid. The adaptive process is characterized by a quantitative and a qualitative fetal gene reprogramming, which is now being confirmed by recent advances in microRNA research. It underscores the fact CH is the physiologic reaction of the heart to a pathologic stimulus. The goal for therapy is economic, not inotropic. Another major issue is myocardial fibrosis, a major determinant of diastolic function and arrhythmias. Recent changes in lifestyle have crucially modified the context in which HF occurs. |
Databáze: | OpenAIRE |
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