Hypertension-induced remodelling: on the interactions of cardiac risk factors.
Hypertension-induced remodelling: on the interactions of cardiac risk factors.
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DOI：
10.1113/jp273043
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发表时间：
2017-06-15
期刊：
影响因子：
--
通讯作者：
Bub G
中科院分区：
文献类型：
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作者：
Tomek J;Bub G
高血压引起大量的心脏重构，如肥厚、间质纤维化和心脏交感神经系统的异常活动，这些都是一些高度危险的心脏病（如心室颤动和充血性心力衰竭）的已知危险因素。所有这些风险因素和心脏病都被广泛地孤立地研究过，但据我们所知，还没有对它们之间的相互作用进行全面的审查。与此同时，越来越多的证据表明，这种相互作用是多种多样的，针对某种特定疾病的成功治疗可能对死亡率的影响出人意料地微弱，因为接受治疗的患者可能死于另一种因治疗而加剧的原因。在本文中，我们对上述危险因素与心脏病之间的关系进行了多尺度的文献回顾，并介绍了一个框架，以深入了解它们之间可能的相互作用。我们使用这一框架来证明，在某些情况下，诸如纤维化和交感神经系统活性升高等情况可能是代偿性的，而不是纯粹的病理性机制。最后，我们展示了为什么所描述的机制不仅与高血压有关，而且与心肌梗死愈合的情况有关。
Hypertension induces considerable cardiac remodelling, such as hypertrophy, interstitial fibrosis, and abnormal activity of the cardiac sympathetic nervous system, which are established risk factors in several highly dangerous heart diseases, such as ventricular fibrillation and congestive heart failure. All these risk factors and heart diseases are studied extensively in isolation, but to our knowledge, there is no comprehensive review of their interactions. At the same time, there is growing evidence suggesting that such interactions are numerous and that a successful therapy against a particular condition may have unexpectedly weak effects on mortality, as treated patients may die of a different cause exacerbated by the therapy. In this article, we present a multiscale review of the literature focusing on the relationships between the above‐mentioned risk factors and heart diseases, and introduce a framework that gives insight into their possible interactions. We use this framework to demonstrate that conditions such as fibrosis and elevated activity of the sympathetic nervous system may be compensatory, rather than purely pathological, mechanisms in certain contexts. Finally, we show why the described mechanisms are relevant not only in hypertension, but also in the case of healed myocardial infarction.