Acute myocardial response to stretch: what we (don’t) know
Myocardial stretch, as result of acute hemodynamic overload, is one of the most frequent challenges to the heart and the ability of the heart to intrinsically adapt to it is essential to prevent circulatory congestion. In this review, we highlight the historical background, the currently known mecha...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-01-01
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| Series: | Frontiers in Physiology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphys.2015.00408/full |
| _version_ | 1818721101440614400 |
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| author | João Sérgio eNeves André M Leite-Moreira Manuel eNeiva-Sousa João eAlmeida-Coelho Ricardo eCastro-Ferreira Adelino F Leite-Moreira |
| author_facet | João Sérgio eNeves André M Leite-Moreira Manuel eNeiva-Sousa João eAlmeida-Coelho Ricardo eCastro-Ferreira Adelino F Leite-Moreira |
| author_sort | João Sérgio eNeves |
| collection | DOAJ |
| description | Myocardial stretch, as result of acute hemodynamic overload, is one of the most frequent challenges to the heart and the ability of the heart to intrinsically adapt to it is essential to prevent circulatory congestion. In this review, we highlight the historical background, the currently known mechanisms, as well as the gaps in the understanding of this physiological response. The systolic adaptation to stretch is well known for over 100 years, being dependent on an immediate increase in contractility – known as the Frank-Starling mechanism – and a further progressive increase – the slow force response. On the other hand, its diastolic counterpart remains largely unstudied. Mechanosensors are structures capable of perceiving mechanical signals and activating pathways that allow their transduction into biochemical responses. Although the connection between these structures and stretch activated pathways remains elusive, we emphasize those most likely responsible for the initiation of the acute response. Calcium-dependent pathways, including angiotensin- and endothelin-related pathways; and cGMP-dependent pathways, comprising the effects of nitric oxide and cardiac natriuretic hormones, embody downstream signaling. The ischemic setting, a paradigmatic situation of acute hemodynamic overload, is also touched upon. Despite the relevant knowledge accumulated, there is much that we still do not know. The quest for further understanding the myocardial response to acute stretch may provide new insights, not only in its physiological importance, but also in the prevention and treatment of cardiovascular diseases. |
| first_indexed | 2024-12-17T20:33:23Z |
| format | Article |
| id | doaj.art-81bbd5d92c404522a5bde4a39747d4c6 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-17T20:33:23Z |
| publishDate | 2016-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-81bbd5d92c404522a5bde4a39747d4c62022-12-21T21:33:31ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2016-01-01610.3389/fphys.2015.00408172132Acute myocardial response to stretch: what we (don’t) knowJoão Sérgio eNeves0André M Leite-Moreira1Manuel eNeiva-Sousa2João eAlmeida-Coelho3Ricardo eCastro-Ferreira4Adelino F Leite-Moreira5Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of PortoDepartment of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of PortoDepartment of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of PortoDepartment of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of PortoDepartment of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of PortoDepartment of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of PortoMyocardial stretch, as result of acute hemodynamic overload, is one of the most frequent challenges to the heart and the ability of the heart to intrinsically adapt to it is essential to prevent circulatory congestion. In this review, we highlight the historical background, the currently known mechanisms, as well as the gaps in the understanding of this physiological response. The systolic adaptation to stretch is well known for over 100 years, being dependent on an immediate increase in contractility – known as the Frank-Starling mechanism – and a further progressive increase – the slow force response. On the other hand, its diastolic counterpart remains largely unstudied. Mechanosensors are structures capable of perceiving mechanical signals and activating pathways that allow their transduction into biochemical responses. Although the connection between these structures and stretch activated pathways remains elusive, we emphasize those most likely responsible for the initiation of the acute response. Calcium-dependent pathways, including angiotensin- and endothelin-related pathways; and cGMP-dependent pathways, comprising the effects of nitric oxide and cardiac natriuretic hormones, embody downstream signaling. The ischemic setting, a paradigmatic situation of acute hemodynamic overload, is also touched upon. Despite the relevant knowledge accumulated, there is much that we still do not know. The quest for further understanding the myocardial response to acute stretch may provide new insights, not only in its physiological importance, but also in the prevention and treatment of cardiovascular diseases.http://journal.frontiersin.org/Journal/10.3389/fphys.2015.00408/fullcardiac functionMyocardial stretchSlow force responsefrank starling mechanismneurohumoral adaptation |
| spellingShingle | João Sérgio eNeves André M Leite-Moreira Manuel eNeiva-Sousa João eAlmeida-Coelho Ricardo eCastro-Ferreira Adelino F Leite-Moreira Acute myocardial response to stretch: what we (don’t) know Frontiers in Physiology cardiac function Myocardial stretch Slow force response frank starling mechanism neurohumoral adaptation |
| title | Acute myocardial response to stretch: what we (don’t) know |
| title_full | Acute myocardial response to stretch: what we (don’t) know |
| title_fullStr | Acute myocardial response to stretch: what we (don’t) know |
| title_full_unstemmed | Acute myocardial response to stretch: what we (don’t) know |
| title_short | Acute myocardial response to stretch: what we (don’t) know |
| title_sort | acute myocardial response to stretch what we don t know |
| topic | cardiac function Myocardial stretch Slow force response frank starling mechanism neurohumoral adaptation |
| url | http://journal.frontiersin.org/Journal/10.3389/fphys.2015.00408/full |
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