左心室肥厚的影响因素及机制的研究进展

Factors and Mechanisms Involved in Left Ventricular Hypertrophy

生理和病理条件下,血流动力学超负荷会引起左心室肥厚。目前尚未完全阐明引起心肌肥厚的主要的刺激因素是心脏自身机械拉伸,还是神经体液因子,抑或是两者的共同作用所致。刺激因素进入细胞后,通过引起细胞内生化改变导致第二信使和第三信使的激活,进一步调节转录,激活多种心肌肥厚相关基因的表达。左心室肥厚时会出现一系列的结构改变,包括心肌细胞肥大、间质结缔组织增生以及冠状循环微血管稀少。本文参考近年来相关文献,总结左心室肥厚的影响因素及机制研究方面的发展动态,旨在为读者阐明左心室肥厚的影响因素及机制的总体情况,提供可参考的研究靶点。

The left ventricular hypertrophy （LVH） occurs in response to the hemodynamic overload in some physiological and pathological conditions. However, it has not been completely elucidated whether the primary stimulation for the hypertrophy is the mechanical stretching of the heart, neurohumoral factors, or even the interaction of both. These factors are translated inside the cell as biochemical alterations that lead to the activation of second and third messengers that will act in the cell nucleus, regulating transcription, and will finally determine the genic expression that induces LVH. The LVH is characterized by structural altera- tions due to the increase in the cardiomyocyte dimensions, the proliferation of the interstitial connective tissue and the rarefaction of the coronary microcirculation. This new knowledge about the hypertrophic signaling pathways will allow the development of new strategies in the treatment of pathological LVH.