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Cardiovascular Research 2000 47(1):23-37; doi:10.1016/S0008-6363(00)00076-6
© 2000 by European Society of Cardiology
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Copyright © 2000, European Society of Cardiology

Mechanical stress-induced cardiac hypertrophy: mechanisms and signal transduction pathways

Cindy Ruwhof and Arnoud van der Laarse*

Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands

* Corresponding author. Tel.: +31-71-526-3704; fax: +31-71-526-6809 a.van_der_laarse{at}lumc.nl

Cardiac hypertrophy is a well known response to increased hemodynamic load. Mechanical stress is considered to be the trigger inducing a growth response in the overloaded myocardium. Furthermore, mechanical stress induces the release of growth-promoting factors, such as angiotensin II, endothelin-1, and transforming growth factor-β, which provide a second line of growth induction. In this review, we will focus on the primary effects of mechanical stress: how mechanical stress may be sensed, and which signal transduction pathways may couple mechanical stress to modulation of gene expression, and to increased protein synthesis. Mechanical stress may be coupled to intracellular signals that are responsible for the hypertrophic response via integrins and the cytoskeleton or via sarcolemmal proteins, such as phospholipases, ion channels and ion exchangers. The signal transduction pathways that may be involved belong to two groups: (1) the mitogen-activated protein kinases (MAPK) pathway; and (2) the janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway. The MAPK pathway can be subdivided into the extracellular-regulated kinase (ERK), the c-Jun N-terminal kinase (JNK), and the 38-kDa MAPK (p38 MAPK) pathway. Alternatively, the stress signal may be directly submitted to the nucleus via the cytoskeleton without the involvement of signal transduction pathways. Finally, by promoting an increase in intracellular Ca2+ concentration stretch may stimulate the calcium/calmodulin-dependent phosphatase calcineurin, a novel hypertrophic signalling pathway.

KEYWORDS Ang II, angiotensin II; ANP, atrial natriuretic peptide; [Ca2+]i, intracellular calcium concentration; DAG, diacylglycerol; ECM, extracellular matrix; ERK, extracellular-regulated kinase; ET-1, endothelin-1; FAC, focal adhesion complex; FAK, focal adhesion kinase; G protein, guanine nucleotide-binding protein; IE genes, immediate-early genes; JAK, Janus-associated kinase; JNKc, Jun N-terminal protein kinase; MAPK, mitogen-activated protein kinase; MEK, MAPK/ERK kinase; MHC, myosin heavy chain; NHE, Na+/H+exchanger; PKC, protein kinase C; PLC, phospholipase C; PLD, phospholipase D; p38 MAPK, 38 kDa mitogen-activated protein kinase; p70S6K, 70 kDa S6 kinase; p90RSK, 90 kDa ribosomal S6 kinase (=MAPKAPK1); SAC, stretch-activated channel; SAPK, stress-activated protein kinase; STAT, signal transducers and activators of transcription; TGF-β, transforming growth factor-beta


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