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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Med+Sci 2014 ; 348 (4): 337-46 Nephropedia Template TP
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The Multiple Mechanistic Faces of a Pure Volume Overload: Implications for Therapy #MMPMID24781435
Barnes J; Dell?Italia LJ
Am J Med Sci 2014[Oct]; 348 (4): 337-46 PMID24781435show ga
Mitral regurgitation, and other conditions marked by a pure isolated volume overload (VO) of the heart, result in a progressive form of eccentric left ventricular (LV) remodeling and dysfunction. As opposed to the more extensively studied pressure overload, there are no approved medical therapies because an understanding of the underlying pathological mechanisms at work in VO is lacking. Over the past twenty years, our laboratory has identified multiple key biological functions involved in the pathological remodeling in VO. Specifically, we have noted perturbed matrix homeostasis, detrimental adrenergic signaling, increased intracellular reactive oxygen species, and an intense inflammatory response that implicates mast cells and their product chymase, which appears to cause extensive remodeling both inside and outside the cardiomyocyte. How these multiple pathways intersect over the course of VO and their response to various single and combined interventions are now the subject of intense investigation.