doi: 10.1161/01.RES.0000077012.11088.BC
© 2003 American Heart Association, Inc.
Editorials |
Phenotyping Hypertrophy
Eschew Obfuscation
From the Departments of Internal Medicine/Cardiology (G.W.D.) and Pediatrics/Molecular Cardiovascular Biology (J.R.), University of Cincinnati Medical Center, Cincinnati, Ohio; and National Heart and Lung Institute Division (Cardiac Medicine Section) (P.H.S.), Faculty of Medicine, Imperial College, London, UK.
Correspondence to G.W. Dorn II, Division of Cardiology, University of Cincinnati Medical Center, 231 Albert B. Sabin Way, Cincinnati, OH 45267-0542. E-mail dorngw@ucmail.uc.edu
Key Words: cardiac hypertrophy • heart failure • transgenic mouse
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Everyone thinks they know what "cardiac hypertrophy" is: a reactive increase in cardiac size/myocardial mass in response to hemodynamic stress that, in humans, predisposes to early death.1 Yet, the term "hypertrophy" has become one of the most misused and inaccurate terms in the cardiovascular basic science literature because of its nonspecificity and, as typically used, lack of mechanistic implication. "Hypertrophy" (noun and verb), derived from Greek hyper (above, more than normal) and trophe (nutrition), is defined as "the enlargement or overgrowth of an organ or part due to an increase in size of its constitute cells."2 The normal heart is "normal," and hypertrophy is, by definition, "not normal." Therefore, normal maturational development at the organ level is not "hypertrophy" (verb) and does not result in cardiac "hypertrophy" (noun), although the cells do "hypertrophy" (verb). (Perhaps the term "eutrophy" is more appropriate to describe maturational development.) Likewise, in many genetic in vivo experimental models, the term "cardiac hypertrophy" has too often been loosely applied to any observed cardiac enlargement, frequently with such modifiers as "physiological" or "pathological."3 Herein, we reflect on the appropriate meanings of terms and criteria that can be used to more accurately describe cardiac enlargement and myocardial growth, with the anticipation that rigorous mechanistic description of such phenotypes will result in a more coherent appreciation of the parallel and redundant processes that result in "myocardial hypertrophy."
A Historical Perspective: the Legacy of a Term
The widespread use of the term "hypertrophy" to describe one or a few specific pathophysiological conditions is a holdover from the earliest
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