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1 Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: pkang{at}bidmc.harvard.edu.
Cardiac hypertrophy from pathologic stimuli often proceeds to heart failure, whereas cardiac hypertrophy from physiologic stimuli does not. In this study, physiologic hypertrophy was created by a daily exercise regimen and pathologic hypertrophy was created from a high salt diet in Dahl salt sensitive rats. The rats continued on a high salt diet progressed to heart failure associated with an increased rate of TUNEL positive cardiomyocytes. We analyzed primary cultures of these hearts and found that only cardiomyocytes made hypertrophic by a pathologic stimulus show increased sensitivity to apoptosis. Examination of the molecular changes associated with these distinct types of hypertrophy revealed changes in Bcl-2 family members and caspases favoring survival during physiologic hypertrophy. However, in pathologic hypertrophy, there were more diffuse pro-apoptotic changes including changes in Fas, Bcl-2 protein family, and caspases. Therefore, we speculate that this increased sensitivity to apoptotic stimulation along with pro-apoptotic changes in the apoptosis program may contribute to the development of heart failure seen in pathologic cardiac hypertrophy.
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